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Obese teens prone to severe obesity later in life

A third to a half of obese adolescents become severely obese in adulthood

Louise Prime

Thursday, 11 November 2010

More than a third of obese adolescents generally, and more than half of obese black female adolescents, become severely obese in adulthood, US research in this week’s JAMA has shown.

Researchers designed a study to determine the incidence and risk of severe obesity in adulthood among individuals who were obese during adolescence. They followed 8,834 adolescents aged 12 to 21 years, enrolled in the US National Longitudinal Study of Adolescent Health, into adulthood. Participants’ height and weight was measured in their homes using standardised procedures.

New cases of adult-onset severe obesity were calculated by sex, race/ethnicity, and adolescent weight status.

At the start of the study in 1996, 79 (1.0%) adolescents were severely obese and of these, 60 (70.5%) remained severely obese as adults. Over the 13-year period between adolescence (1996) and adulthood (2007-2009), a total of 703 new cases of severe obesity in adulthood were observed: a total incidence rate of 7.9%. People with incident severe obesity in adulthood had had a higher adolescent BMI, and were more likely to be from a racial/ethnic minority, compared with individuals without severe obesity.

The authors write: “A substantial proportion of obese adolescents became severely obese by their early 30s, with significant variation by sex. Among individuals who were obese as adolescents, incident severe obesity was 37.1% in men and 51.3% in women. Incident severe obesity was highest among black women at 52.4%.”

Adolescents who were obese were significantly more likely than normal-weight or overweight adolescents to develop severe obesity as adults, with variation across race/ethnicity and sex. The authors found: “Across all sex and racial/ethnic groups, less than 5% of individuals who were at a normal weight in adolescence became severely obese in adulthood.”

They conclude: “The clinical implications of these observed trends are concerning given the comorbidities and chronic disease associated with severe obesity. Findings highlight the need for interventions prior to adulthood to prevent the progression of obesity to severe obesity, which may reduce severe obesity incidence and its potentially life-threatening consequences.”

Ellen Mason, senior cardiac nurse at the British Heart Foundation, said: “This is one of the few studies to track young people’s obesity over a long period of time. It doesn’t explain much about the circumstances of these children’s lives but it clearly shows that obese youngsters are much more likely to become morbidly obese adults.

“Obesity should remain a great cause of concern in the UK because of the associated risk of type 2 diabetes, some cancers and heart and circulatory disease.”

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