, Volume 51, Issue 5, pp 1573–1596 | Cite as

Body Size, Skills, and Income: Evidence From 150,000 Teenage Siblings

  • Petter Lundborg
  • Paul NystedtEmail author
  • Dan-Olof Rooth


We provide new evidence on the long-run labor market penalty of teenage overweight and obesity using unique and large-scale data on 150,000 male siblings from the Swedish military enlistment. Our empirical analysis provides four important results. First, we provide the first evidence of a large adult male labor market penalty for being overweight or obese as a teenager. Second, we replicate this result using data from the United States and the United Kingdom. Third, we note a strikingly strong within-family relationship between body size and cognitive skills/noncognitive skills. Fourth, a large part of the estimated body-size penalty reflects lower skill acquisition among overweight and obese teenagers. Taken together, these results reinforce the importance of policy combating early-life obesity in order to reduce healthcare expenditures as well as poverty and inequalities later in life.


Obesity Overweight Discrimination Earnings Skills 



We thank John Cawley, Andrew Clark, Gordon Dahl, Fabrice Etile, Pierre-Yves Geoffard, John Komlos, Fabian Lange, Inas Rashad, and participants at the 9th IZA-SOLE conference, the workshop on the Economics of Obesity at the Paris School of Economics, the 3rd ASHE conference, the Seminar at the Centre for Economic Demography, Lund University, and anonymous referees for useful comments. Research grants from the Centre for Economic Demography at Lund University and the Swedish Council for Working Life and Social Research are gratefully acknowledged.

Supplementary material

13524_2014_325_MOESM1_ESM.pdf (261 kb)
ESM 1 (PDF 260 kb)


