A heavy cost

Paul Veugelers, Sara Kirk and Stefan Kuhle are co-authors of a new study published in the International Journal of Pediatric Obesity. (Danny Abriel Photo)

Children as young as three may already be clocking more time in doctors' offices if they’re overweight or obese compared to normal weight peers.

This eye-opening result comes from a study that is the first in Canada to link measured weights from a population based survey with the use of health care services. The International Journal of Pediatric Obesity recently published "Use and cost of health services among overweight and obese Canadian children."

Researcher Sara Kirk, who holds a Canada Research Chair in Health Services Research at Dalhousie’s School of Health Services Administration, collaborated with Stefan Kuhle and Paul Veugelers, both from the University of Alberta.

"Our study shows that the deviation in health care costs may be starting as early as age three and four," says Dr. Kirk. "This study reinforces the need to intervene early, ideally as early as pregnancy."

As well as obesity being on the rise among children, obesity-related clinical disorders, such as hypertension, obstructive sleep apnea, polycystic ovary syndrome and slipped capital femoral epiphysis, are seen with increasing frequency in children.

The situation underscores the benefit of early health promotion programs, in terms of the potential to reduce the cost to the health care system. The next step will be to assess the type of conditions seen in children that are associated with these increased costs.

"Nova Scotia is already providing leadership as the first province with a school nutrition policy, and we already have good evidence for the effectiveness of health promotion in the school system," she adds. "We need supportive environments where children live, play and learn."

Dr. Kirk’s research program is also exploring the role of the ‘obesogenic environment,’ which refers to the cultural, social and geographic features of our surroundings that promote obesity.

"The food environment is much more powerful than people realize," she says. "It’s a myth that we can be physically active enough to control for our food environment. You won’t lose weight by exercise alone."

Dr. Kirk continues to stress that this is not an individual problem as it is so often framed.

"People who are overweight are so stigmatized, they don’t even have a voice. They’re told over and over ‘you just have to eat less and be more physically active‘ — and yet, we have constructed an environment that promotes the opposite, and this undermines them at every turn. We blame them for failing and then they feel worthless and don’t complain."

With this latest study, there is ample evidence to support prevention programs.

"We need to stop blaming individuals and do something as a society," says Dr. Kirk.

LINKS: "Use and cost of health services among overweight and obese Canadian children." in The International Journal of Pediatric Obesity | The International Journal of Pediatric Obesity |  Applied Research Collaborations for Health

FURTHER READING:  "When did fruit become a trick?" in Weighty Matters