Email updates

Keep up to date with the latest news and content from BMC Pediatrics and BioMed Central.

Open Access Highly Accessed Research article

Health state preferences associated with weight status in children and adolescents

Mandy B Belfort1*, John AF Zupancic12, Katherine M Riera1, Jane HG Turner1 and Lisa A Prosser3

Author Affiliations

1 Div of Newborn Medicine, Children's Hospital Boston/Harvard Medical School, Boston MA, USA

2 Dept of Neonatology, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston MA, USA

3 Child Health Evaluation and Research Unit, Div of General Pediatrics, U. of Michigan, Ann Arbor MI, USA

For all author emails, please log on.

BMC Pediatrics 2011, 11:12  doi:10.1186/1471-2431-11-12

Published: 7 February 2011



Childhood obesity is a substantial public health problem. The extent to which health state preferences (utilities) are related to a child's weight status has not been reported. The aims of this study were (1) to use a generic health state classification system to measure health related quality of life and calculate health utilities in a convenience sample of children and adolescents and (2) to determine the extent to which these measures are associated with weight status and body mass index (BMI).


We enrolled 76 children 5-18 years of age from a primary care clinic and an obesity clinic in Boston MA. We administered the Health Utilities Index (HUI) and used the HUI Mark 3 single- and multi-attribute utility functions to calculate health utilities. We determined BMI percentile and weight status based on CDC references. We examined single-attribute and overall utilities in relation to weight status and BMI.


Mean (range) age was 10.8 (5-18) years. Mean (SD) BMI percentile was 76 (26); 55% of children were overweight or obese. The mean (SD) overall utility was 0.79 (0.17) in the entire sample. For healthy-weight children, the mean overall utility was higher than for overweight or obese children (0.81 vs. 0.78), but the difference was not statistically significant (difference 0.04, 95% CI -0.04, 0.11).


Our results provide a quantitative estimate of the health utility associated with overweight and obesity in children, and will be helpful to researchers performing cost effectiveness analyses of interventions to prevent and/or treat childhood obesity.