Clinical Edge

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Risk of Obesity From Childhood into Adulthood

N Engl J Med; 2017 Nov 30; Ward, Long, et al

More than half of today’s children will be obese at the age of 35 years, according to a recent study that examined early development of obesity and its continued risk into adulthood. A simulation model was developed to estimate the risk of adult obesity at age 35 years for the current population of children in the US. Height and weight data from 5 nationally representative longitudinal studies totaling 176,720 observations from 41,567 children and adults were pooled and growth trajectories across the life course were simulated and adjusted for secular trends. Researchers found:

  • The models predicted that a majority of today’s US children (57.3%) will be obese at age 35 years, and half of the projected prevalence will occur during childhood.
  • The simulations indicated the relative risk of adult obesity increased with age and body mass index (BMI), from 1.17 for overweight 2-year-olds to 3.10 for those aged 19 years with severe obesity.
  • For children with severe obesity, the chance that they will no longer be obese at the age of 35 years fell from 21.0% at the age of 2 years to 6.1% at the age of 19 years.

Citation:

Ward ZJ, Long MW, Resch SC, Giles CM, Cradock AL, Gortmaker SL. Simulation of growth trajectories of childhood obesity into adulthood. N Engl J Med. 2017;377:2145-2153. doi:10.1056/NEJMoa1703860.

Commentary:

There is a storm a coming… if this simulation model is correct. The fact that the editors of the New England Journal decided to publish this article suggests it may be correct, and that there is going to be an incredible epidemic of obesity followed by consequences of obesity including hypertension, diabetes, coronary disease, stroke, and severe arthritis. While medications to address these consequences are better than ever, what this study really shows is that we need to find the will and the way to engage our patients, and ourselves and family members, in an ongoing commitment to exercise and diet in order to stem the tide of this epidemic. It’s that simple, and that difficult. —Neil Skolnik, MD

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