  1. Antelius, J., & Björklund, A. (2000). How reliable are register data for studies of the return on schooling? An examination of Swedish data. Scandinavian Journal of Educational Research, 44, 341–355.CrossRefGoogle Scholar
  2. Averett, S., & Korenman, S. (1996). The economic reality of the beauty myth. Journal of Human Resources, 31, 304–330.CrossRefGoogle Scholar
  3. Borghans, L., Duckworth, A., Heckman, J., & ter Weel, B. (2008). The economics and psychology of personality traits. Journal of Human Resources, 43, 972–1059.CrossRefGoogle Scholar
  4. Brown, H. S., III, Pérez, A., Li, Y. P., Hoelscher, D. M., Kelder, S. H., & Rivera, R. (2007). The cost-effectiveness of a school-based overweight program. International Journal of Behavioral Nutrition and Physical Activity, 4, 47. doi: 10.1186/1479-5868-4-47 CrossRefGoogle Scholar
  5. Brunello, G., & D’Hombres, B. (2007). Does body weight affect wages? Evidence from Europe. Economics and Human Biology, 5, 1–19.CrossRefGoogle Scholar
  6. Burkhauser, R. V., & Cawley, J. (2008). Beyond BMI: The value of more accurate measures of fatness and obesity in social science research. Journal of Health Economics, 27, 519–529.CrossRefGoogle Scholar
  7. Case, A., & Paxson, C. (2008). Stature and status: Height, ability, and labor market outcomes. Journal of Political Economy, 116, 499–532.CrossRefGoogle Scholar
  8. Cawley, J. (2004). The impact of obesity on wages. Journal of Human Resources, 39, 451–474.CrossRefGoogle Scholar
  9. Cawley, J., & Danziger, S. (2005). Morbid obesity and the transition from welfare to work. Journal of Policy Analysis and Management, 24, 727–743.CrossRefGoogle Scholar
  10. Cawley, J., Heckman, J., & Vytlacil, E. (2001). Three observations on wages and measured cognitive ability. Labour Economics, 8, 419–442.CrossRefGoogle Scholar
  11. Cawley, J., & Maclean, J. C. (2012). Unfit for service: The implications of rising obesity for US military recruitment. Health Economics, 21, 1348–1366.CrossRefGoogle Scholar
  12. Cawley, J., & Spiess, C. (2008). Obesity and skill attainment in early childhood. Economics and Human Biology, 6, 388–397.CrossRefGoogle Scholar
  13. Cole, T. J., Bellizzzi, M. C., Flegal, M. K., & Dietz, W. H. (2000). Establishing a standard definition for child overweight and obesity worldwide: International survey. British Medical Journal, 320, 1240–1243.CrossRefGoogle Scholar
  14. Conley, D., & Glauber, R. (2006). Gender, body mass and economic status: New evidence from the PSID. In K. Bolin & J. Cawley (Eds.), Advances in health economics and health services research, Vol. 17: The economics of obesity (pp. 253–275). New York, NY: Elsevier.Google Scholar
  15. Cramer, P., & Steinwert, T. (1998). Thin is good, fat is bad: How early does it begin? Journal of Applied Developmental Psychology, 19, 429–451.CrossRefGoogle Scholar
  16. Currie, J., Della Vigna, S., Moretti, E., & Pathania, V. (2010a). The effect of fast food restaurants on obesity and weight gain. American Economic Journal: Economic Policy, 2(3), 32–63.Google Scholar
  17. Currie, J., Manivong, P., Roos, L., & Stabile, M. (2010b). Child health and young adult outcomes. Journal of Human Resources, 45, 517–548.CrossRefGoogle Scholar
  18. Cutler, D. M., Glaeser, E. L., & Shapiro, J. M. (2003). Why have Americans become more obese? Journal of Economic Perspectives, 17, 93–118.CrossRefGoogle Scholar
  19. Dietz, W. H. (1994). Critical periods in childhood for the development of obesity. American Journal of Clinical Nutrition, 59, 955–959.Google Scholar
  20. Duckworth, A. L., Tsukayama, E., & Geier, A. B. (2010). Self-controlled children stay leaner in the transition to adolescence. Appetite, 54, 304–308.CrossRefGoogle Scholar
  21. Elias, M. F., Elias, P. K., Robbins, M. A., Wolf, P. A., & D’Agostino, R. B. (2001). Cardiovascular risk factors and cognitive functioning: An epidemiological perspective. In S. R. Waldstein & M. F. Elias (Eds.), Neuropsychology of cardiovascular disease (pp. 83–104). Mahwah, NJ: Lawrence Erlbaum.Google Scholar
  22. Finkelstein, E. A., Trogdon, J. G., Cohen, J. W., & Dietz, W. (2009). Annual medical spending attributable to obesity: Payer- and service-specific estimates. Health Affairs, 28, 822–831.CrossRefGoogle Scholar
  23. Fletcher, J., & Lehrer, S. (2009). The effects of adolescent health on educational outcomes: Causal evidence using genetic lotteries between siblings. Forum for Health Economics & Policy, 12(2). doi: 10.2202/1558-9544.1180
  24. Francis, L. A., & Susman, E. J. (2009). Self-regulation and rapid weight gain in children from age 3 to 12 years. Archives of Pediatrics and Adolescent Medicine, 163, 297–302.CrossRefGoogle Scholar
