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US obesity rates

Most US children will have obesity as adults if current trends continue

For children with severe obesity at age 2, only a one in five chance of not having obesity at age 35

If current trends in child obesity continue, more than 57% of today's children in the US will have obesity at age 35, according to a study from Harvard TH Chan School of Public Health. The study also found that excess weight in childhood is predictive of adult obesity, even among young children, and that only children currently at a healthy weight have less than a 50% chance of having obesity as adults. The findings were based on a rigorous simulation model that provides the most accurate predictions to date of obesity prevalence at various ages.

"Adult obesity is linked with increased risk of diseases such as diabetes, heart disease, and cancer," said Zachary Ward, programmer/analyst at Harvard Chan School's Center for Health Decision Science and lead author of the study. "Our findings highlight the importance of prevention efforts for all children as they grow up, and of providing early interventions for children with obesity to minimize their risk of serious illness in the future."

The study, ‘Simulation of Growth Trajectories of Childhood Obesity into Adulthood’, published in the New England Journal of Medicine, sought to estimate the risk of adult obesity at the age of 35 years for the current population of children in the US using a computational methods and a novel statistical approach to account for long-term population-level trends in weight gain.

The researchers pooled height and weight data from five nationally representative longitudinal studies that included 176,720 observations of 41,567 children and adults. Using these data, they created 1,000 virtual populations of one million children up to age 19 that were representative of the 2016 US population. They then projected height and weight trajectories from childhood to age 35. Severe obesity was defined as a BMI>35 in adults and 120% or more of the 95th percentile in children.

The results showed that obesity will be a significant problem for most children in the U.S. as they grow older. Of the children predicted to have obesity as adults, half will develop it as children, according to the study simulations. Excess weight gained during childhood can put children on a trajectory that is difficult to change, the authors said. For example, the study found that 3 out of 4 two-year-olds with obesity will still have obesity at age 35. For children with severe obesity - a condition that currently affects 4.5 million children in the US - the risks are even greater: at age 2, these children have only a one in five chance of not having obesity at age 35; at age 5, that chance drops to just one in ten.

Even children without obesity face a high risk of adult obesity. The study estimated that for youth ages 2-19 in 2016, over half will have obesity at age 35 - and that most of these youth do not currently have obesity.

The study also found that racial and ethnic disparities in obesity are already present at age 2 and persist into adulthood, with non-Hispanic black and Hispanic individuals more likely to have obesity than white individuals at all ages from ages 2-35.

“On the basis of our simulation models, childhood obesity and overweight will continue to be a major health problem in the US,” the authors conclude. “Early development of obesity predicted obesity in adulthood, especially for children who were severely obese.”

"It is critically important to implement policies and programmes to prevent excess weight gain, starting at an early age,” said senior author Steven Gortmaker, professor of the practice of health sociology at Harvard Chan School. “Plenty of cost-effective strategies have been identified that promote healthy foods, beverages, and physical activity within school and community settings."

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