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Long-term health issues

Severe teenage obesity increases risk adult health problems

class ≥2 obesity at age 18 independently increased the risk of lower-extremity venous oedema with skin manifestations by 435%
class ≥2 obesity at age 18 independently of increased the risk abnormal kidney function by 302%

From abnormal kidney function to difficulty walking and diabetes, severely obese adults who were obese as teenagers have greater risk of developing numerous harmful health conditions. Led by investigators at Cincinnati Children's Hospital Medical Center and the University of Pittsburgh, and published in the journal Pediatrics, the multicentre study links health risks later in life to weight status in adolescence.

"These findings underscore the importance of interventions in children to prevent the progression to obesity in teenage years and young adulthood.” said Dr David R Flum, Professor of Surgery, Health Services and Pharmacy at the University of Washington and co-author of the study. “We failed to prevent the progression from normal weight to obesity in four out of ten adults having bariatric surgery, which is at least in part a manifestation of a sickness-oriented system instead of a wellness-oriented system." 

Study

The study was designed to test the hypothesis that adolescent obesity would be independently associated with greater risks of adverse health in severely obese adults.

A total of 1,502 adults with severe obesity, ranging in age from 19–76, who were about to undergo bariatric surgery were examined. Participants were asked to report their height and weight at age 18 and were then evaluated for medical conditions related to obesity. The investigators wanted to know whether those who were obese or severely obese as teenagers were more likely to have health problems as adults. 

They found that 42 percent of the adults scheduled for surgery reported age 18 weights in the normal weight range, and 29 percent reported weights in the obese range, including 13 percent in the severely obese range. Ninety-six percent of the study participants had at least one obesity-related medical condition as an adult. 

Compared with healthy weight at age 18, class ≥2 obesity at age 18 independently increased the risk of lower-extremity venous oedema with skin manifestations by 435% (p<0.0001), severe walking limitation by 321% (p< 0.0001), abnormal kidney function by 302% (p<0.0001), polycystic ovary syndrome by 74% (p=0.03), asthma by 48% (p=0.01), diabetes by 42% (p< 0.01), obstructive sleep apnoea by 25% (p<0.01), and hypertension (by varying degrees based on age and gender). Conversely, the associated risk of hyperlipidemia was reduced by 61% (p<0.01).

"Most people understand that the longer you carry extra weight, the higher your chances of developing heart disease or diabetes," said Dr Thomas H Inge, Professor of Surgery and Pediatrics at Cincinnati Children's Hospital Medical Center, "But now it seems that an even larger number of conditions should be added to the list of health problems that some obese teenagers will likely face down the road."

Among the most startling findings: those who were severely obese as teens were more than four times more likely to have swollen legs with skin ulcers and more than three times more likely to have severe walking limitations and abnormal kidney function. 

"As the number of children with severe obesity continues to increase, it is important for paediatricians to inform families about the short- and longer-term health issues linked to this weight gain," added Inge.

The study also found that those who were severely obese as teens were also significantly more likely to have polycystic ovary syndrome, asthma, diabetes and obstructive sleep apnoea than those who were normal weight as teens.

Study participants were enrolled in the Longitudinal Assessment of Bariatric Surgery-2 (LABS-2). LABS-2 is a long-term study with more than 2,400 participants designed to assess the risks and benefits of bariatric surgery in adults. The study, funded by the National Institutes of Health, included researchers from University of Pittsburgh, Columbia, Cornell University Medical Center, the University of Washington, Neuropsychiatric Research Institute, East Carolina University and Oregon Health & Science University, as well as collaborators from Cincinnati Children's Hospital Medical Center.

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