  25. Freedman, D. S., Khan, L. K., Dietz, W. H., Srinivasan, S. R., & Berenson, G. S. (2001). Relationship of childhood obesity to coronary heart disease risk factors in adulthood: The Bogalusa Heart Study. Pediatrics, 108, 712–718.CrossRefGoogle Scholar
  26. French, S. A. (2003). Pricing effects on food choices. Journal of Nutrition, 133, 841–843.Google Scholar
  27. French, S. A., Story, M., Jeffery, R. W., Snyder, P., Eisenberg, M., Sidebottom, A., & Murray, D. (1997). Pricing strategy to promote fruit and vegetable purchase in high school cafeterias. Journal of the American Diet Association, 97, 1008–1010.CrossRefGoogle Scholar
  28. Fryar, C. D., Carroll, M. D., & Ogden, C. L. (2012). Prevalence of obesity among children and adolescents: United States, trends 1963–1965 through 2009–2010 (National Center for Health Statistics report). Retrieved from
  29. Griliches, Z. (1979). Sibling models and data in economics: Beginnings of a survey. Journal of Political Economy, 87, 37–64.CrossRefGoogle Scholar
  30. Grilo, C. M., & Pogue-Geile, M. F. (1991). The nature of environmental influences on weight and obesity: A behavioral genetic analysis. Psychological Bulletin, 110, 520–537.CrossRefGoogle Scholar
  31. Grossman, M., & Kaestner, R. (2009). Effect of weight on children’s educational achievement. Economics of Education Review, 28, 651–661.CrossRefGoogle Scholar
  32. Gustafson, D., Lissner, L., Bengtsson, C., Björkelund, C., & Skoog, I. (2004). A 24-year follow-up of body mass index and cerebral atrophy. Neurology, 63, 1876–1881.CrossRefGoogle Scholar
  33. Gustafson, D., Rothenberg, E., Blennow, K., Steen, B., & Skoog, I. (2003). An 18-year follow-up of overweight and risk of Alzheimer disease. Archives of Internal Medicine, 163, 1524–1528.CrossRefGoogle Scholar
  34. Han, E., Norton, E., & Powell, L. M. (2011). Direct and indirect effects of body weight on adult wages. Economics and Human Biology, 9, 381–392.CrossRefGoogle Scholar
  35. He, Q., & Karlberg, J. (2001). BMI in childhood and its association with height gain, timing of puberty, and final height. Pediatric Research, 49, 244–251.CrossRefGoogle Scholar
  36. Hebebrand, J., Hennighausen, K., Nau, S., Himmelmann, G. W., Schulz, E., Schäfer, H., & Remschmidt, H. (1997). Low body weight in male children and adolescents with schizoid personality disorder or Asperger’s disorder. Acta Psychiatrica Scandinavica, 96, 64–67.CrossRefGoogle Scholar
  37. Heckman, J. (2008). Schools, skills, and synapses. Economic Inquiry, 46, 289–324.CrossRefGoogle Scholar
  38. Heckman, J., & Rubinstein, Y. (2001). Importance of noncognitive skills: Lessons from the GED testing program. American Economic Review, 91, 145–149.CrossRefGoogle Scholar
  39. Heckman, J., Stixrud, J., & Urzua, S. (2006). The effects of cognitive and noncognitive abilities on labor market outcomes and social behavior. Journal of Labor Economics, 24, 411–482.CrossRefGoogle Scholar
  40. Janssen, I., Craig, W. M., Boyce, W. F., & Pickett, W. (2004). Associations between overweight and obesity with bullying behaviors in school-aged children. Pediatrics, 113, 1187–1194.CrossRefGoogle Scholar
  41. Jia, H., & Lubetkin, E. (2010). Trends in quality-adjusted life-years lost contributed by smoking and obesity. American Journal of Preventive Medicine, 38, 138–144.CrossRefGoogle Scholar
  42. Kautiainen, S. (2005). Trends in adolescent overweight and obesity in the Nordic countries. Scandinavian Journal of Nutrition, 49, 4–14.CrossRefGoogle Scholar
  43. Lawlor, D. A., Windmeijer, F., & Davey Smith, G. (2008). Is Mendelian randomization “lost in translation”? Statistics in Medicine, 27, 2750–2755.CrossRefGoogle Scholar
  44. Lindqvist, E., & Vestman, R. (2011). The labor market returns to cognitive and noncognitive ability: Evidence from the Swedish enlistment. American Economic Journal: Applied Economics, 3, 101–128.Google Scholar
  45. Lobstein, T., Baur, L., Uauy, R., & IASO International Obesity Task Force. (2004). Obesity in children and young people: A crisis in public health. Obesity Reviews, 5(l1), 4–104.CrossRefGoogle Scholar
  46. Luder, E., & Alton, I. (2005). The underweight adolescent. In J. Strang & M. Story (Eds.), Guidelines for adolescent nutrition services (pp. 93–100). Minneapolis: University of Minnesota.Google Scholar
  47. Lumeng, J., Forrest, P., Appugliese, D. P., Kaciroti, N., Corwyn, R. F., & Bradley, R. H. (2010). Weight status as a predictor of being bullied in third through sixth grades. Pediatrics, 125, 1301–1307.CrossRefGoogle Scholar
  48. Lundborg, P., Lindeboom, M., & van der Klaauw, B. (2010). Assessing the impact of obesity on labor market outcomes. Economics and Human Biology, 8, 309–319.CrossRefGoogle Scholar
