Obesity is the most common long-lasting disease among young people. Obesity, including at a young age, can lead to many health problems such as diabetes, respiratory issues, and liver disease, in addition to mental ill health.
Lifestyle interventions, medication, and weight loss surgery are treatment options. Interventions like diet and exercise are recommended in the first instance. Medications may be offered when lifestyle changes are not successful in reducing weight. Measures such as restricting the placement of less healthy items in supermarkets and in online adverts, calorie labelling on menus, and increasing financial support for school sports to help young people have been introduced.
Studies on obesity at younger ages often group children less than 12 years with those aged 12 and above. Therefore, exact estimates of overweight and obesity in 12-17 year olds are unmonitored. We will use anonymised primary and secondary care health records to determine how many young people are overweight and obese in England. We will also describe the amount of healthcare interaction they have and what health problems they have while young and into adulthood, as well as any treatments they receive from their doctor. This research will provide clinical and public health audiences with insight into overweight and obesity in young people in England that are currently not well defined to help tackle this public health issue.
Obesity is the most common chronic disease among adolescents. Adolescent obesity is associated with significant clinical morbidity including diabetes, orthopaedic problems, respiratory conditions, and fatty liver disease, in addition to mental ill health.
Lifestyle interventions like diet and exercise are the recommended first-line treatments, but studies have shown that severely obese adolescents are reluctant to take part in these interventions. Medications are offered when lifestyle modifications are not successful in limiting weight gain.
The United Kingdom government estimates current costs of obesity to be £6.5 billion, with an additional societal cost estimated at £65 billion. Measures like restricting placement of less healthy items in supermarkets and in online adverts, calorie labelling on menus, and increasing financial support for school sports to help young people have been introduced.
Studies on childhood obesity often group children together with adolescents, e.g., prevalence for ages 2-16 or <18 years, leaving adolescent overweight and obesity prevalence largely undocumented. Additionally, there is a paucity in quantification of multimorbidity and healthcare resource use (HCRU) and cost among overweight and obese adolescents in England.
We will use routinely collected primary, secondary care, and other statistical data from England (i.e., Clinical Practice Research Datalink, Hospital Episode Statistics, and Office for National Statistics death registrations and index of multiple deprivation deciles) to describe prevalence of overweight and obesity per 100,000 adolescents, describe characteristics of adolescents with overweight or obesity using frequency and summary statistics, prevalence of comorbidities using frequency statistics, change in body mass index (BMI) using summary statistics, HCRU and costs using per-person-per-year summary statistics, and treatment patterns using frequency statistics among adolescents aged 12-17 years. We will explore the association between adolescent BMI and change in BMI with adolescent- and adult-onset comorbidities as well as HCRU and costs using Cox proportional hazards regression and generalised linear models, respectively
Prevalence of adolescent overweight and obesity (primary objective); BMI reading completeness (primary objective); Distribution of BMI centiles (primary objective); Number of BMI recordings per patient (primary objective); Socio-demographic and clinical baseline characteristics (secondary objective 1); Incidence of comorbidities (secondary objective 2 and exploratory objective 3); Number of all-cause primary care consultations (secondary objective 3 and exploratory objective 3); Cost of all-cause primary care consultations (secondary objective 3); Cost of primary care prescriptions (secondary objective 3); Number of all-cause inpatient admissions (secondary objective 3); Cost of all-cause inpatient admissions (secondary objective 3); Cumulative length of all-cause inpatient stay (secondary objective 3); Number of all-cause outpatient appointments (secondary objective 3 and exploratory objective 3); Cost of all-cause outpatient appointments (secondary objective 3); Number of adolescents with overweight or obesity that were censored due to bariatric surgery (secondary objective 3); Number of all-cause accident and emergency (A&E) attendances (secondary objective 3); Cost of all-cause A&E attendances (secondary objective 3); Number of procedures (secondary objective 3); Cost of procedures (secondary objective 3); Number of primary care prescriptions (secondary objective 4); Treatment patterns (secondary objective 4); Change in body mass index (BMI) (secondary objective 5); Difference in incidence of comorbidities among adolescents with overweight and obesity and healthy weight controls (exploratory objective 1); Difference in healthcare resource use (HCRU) and direct healthcare costs among adolescents with overweight and obesity and healthy weight controls (exploratory objective 1); Difference in long-term comorbidities associated with BMI change (exploratory objective 2); Difference in HCRU and direct healthcare costs associated with BMI change (exploratory objective 2)
Jennifer Davidson - Chief Investigator - Health iQ Ltd ( UK ) t/a CorEvitas
Caitlin Winton - Corresponding Applicant - Health iQ Ltd ( UK ) t/a CorEvitas
Andre Ng - Collaborator - Health iQ Ltd ( UK ) t/a CorEvitas
Caoimhe Rice - Collaborator - Health iQ Ltd ( UK ) t/a CorEvitas
Ghazanfar Ali - Collaborator - Novo Nordisk Ltd
Hannah Brewer - Collaborator - Health iQ Ltd ( UK ) t/a CorEvitas
Margherita Bortolini - Collaborator - Novo Nordisk Ltd
Marion Escafit - Collaborator - Novo Nordisk Ltd
Rebecca Joseph - Collaborator - Health iQ Ltd ( UK ) t/a CorEvitas
Sara Carvalho - Collaborator - Health iQ Ltd ( UK ) t/a CorEvitas
HES Accident and Emergency;HES Admitted Patient Care;HES Outpatient;ONS Death Registration Data;Patient Level Index of Multiple Deprivation;Practice Level Index of Multiple Deprivation