Obese adolescents at greatest risk of becoming severely obese adults

Dr. Gordon-Larsen

Obese adolescents are 16 times more likely to become severely obese by age 30 than their healthy weight or even overweight peers, according to a new study led by Penny Gordon-Larsen, PhD, associate professor of nutrition in the UNC Gillings School of Global Public Health.

The link found between adolescent obesity and adult severe obesity suggests intervention programs might be most effective during childhood or adolescence, before the worst weight gain occurs, said senior study author Gordon-Larsen, who is a fellow at UNC’s Carolina Population Center.

“Severe obesity can lead to life-threatening complications, including diabetes, hypertension, hyperlipidemia, asthma and arthritis, as well as substantial reductions in life expectancy,” she said. “It’s critical that we identify who is most at risk for this condition, and when they are most vulnerable to it. Then we’ll have better evidence for when and how to effectively intervene.”

Dr. The

Current weight loss drugs are either minimally effective or come with a high risk of side effects, while people who have bariatric surgery, or “stomach stapling” operations, can suffer major potential complications, said Natalie The, PhD, postdoctoral research associate and lead author of the study. Therefore, preventing severe obesity may be the most effective strategy to avoid obesity-related health risks, she said.

Researchers defined adult severe obesity as a body mass index (BMI) of greater than or equal to 40, and being overweight and obese as a BMI greater than 25.

The study found that while 1.2 percent of males and 2.4 percent of females who were normal weight as adolescents became severely obese as adults, 37 percent of males and 51 percent of females who were obese as adolescents became severely obese as adults. The risk of becoming severely obese was highest in black females.

“While we know that the transition from the teenage years to the adult years is one of high risk for weight gain, few studies have tracked individuals over time to understand the risk of developing severe obesity,” The said.

To measure the association between obesity in adolescence and severe obesity in adulthood, researchers studied data from the U.S. National Longitudinal Study of Adolescent Health. More than 8,800 people who were 12- to 21-year-olds in 1996 were followed into adulthood (ages 24-33 in 2007-2009).

Results showed that across all weight, sex and racial and ethnic groups, 7.9 percent of these teenagers who were not severely obese as adolescents became severely obese as young adults 13 years later. On the other hand, 70 percent of the teens who were severely obese remained so as they aged.

On average, over the period of the study, a teenage female who was 5 feet 4 inches tall, weighed 130 pounds and never developed severe obesity gained about 30 pounds; however a female of the same height who did become severely obese gained about 80 pounds.

“Obese adolescents are at considerably high risk for becoming adults with severe obesity,” Gordon-Larsen said. “Given the rapid rise in severe obesity and its associated health risks, early prevention efforts are critically needed.”

Dr. Suchindran

Dr. Popkin

Dr. North

Along with Gordon-Larsen and The, the study co-authors were Chirayath Suchindran, PhD, professor of biostatistics, Kari North, PhD, associate professor of epidemiology, and Barry Popkin, PhD, Carla Smith Chamblee Distinguished Professor of Global Nutrition, all in UNC Gillings School of Global Public Health.

The study’s title is “Association of Adolescent Obesity with Risk of Severe Obesity in Adulthood.”

UNC Gillings School of Global Public Health contact: Ramona DuBose, director of communications, or ramona_dubose@unc.edu.