  49. Lundborg, P., Nilsson, A., & Rooth, D. (Forthcoming). Early life health and adult earnings: Evidence from a large sample of siblings and twins Journal of Health Economics.Google Scholar
  50. Lundborg, P., Nystedt, P., & Rooth, D. (2014). Height and earnings: The role of cognitive and non-cognitive skills. Journal of Human Resources, 49, 141–166.CrossRefGoogle Scholar
  51. Lusky, A., Barell, V., Lubin, F., Kaplan, G., Layani, V., Shohat, Z., & Wiener, M. (1996). Relationship between morbidity and extreme values of body mass index in adolescents. International Journal of Epidemiology, 25, 829–834.CrossRefGoogle Scholar
  52. Mårild, S., Bondestam, M., Bergström, R., Ehnberg, S., Hollsing, A., & Albertsson-Wikland, K. (2004). Prevalence trends of obesity and overweight among 10-year-old children in Western Sweden and relationship with parental body mass index. Acta Paediatrica, 93, 1588–1595.CrossRefGoogle Scholar
  53. Must, A., Spadano, J., Coakley, E. H., Field, A. E., Colditz, G., & Dietz, W. H. (1999). The disease burden associated with overweight and obesity. Journal of the American Medical Association, 282, 1523–1529.CrossRefGoogle Scholar
  54. Must, A., & Strauss, R. S. (1999). Risk and consequences of childhood and adolescent obesity. International Journal of Obesity Related Metabolic Disorders, 23, 2–11.CrossRefGoogle Scholar
  55. Oreopoulos, P., Stabile, M., Walld, R., & Roos, L. L. (2008). The short-, medium-, and long-term effects of poor infant health: An analysis using siblings and twins. Journal of Human Resources, 43, 88–138.CrossRefGoogle Scholar
  56. Persico, N., Postlewaite, A., & Silverman, D. (2004). The effect of adolescent experience on labor market outcomes: The case of height. Journal of Political Economy, 112, 1019–1053.CrossRefGoogle Scholar
  57. Puhl, R., & Latner, J. (2006). Stigma, obesity, and the health of the nation’s children. Psychological Bulletin, 133, 557–580.CrossRefGoogle Scholar
  58. Rooth, D. (2009). Obesity, attractiveness and differential treatment in hiring—A field experiment. Journal of Human Resources, 44, 710–735.Google Scholar
  59. Salm, M., & Schunk, D. (2012). The relationship between childhood health, developmental gaps, and parental education: Evidence from administrative data. Journal of the European Economic Association, 10, 1425–1449.CrossRefGoogle Scholar
  60. Sargent, J. D., & Blanchflower, D. G. (1994). Obesity and stature in adolescence and earnings in young adulthood. An analysis of a British birth cohort. Archives of Pediatrics and Adolescent Medicine, 148, 681–687.CrossRefGoogle Scholar
  61. Schwimmer, J. B., Burwinkle, T. M., & Varni, J. W. (2003). Health-related quality of life of severely obese children and adolescents. Journal of the American Medical Association, 289, 1813–1819.CrossRefGoogle Scholar
  62. Shalikashvili, J. M., & Shelton, H. (2010, April 30). The latest national security threat: Obesity. The Washington Post. Retrieved from
  63. Sjöberg, L., Moraeus, A., Yngve, E., Poortvliet, U., & Al-Ansari, L. L. (2011). Overweight and obesity in a representative sample of schoolchildren—Exploring the urban-rural gradient in Sweden. Obesity Reviews, 5, 305–314.CrossRefGoogle Scholar
  64. Thomas, D., & Strauss, J. (1997). Health and wages: Evidence on men and women in urban Brazil. Journal of Econometrics, 77, 159–185.CrossRefGoogle Scholar
  65. Tsukayama, E., Toomey, S. L., Faith, M. S., & Duckworth, A. L. (2010). Self-control as a protective factor against overweight status in the transition from childhood to adolescence. Archives of Pediatrics and Adolescent Medicine, 164, 631–635.CrossRefGoogle Scholar
  66. Wang, Y., & Lobstein, T. (2006). Worldwide trends in childhood overweight and obesity. International Journal of Pediatric Obesity, 1, 11–25.CrossRefGoogle Scholar
  67. Whitaker, R. C., Wright, J. A., Pepe, M. S., Seidel, K. D., & Dietz, W. H. (1997). Predicting obesity in young adulthood from childhood and parental obesity. New England Journal of Medicine, 337, 869–873.CrossRefGoogle Scholar
  68. World Health Organization. (2000). Obesity: Preventing and managing the global epidemic (WHO Technical Report Series 894). Geneva, Switzerland: WHO.Google Scholar

Copyright information

© Population Association of America 2014

Authors and Affiliations

  • Petter Lundborg
    • 3
    • 4
  • Paul Nystedt
    • 1
    • 2
    • 3
    Email author
  • Dan-Olof Rooth
    • 3
    • 5
  1. 1.Jönköping International Business SchoolJönköpingSweden
  2. 2.Jönköping Academy for Improvement of Health and WelfareJönköpingSweden
  3. 3.Centre for Economic Demography, and HEPLund UniversityLundSweden
  4. 4.Department of EconomicsLund UniversityLundSweden
  5. 5.Centre for Labour Market and Discrimination StudiesLinneaus UniversityKalmarSweden

Personalised recommendations