TBD Meeting (5436-22)

New research from 10 countries around the globe, including 1,164 participants from the United Kingdom, presented at this year’s European Congress on Obesity shows that nearly one-quarter (24%) of adolescents living with obesity (ALwO) do not know they have obesity.

“The impact of obesity – in children and adults – on individuals, society, and our health care systems should not be underestimated,” said lead author Professor Jason C.G. Halford, PhD, C.Psychol, AFBPS, head of the school of psychology, University of Leeds (England), and president of the European Association for the Study of Obesity.

The new findings come from the ACTION teens global survey study, a quantitative survey-based study that collected data in 10 countries (Australia, Colombia, Italy, Korea, Mexico, Saudi Arabia, Spain, Taiwan, Turkey, and the United Kingdom) and included ALwO, their caregivers, and health care professionals (HCPs) who had direct, recent experience of clinical obesity management in adolescents.

Included in the survey were:

• 5,275 ALwO aged 12-17 years with current body mass index–for-age (based on self-reported sex, age, height, and weight) in the top 5% (≥95th percentile) for age and sex.
• 5,389 caregivers aged 25 years and over, who were the parent or legal guardian of an ALwO who lived in the same household at least 50% of the time and were involved in their ALwO’s health care decisions.
• 2,323 HCP, primary care physicians, pediatricians, or other specialists, who had been in clinical practice for at least 2 years, spent at least 50% of their time in direct patient care, and treated at least 10 ALwO in a typical month

An online panel, telephone calls, and in-person meetings were utilized to survey participants on a wide range of topics, including attitudes towards obesity and its impact, number of weight-loss attempts, and motivations/barriers to weight loss.
 

Many believe losing weight is their sole responsibility

The authors reported that around 9 out of 10 (89%) HCPs indicated that obesity has a strong impact on a person’s overall health and wellbeing. Fewer ALwO and caregivers, however, had similar views about this (72% and 67% respectively). In addition, the authors said that “most participants thought obesity was at least as, or more, impactful than heart disease, cancer, or diabetes.”

Despite many ALwO not recognizing being obese, most surveyed (85%) were worried about the impact of their weight on their future health, with two-thirds (65%) feeling it was their sole responsibility to deal with their excess weight. This compared to 37% of caregivers and around one in four HCPs (27%) feeling that losing weight was solely the ALwO’s responsibility.

Study coauthor Vicki Mooney, chairwoman of the Irish Coalition for People Living with Obesity and executive director of the European Coalition for People living with Obesity, said: “It is hard to fathom the pressure for these teenagers, especially as two-thirds believe it is their sole responsibility to lose weight, with many of their parents/caregivers struggling to know how to best care for their child.”
 

Teenagers unable to speak to parents about losing weight

Many ALwO said they struggled to talk to those closest to them about their weight, with 1 in 3 saying they couldn’t talk to either parent about their weight, and alarmingly 1 in 10 feeling they couldn’t talk to anyone about their weight. However, around one in three could talk to their doctor, and 74% said that they trusted the advice of a HCP about weight management.

Ms. Mooney said: “The results show us teenagers want to lose weight and improve their health, however, one in three teenagers feel unable to speak to their parents about it and many revert to social media for guidance.”

When it came to sources of information YouTube (34%), social media (28%), family and friends (25%), search engines (25%), and doctors (24%) were the most popular.
 

Motivation, barriers, and attempts

Weight-loss attempts by ALwO appeared to be underestimated by HCPs, the authors explained, while caregivers tended to underestimate both the impact of obesity on health and wellbeing, and ALwO’s weight-loss attempts.

Efforts had been made to try and lose weight in the past year by more than half (58%) of ALwO, with three-quarters (75%) being somewhat/very likely to attempt to lose weight in the next 6 months. However, fewer (41%) caregivers reported that their ‘linked’ ALwO attempted weight loss over the past year or that their ALwO was somewhat/very likely (63%) to attempt to lose weight in the next 6 months. Amongst HCPs, only about two out of five (38%) responded that their ALwO patients had made a serious weight loss attempt in the past year.

Motivation is a key component of successful weight reduction and wanting to be more fit/in better shape (40%), not being happy with their weight (37%), and wanting to feel more confident (35%) were the most common motivators for ALwO, and also the most common motivators reported by caregivers for their ALwO. For HCPs, though, things were somewhat different, with the top three motivators they reported for ALwO to lose weight were wanting the have more confidence/self-esteem (69%), improved social life and popularity (69%), and wanting to look like peers their age (65%).

The top three barriers to losing weight reported by ALwO and by caregivers for their ALwO were not being able to control hunger (38%), lack of motivation (34%), and enjoying eating unhealthy food (32%). For HCPs, the top three barriers they reported for ALwO losing weight were unhealthy eating habits (93%), lack of exercise (92%), and enjoying eating unhealthy food (91%).

