Childhood severe obesity and related cardio-metabolic risk factors and the cost-effectiveness of bariatric surgery for severely obese adolescents
Severe obesity is significantly associated with higher mortality rate and higher risks of obesity-related comorbidities. This dissertation was aiming at describing the prevalence of severe obesity among children and adolescents in the U.S, investigating the risks of cardio-metabolic risk factors by weight status, and evaluating the cost-effectiveness of bariatric surgery as the treatment in severely obese adolescents. The National Health and Nutrition Examination Survey data were used in all the analyses. ^ We found that the prevalence of severe obesity among children and adolescents aged from 2 through 19 years in the U.S had risen nearly 6-fold from 1.1% in early 1970s to 6.7% in 2011-2012. A general increasing linear trend of severe obesity was found, indicating the prevalence of severe obesity among U.S children and adolescents was increased annually by 7%. The odds of developing cardiovascular risk factors differed by weight status, and significantly associated with obesity. Severely obese children and adolescents have a substantially higher risk of developing cardiovascular risk factors than children with normal weight, as well as moderately obese children and adolescents. The cost-effectiveness study revealed that both of the two types of bariatric surgery procedures we evaluated (LAGB and RYGB) were more cost-effective than receiving no treatment. The results also suggested that earlier intervention and treatment in adolescence, versus taking the surgery treatment in adulthood, would be more cost-effective and result in optimal efficacy of treatment and better health outcomes. ^ Overall, our findings reveal that more thorough and specific prevention and treatment plans and policies targeting severely obese children and adolescents are urgently needed in order to avoid future severe medical comorbidities. ^
Health Sciences, Public Health|Health Sciences, Epidemiology
Li, Linlin, "Childhood severe obesity and related cardio-metabolic risk factors and the cost-effectiveness of bariatric surgery for severely obese adolescents" (2014). Texas Medical Center Dissertations (via ProQuest). AAI3689778.