| Summary: | <p><strong>Background:</strong> Over the past four decades, the prevalence of childhood excess weight has risen significantly globally and remains high in many countries. In England, the prevalence of excess weight among Year 6 children (10–11-year-olds) increased from 31.6% in 2006/07 to 36.6% in 2022/23. Despite the increasing public health burden, substantial uncertainty persists regarding key economic parameters and outcomes necessary to guide research and inform policy for the efficient allocation of resources that target childhood excess weight.</p>
<p><strong>Methods:</strong> This thesis presents a structured review of economic aspects of childhood excess weight as a foundation for further analyses. A systematic review of economic evaluations of interventions targeting childhood excess weight was conducted, followed by an analysis of data from the UK Millennium Cohort Study to estimate transitions in childhood weight status. Additionally, electronic health records extracted from the Clinical Practice Research Datalink (CPRD), linked with Hospital Episode Statistics (HES), were analysed to estimate direct healthcare costs attributable to childhood excess weight.</p>
<p><strong>Results:</strong> The systematic review found that early prevention strategies for childhood excess weight are generally cost-effective. Analysis of data from the Millennium Cohort Study indicated that children aged 3 to 7 years had a significantly higher probability of transitioning from overweight or obesity to a healthy weight compared to older children, with more than twice the annual likelihood of such transitions. These movements between weight status categories were also influenced by child, maternal, and sociodemographic factors. My analyses of CPRD-HES data revealed that children living with overweight and obesity incurred significantly higher direct healthcare costs than their peers with a healthy weight. In comparison to children with healthy weight, those living with overweight generated additional costs of £133.93 and £66.32, on average, in the year preceding and following a BMI measurement, respectively, while children with obesity incurred additional costs of £115.47 and £154.51, on average, during the same periods. The total annual healthcare cost attributable to childhood excess weight in England was estimated at £0.3 billion.</p>
<p><strong>Conclusions:</strong> This thesis identifies critical areas for future economic research, offering insights for researchers and policymakers. It underscores the significance of investing early in cost-effective interventions to address childhood excess weight. The evidence presented in this thesis can serve as data inputs for future economic evaluations in this field.</p>
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