“Key motivations and barriers for weight loss were not aligned between ALwO and HCPs,” said the authors. They pointed out that these disconnects may “negatively impact the level of support and effectiveness” of obesity care ALwO receive from caregivers and HCPs.

Prof. Halford said: “There is urgent need for governments and society to recognize and treat obesity as a disease, so that more teens can get the right support to help them live happier and healthier lives.”

The conference posters have yet to be published in a journal but were peer reviewed by the ECO selection committee.

The studies were sponsored by Novo Nordisk A/S.

A version of this article first appeared on Univadis.

New research from 10 countries around the globe, including 1,164 participants from the United Kingdom, presented at this year’s European Congress on Obesity shows that nearly one-quarter (24%) of adolescents living with obesity (ALwO) do not know they have obesity.

“The impact of obesity – in children and adults – on individuals, society, and our health care systems should not be underestimated,” said lead author Professor Jason C.G. Halford, PhD, C.Psychol, AFBPS, head of the school of psychology, University of Leeds (England), and president of the European Association for the Study of Obesity.

The new findings come from the ACTION teens global survey study, a quantitative survey-based study that collected data in 10 countries (Australia, Colombia, Italy, Korea, Mexico, Saudi Arabia, Spain, Taiwan, Turkey, and the United Kingdom) and included ALwO, their caregivers, and health care professionals (HCPs) who had direct, recent experience of clinical obesity management in adolescents.

Included in the survey were:

• 5,275 ALwO aged 12-17 years with current body mass index–for-age (based on self-reported sex, age, height, and weight) in the top 5% (≥95th percentile) for age and sex.
• 5,389 caregivers aged 25 years and over, who were the parent or legal guardian of an ALwO who lived in the same household at least 50% of the time and were involved in their ALwO’s health care decisions.
• 2,323 HCP, primary care physicians, pediatricians, or other specialists, who had been in clinical practice for at least 2 years, spent at least 50% of their time in direct patient care, and treated at least 10 ALwO in a typical month

An online panel, telephone calls, and in-person meetings were utilized to survey participants on a wide range of topics, including attitudes towards obesity and its impact, number of weight-loss attempts, and motivations/barriers to weight loss.
 

Many believe losing weight is their sole responsibility

The authors reported that around 9 out of 10 (89%) HCPs indicated that obesity has a strong impact on a person’s overall health and wellbeing. Fewer ALwO and caregivers, however, had similar views about this (72% and 67% respectively). In addition, the authors said that “most participants thought obesity was at least as, or more, impactful than heart disease, cancer, or diabetes.”

Despite many ALwO not recognizing being obese, most surveyed (85%) were worried about the impact of their weight on their future health, with two-thirds (65%) feeling it was their sole responsibility to deal with their excess weight. This compared to 37% of caregivers and around one in four HCPs (27%) feeling that losing weight was solely the ALwO’s responsibility.

Study coauthor Vicki Mooney, chairwoman of the Irish Coalition for People Living with Obesity and executive director of the European Coalition for People living with Obesity, said: “It is hard to fathom the pressure for these teenagers, especially as two-thirds believe it is their sole responsibility to lose weight, with many of their parents/caregivers struggling to know how to best care for their child.”
 

Teenagers unable to speak to parents about losing weight

Many ALwO said they struggled to talk to those closest to them about their weight, with 1 in 3 saying they couldn’t talk to either parent about their weight, and alarmingly 1 in 10 feeling they couldn’t talk to anyone about their weight. However, around one in three could talk to their doctor, and 74% said that they trusted the advice of a HCP about weight management.

Ms. Mooney said: “The results show us teenagers want to lose weight and improve their health, however, one in three teenagers feel unable to speak to their parents about it and many revert to social media for guidance.”

When it came to sources of information YouTube (34%), social media (28%), family and friends (25%), search engines (25%), and doctors (24%) were the most popular.
 

Motivation, barriers, and attempts

Weight-loss attempts by ALwO appeared to be underestimated by HCPs, the authors explained, while caregivers tended to underestimate both the impact of obesity on health and wellbeing, and ALwO’s weight-loss attempts.

Efforts had been made to try and lose weight in the past year by more than half (58%) of ALwO, with three-quarters (75%) being somewhat/very likely to attempt to lose weight in the next 6 months. However, fewer (41%) caregivers reported that their ‘linked’ ALwO attempted weight loss over the past year or that their ALwO was somewhat/very likely (63%) to attempt to lose weight in the next 6 months. Amongst HCPs, only about two out of five (38%) responded that their ALwO patients had made a serious weight loss attempt in the past year.

