Obesity Trend Shifts to the Extreme in Children

Major Finding: More than 6% of subjects aged 2-19 years met the criteria for extreme obesity, with the highest rates seen in Hispanic boys aged 6-11 years and 12-19 years (11%), and black girls aged 12-19 years (12%).

Data Source: A cross-sectional study of 710,949 patients aged 2-19 years who were enrolled in an integrated prepaid health plan.

Disclosures: The study was supported by Kaiser Permanente Direct Community Benefit Funds. Dr. Koebnick and her associates declared no conflicts of interest.

Extreme obesity is on the rise in children and adolescents, and certain ethnic/racial minorities face a higher risk than do others, according to a southern Californian study of more than 710,000 subjects.

More than 6% of subjects aged 2-19 years met the criteria for extreme obesity, with the highest rates seen in Hispanic boys aged 6-11 years and 12-19 years (11%), and black girls aged 12-19 years (12%).

“Extreme obesity was observed early in life,” wrote Corinna Koebnick, Ph.D., of Kaiser Permanente Southern California, Pasadena, and her colleagues (J. Pediatr. 2010 March 18 [doi:10.1016/j. jpeds.2010.01.025]).

“Analogous to the concept of 'pack-years' for smoking patients, extremely obese children may suffer cumulative effects of their 'pound-years,'” the authors suggested.

“Without major lifestyle changes, these kids face a 10 to 20 year shorter life span and will develop health problems in their twenties that we typically see in 40- to 60-year-olds,” Dr. Koebnick said in a written statement.

The cross-sectional study included 710,949 patients aged 2-19 years who were enrolled in an integrated, prepaid health plan in 2007 and 2008. All patients had at least one medical office visit during the 2-year study period, and the average number of medical encounters was 2.6 per child per year. Data for body weight and height measurements, which were routinely recorded during such visits, were extracted from a total of 1,849,256 inpatient and outpatient visits.

Weight differences and distribution was assessed across sex- and race/ethnicity–specific categories. Race and ethnicity information was obtained from administrative records and birth certificates, with incomplete information supplemented by data from the U.S. Census Bureau.

Overweight was defined according to Centers for Disease Control growth charts as a body mass index of 25 kg/m

The study found an overall prevalence of overweight, obesity, and extreme obesity in 37.1%, 19.4%, and 6.4% of the subjects, respectively—a combined total of 63% of the study population. Compared with data from 1999 to 2004 from the National Health and Nutrition Examination Survey (NHANES), which found a 3.8% prevalence of extreme obesity, the new findings demonstrate a shift. “Our study does not reflect a right shift of the entire population, but a right shift of obesity towards extreme obesity,” the authors explained.

“Children who are extremely obese are at higher risk of heart disease, type 2 diabetes, fatty liver disease and joint problems, just to name a few,” Dr. Koebnick said in her statement.

However, overall there is relatively limited knowledge about the economic burden and health consequences of extreme childhood obesity, the authors wrote. Given the marked variance in obesity across ethnic/racial groups, “robust and validated risk stratification schemes are needed to address the variability in risks for adverse health outcomes.”

Major Finding: More than 6% of subjects aged 2-19 years met the criteria for extreme obesity, with the highest rates seen in Hispanic boys aged 6-11 years and 12-19 years (11%), and black girls aged 12-19 years (12%).

Data Source: A cross-sectional study of 710,949 patients aged 2-19 years who were enrolled in an integrated prepaid health plan.

Disclosures: The study was supported by Kaiser Permanente Direct Community Benefit Funds. Dr. Koebnick and her associates declared no conflicts of interest.

Extreme obesity is on the rise in children and adolescents, and certain ethnic/racial minorities face a higher risk than do others, according to a southern Californian study of more than 710,000 subjects.

More than 6% of subjects aged 2-19 years met the criteria for extreme obesity, with the highest rates seen in Hispanic boys aged 6-11 years and 12-19 years (11%), and black girls aged 12-19 years (12%).

“Extreme obesity was observed early in life,” wrote Corinna Koebnick, Ph.D., of Kaiser Permanente Southern California, Pasadena, and her colleagues (J. Pediatr. 2010 March 18 [doi:10.1016/j. jpeds.2010.01.025]).

“Analogous to the concept of 'pack-years' for smoking patients, extremely obese children may suffer cumulative effects of their 'pound-years,'” the authors suggested.

“Without major lifestyle changes, these kids face a 10 to 20 year shorter life span and will develop health problems in their twenties that we typically see in 40- to 60-year-olds,” Dr. Koebnick said in a written statement.

