Obese Teens Grow Into Severely Obese Adults, Study Finds
If you're worried that your overweight teen may have a long, difficult struggle ahead of her, there's probably good reason for your concern.
Being obese in adolescence increases the risk of being severely obese in adulthood, with the risk higher in women and highest for black women, according to a study appearing Nov. 10 in JAMA.
Characterized by a body mass index (BMI) of 40 or above, severe obesity brings with it a host of serious and potentially life-threatening health complications, including diabetes, hypertension, asthma and arthritis, as well as a substantially shortened life expectancy, the study reports.
Over the past few decades, the rate of occurrence of severe obesity has increased substantially and at an even faster rate than moderate obesity.
"In 2000, an estimated 2.2 percent of adults, or 4.8 million individuals, were severely obese, with a disproportionately higher prevalence in women and racial/ethnic minorities," the authors write. "Yet, few national studies track individuals over time to understand the progression of obesity to severe obesity."
Diet, exercise and behavioral modification are recommended as initial treatments for severe obesity and result in short-term weight loss. Adding prescription drug therapy to the mix can yield a 5 to 10 percent reduction in weight. However, anti-obesity drugs have substantial side effects, and people often regain weight after the drugs are discontinued, according to the study.
Bariatric surgery is an option that can result in 60 to 70 percent weight loss for severely obese individuals and last for at least 10 years. The procedure also usually puts an end to related diseases, such as diabetes and hypertension, and is the only treatment that has been shown to have long-term success. However, the surgery can potentially cause some major complications, including leakage, pneumonia, pulmonary embolism, band slippage and band erosion, the study reports.
Given the lack of successful treatment options, potential risks of treatment and serious health consequences associated with severe obesity, the authors say preventing the condition is critical.
"Understanding which individuals are at risk of severe obesity is essential for determining when interventions would need to be implemented to prevent obese individuals from progressing to severe obesity," the authors write.
The study looked at 8,834 individuals, ages 12 to 21, who were enrolled in 1996 in the U.S. National Longitudinal Study of Adolescent Health, and followed them into adulthood during two successive periods -- ages 18 to 27 (2001-2002) and ages 24 to 33 (2007-2009).
In 1996, 79 adolescents were severely obese and 60 of them (70.5 percent) remained severely obese in adulthood. Over 13 years, 703 new cases of severe obesity in adulthood were reported, and the authors found that those who developed severe obesity in adulthood had a higher BMI in adolescence, and also were more likely to be racial/ethnic minorities.
A substantial proportion of obese adolescents became severely obese by their early 30s, with the rate of incidence in women (51.3 percent) significantly higher than in men (37.1 percent). The incidence of severe obesity was highest among black women (52.4 percent).
Strikingly, across all gender and racial/ethnic groups, less than 5 percent of individuals who were at a normal weight in adolescence became severely obese in adulthood, the authors write.
"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," the authors conclude.
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