Study links health risks later in life to weight status in adolescence

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 online today in the journal Pediatrics, this national, multicenter study links health risks later in life to weight status in adolescence.

The study examined 1,502 adults with severe obesity, ranging in age from 19–76, who were about to undergo bariatric surgery. Severe obesity is defined by a BMI of 35 or greater (which is at least 220 pounds for a woman who is average height). 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 (BMI of greater than or equal to 30) 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. 

Thomas H. Inge, MD, PhD, Professor of Surgery and Pediatrics at Cincinnati Children's Hospital Medical Center, and colleagues found that adolescent obesity was associated with a greatly increased risk of serious health problems among adults at the time they presented for bariatric surgery, after taking into account change in BMI since adolescence and age.

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.  Those who were severely obese as teens were also significantly more likely to have polycystic ovary syndrome, asthma, diabetes and obstructive sleep apnea than those who were normal weight as teens.

"Most people understand that the longer you carry extra weight, the higher your chances of developing heart disease or diabetes," said Inge. "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."

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

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.

David R. Flum, MD, MPH, Professor of Surgery, Health Services and Pharmacy at the University of Washington and coauthor of the study, believes that "these findings underscore the importance of interventions in children to prevent the progression to obesity in teenage years and young adulthood.  We failed to prevent the progression from normal weight to obesity in four out of 10 adults having bariatric surgery, which is at least in part a manifestation of a sickness-oriented system instead of a wellness-oriented system."