Prevalence, Sociodemographic Differences, and Comorbidity in Pediatric Obesity

Background: Pediatric obesity is a major public health concern with important implications for acute care and long-term health outcomes. National estimates of obesity among hospitalized children using recent data are limited. Objectives: To estimate the prevalence of documented obesity among hospitalized children and examine associated sociodemographic differences and comorbidity patterns using the 2021 National Inpatient Sample. Methods: We conducted a cross-sectional analysis of pediatric discharges (ages 2–17 y) in the 2021 National Inpatient Sample. Obesity was defined using the International Classification of Diseases, 10th Revision, Clinical Modification codes. Survey-weighted analyses were used to estimate prevalence and examine comorbidity patterns. Multivariable logistic regression models were used to evaluate sociodemographic correlates of obesity. Results: Among an estimated 961,529 pediatric hospitalizations, 6.29% had a documented obesity diagnosis. Obesity prevalence was higher among Black, Hispanic, and Native American children and increased with decreasing neighborhood income. In adjusted analyses, older age and Medicaid coverage were associated with higher odds of obesity, while females had lower odds than males. Children with obesity had substantially higher prevalence of cardiometabolic, respiratory, and mental health comorbidities compared with nonobese children. Discussion: Pediatric obesity among hospitalized children is associated with significant sociodemographic disparities and a high burden of comorbidities. Hospitalization represents a vital opportunity for identification and linkage to care.