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Are overweight children likely to become overweight adults?

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EVIDENCE-BASED ANSWER:

Yes. Overweight children (body mass index [BMI] ≥85th to <95th percentile) are likely to become overweight or obese adults with a BMI ≥25 (strength of recommendation [SOR]: B, systematic review of high-quality prospective longitudinal studies).

Obese adolescents are significantly more likely to develop severe obesity than normal weight or overweight adolescents (SOR: B, prospective cohort study). (See “Definition of terms” below.)

The trend to overweight and obesity in adulthood is clear

A systematic review of 20 prospective and 5 retrospective trials tracked 179,303 overweight and obese children into adulthood.1 Investigators included studies for evaluation if they were written in English, prospective or retrospective longitudinal in design, described at least one anthropometric measurement, and included odds ratios or risk ratios in the results. The results were not pooled because of heterogeneity among studies.

In high-quality trials, the percentages of overweight or obese children and adolescents who became overweight or obese adults varied: overweight children (76% to 83%), obese children (18% to 60%), overweight adolescents (22% to 58%) and obese adolescents (24% to 90%). Limitations of the review included an inadequate description of the anthropometric measurement protocol, use of self-reported weight and height, and the fact that all studies were conducted in high-income countries.

Evidence-based answers from the Family Physicians Inquiries Network

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