The cross-sectional study included 710,949 patients aged 2-19 years who were enrolled in an integrated, prepaid health plan in 2007 and 2008. All patients had at least one medical office visit during the 2-year study period, and the average number of medical encounters was 2.6 per child per year. Data for body weight and height measurements, which were routinely recorded during such visits, were extracted from a total of 1,849,256 inpatient and outpatient visits.

Weight differences and distribution was assessed across sex- and race/ethnicity–specific categories. Race and ethnicity information was obtained from administrative records and birth certificates, with incomplete information supplemented by data from the U.S. Census Bureau.

Overweight was defined according to Centers for Disease Control growth charts as a body mass index of 25 kg/m

The study found an overall prevalence of overweight, obesity, and extreme obesity in 37.1%, 19.4%, and 6.4% of the subjects, respectively—a combined total of 63% of the study population. Compared with data from 1999 to 2004 from the National Health and Nutrition Examination Survey (NHANES), which found a 3.8% prevalence of extreme obesity, the new findings demonstrate a shift. “Our study does not reflect a right shift of the entire population, but a right shift of obesity towards extreme obesity,” the authors explained.

“Children who are extremely obese are at higher risk of heart disease, type 2 diabetes, fatty liver disease and joint problems, just to name a few,” Dr. Koebnick said in her statement.

However, overall there is relatively limited knowledge about the economic burden and health consequences of extreme childhood obesity, the authors wrote. Given the marked variance in obesity across ethnic/racial groups, “robust and validated risk stratification schemes are needed to address the variability in risks for adverse health outcomes.”

Major Finding: More than 6% of subjects aged 2-19 years met the criteria for extreme obesity, with the highest rates seen in Hispanic boys aged 6-11 years and 12-19 years (11%), and black girls aged 12-19 years (12%).

Data Source: A cross-sectional study of 710,949 patients aged 2-19 years who were enrolled in an integrated prepaid health plan.

Disclosures: The study was supported by Kaiser Permanente Direct Community Benefit Funds. Dr. Koebnick and her associates declared no conflicts of interest.

Extreme obesity is on the rise in children and adolescents, and certain ethnic/racial minorities face a higher risk than do others, according to a southern Californian study of more than 710,000 subjects.

More than 6% of subjects aged 2-19 years met the criteria for extreme obesity, with the highest rates seen in Hispanic boys aged 6-11 years and 12-19 years (11%), and black girls aged 12-19 years (12%).

“Extreme obesity was observed early in life,” wrote Corinna Koebnick, Ph.D., of Kaiser Permanente Southern California, Pasadena, and her colleagues (J. Pediatr. 2010 March 18 [doi:10.1016/j. jpeds.2010.01.025]).

“Analogous to the concept of 'pack-years' for smoking patients, extremely obese children may suffer cumulative effects of their 'pound-years,'” the authors suggested.

“Without major lifestyle changes, these kids face a 10 to 20 year shorter life span and will develop health problems in their twenties that we typically see in 40- to 60-year-olds,” Dr. Koebnick said in a written statement.

The cross-sectional study included 710,949 patients aged 2-19 years who were enrolled in an integrated, prepaid health plan in 2007 and 2008. All patients had at least one medical office visit during the 2-year study period, and the average number of medical encounters was 2.6 per child per year. Data for body weight and height measurements, which were routinely recorded during such visits, were extracted from a total of 1,849,256 inpatient and outpatient visits.

Weight differences and distribution was assessed across sex- and race/ethnicity–specific categories. Race and ethnicity information was obtained from administrative records and birth certificates, with incomplete information supplemented by data from the U.S. Census Bureau.

Overweight was defined according to Centers for Disease Control growth charts as a body mass index of 25 kg/m

The study found an overall prevalence of overweight, obesity, and extreme obesity in 37.1%, 19.4%, and 6.4% of the subjects, respectively—a combined total of 63% of the study population. Compared with data from 1999 to 2004 from the National Health and Nutrition Examination Survey (NHANES), which found a 3.8% prevalence of extreme obesity, the new findings demonstrate a shift. “Our study does not reflect a right shift of the entire population, but a right shift of obesity towards extreme obesity,” the authors explained.

“Children who are extremely obese are at higher risk of heart disease, type 2 diabetes, fatty liver disease and joint problems, just to name a few,” Dr. Koebnick said in her statement.

However, overall there is relatively limited knowledge about the economic burden and health consequences of extreme childhood obesity, the authors wrote. Given the marked variance in obesity across ethnic/racial groups, “robust and validated risk stratification schemes are needed to address the variability in risks for adverse health outcomes.”