Association between overweight and obesity and the frequency of general practice consultations among children aged 2-17 years: a French retrospective cohort study.

Background

Childhood obesity and overweight are increasing, with consequences for children and for healthcare systems. Data on how a child's Body Mass Index (BMI) is associated with primary healthcare use in children remain limited, especially in France.

Aim

Exploring the association between general practice (GP) consultation rates and children aged 2-17 years living with overweight or obesity.

Design

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Setting

A retrospective cohort study (2012-2022) was created from the PRIMEGE database, including 205 757 consultations from 10 067 children. BMI categories (underweight, normal, overweight, obesity) followed International Obesity Task Force criteria. The outcome was the age-adjusted GP consultation rates.

Method

Inter-individual comparisons of mean normalized consultation rates across BMI categories were performed using linear regression models. Intra-individual interrupted time-series analysis was conducted with a negative binomial and zero-inflated mixed model to estimate the Incidence Rate Ratio (IRR) following transitions from normal BMI to overweight BMI, and from overweight BMI to obesity BMI.

Results

In inter-individual analyses, children with overweight/obesity BMI had significantly higher GP consultation rates than those with normal BMI. In intra-individual analyses, transitioning from normal BMI to overweight BMI was associated with an increase consultations rate (IRR=1.49; 95% CI [1.39;1.59]; P<0.001), and the transition from overweight to obesity BMI was associated with an increase consultation rate (IRR=1.64; 95% CI [1.37;1.96]; P<0.001).

Conclusion

This study, with inter- and intra-individual analytical approaches, shows that increases in BMI categories are associated with higher GP consultation rates. These findings highlight the need for prevention and tailored care for children with excess weight, helping adapt healthcare systems to population needs.