title: Lifetime indirect cost of childhood overweight and obesity: A decision analytic model.
abstract: OBJECTIVE
  To estimate the indirect lifetime cost of childhood overweight and obesity for Germany.
  
  
  METHODS
  The lifetime cohort model consisted of two parts: (a) Model I used data from the German Interview and Examination Survey for Children on prevalence of BMI categories during childhood to evaluate BMI trajectories before the age of 18; and (b) Model II estimated lifetime excess indirect cost based on the history of childhood BMI. Indirect costs were defined as the opportunity cost of lost productivity due to mortality and morbidity and were identified through a systematic literature review.
  
  
  RESULTS
  Our analysis showed that the majority of children with overweight and obesity remained in the same BMI category during their adult life, resulting in significant indirect lifetime costs. We estimated that overweight and obesity during childhood resulted in an excess lifetime cost per person of €4,209 (men) and €2,445 (women). For the current prevalent German population, the excess lifetime cost was €145 billion.
  
  
  CONCLUSIONS
  Our study showed that childhood obesity results in significant economic burden on the society. Therefore, cost-effective strategies targeted at reducing the prevalence of obesity during the early years of life can significantly reduce both healthcare and nonhealthcare costs over the lifetime.
authors.affiliation: Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty of Heidelberg University, Mannheim, Germany.
authors.forename: Diana
authors.initials: D
authors.lastname: Sonntag
authors.affiliation: Department of Health Sciences and Centre for Health Economics, University of York, York, United Kingdom.
authors.forename: Shehzad
authors.initials: S
authors.lastname: Ali
authors.affiliation: Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty of Heidelberg University, Mannheim, Germany.|Department of Pediatrics, University Medicine Mannheim, Mannheim, Germany.
authors.forename: Freia
authors.initials: F
authors.lastname: De Bock
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005858:Germany; D005102:Health Expenditures; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D050177:Overweight / Q000191:economics* / Q000453:epidemiology; D063766:Pediatric Obesity / Q000191:economics* / Q000453:epidemiology