Motivation is a key component of successful weight reduction and wanting to be more fit/in better shape (40%), not being happy with their weight (37%), and wanting to feel more confident (35%) were the most common motivators for ALwO, and also the most common motivators reported by caregivers for their ALwO. For HCPs, though, things were somewhat different, with the top three motivators they reported for ALwO to lose weight were wanting the have more confidence/self-esteem (69%), improved social life and popularity (69%), and wanting to look like peers their age (65%).

The top three barriers to losing weight reported by ALwO and by caregivers for their ALwO were not being able to control hunger (38%), lack of motivation (34%), and enjoying eating unhealthy food (32%). For HCPs, the top three barriers they reported for ALwO losing weight were unhealthy eating habits (93%), lack of exercise (92%), and enjoying eating unhealthy food (91%).

“Key motivations and barriers for weight loss were not aligned between ALwO and HCPs,” said the authors. They pointed out that these disconnects may “negatively impact the level of support and effectiveness” of obesity care ALwO receive from caregivers and HCPs.

Prof. Halford said: “There is urgent need for governments and society to recognize and treat obesity as a disease, so that more teens can get the right support to help them live happier and healthier lives.”

The conference posters have yet to be published in a journal but were peer reviewed by the ECO selection committee.

The studies were sponsored by Novo Nordisk A/S.

A version of this article first appeared on Univadis.

New research from 10 countries around the globe, including 1,164 participants from the United Kingdom, presented at this year’s European Congress on Obesity shows that nearly one-quarter (24%) of adolescents living with obesity (ALwO) do not know they have obesity.

“The impact of obesity – in children and adults – on individuals, society, and our health care systems should not be underestimated,” said lead author Professor Jason C.G. Halford, PhD, C.Psychol, AFBPS, head of the school of psychology, University of Leeds (England), and president of the European Association for the Study of Obesity.

The new findings come from the ACTION teens global survey study, a quantitative survey-based study that collected data in 10 countries (Australia, Colombia, Italy, Korea, Mexico, Saudi Arabia, Spain, Taiwan, Turkey, and the United Kingdom) and included ALwO, their caregivers, and health care professionals (HCPs) who had direct, recent experience of clinical obesity management in adolescents.

Included in the survey were:

• 5,275 ALwO aged 12-17 years with current body mass index–for-age (based on self-reported sex, age, height, and weight) in the top 5% (≥95th percentile) for age and sex.
• 5,389 caregivers aged 25 years and over, who were the parent or legal guardian of an ALwO who lived in the same household at least 50% of the time and were involved in their ALwO’s health care decisions.
• 2,323 HCP, primary care physicians, pediatricians, or other specialists, who had been in clinical practice for at least 2 years, spent at least 50% of their time in direct patient care, and treated at least 10 ALwO in a typical month

An online panel, telephone calls, and in-person meetings were utilized to survey participants on a wide range of topics, including attitudes towards obesity and its impact, number of weight-loss attempts, and motivations/barriers to weight loss.
 

Many believe losing weight is their sole responsibility

The authors reported that around 9 out of 10 (89%) HCPs indicated that obesity has a strong impact on a person’s overall health and wellbeing. Fewer ALwO and caregivers, however, had similar views about this (72% and 67% respectively). In addition, the authors said that “most participants thought obesity was at least as, or more, impactful than heart disease, cancer, or diabetes.”

Despite many ALwO not recognizing being obese, most surveyed (85%) were worried about the impact of their weight on their future health, with two-thirds (65%) feeling it was their sole responsibility to deal with their excess weight. This compared to 37% of caregivers and around one in four HCPs (27%) feeling that losing weight was solely the ALwO’s responsibility.

Study coauthor Vicki Mooney, chairwoman of the Irish Coalition for People Living with Obesity and executive director of the European Coalition for People living with Obesity, said: “It is hard to fathom the pressure for these teenagers, especially as two-thirds believe it is their sole responsibility to lose weight, with many of their parents/caregivers struggling to know how to best care for their child.”
 

Teenagers unable to speak to parents about losing weight

Many ALwO said they struggled to talk to those closest to them about their weight, with 1 in 3 saying they couldn’t talk to either parent about their weight, and alarmingly 1 in 10 feeling they couldn’t talk to anyone about their weight. However, around one in three could talk to their doctor, and 74% said that they trusted the advice of a HCP about weight management.

Ms. Mooney said: “The results show us teenagers want to lose weight and improve their health, however, one in three teenagers feel unable to speak to their parents about it and many revert to social media for guidance.”

When it came to sources of information YouTube (34%), social media (28%), family and friends (25%), search engines (25%), and doctors (24%) were the most popular.
 

Motivation, barriers, and attempts

Weight-loss attempts by ALwO appeared to be underestimated by HCPs, the authors explained, while caregivers tended to underestimate both the impact of obesity on health and wellbeing, and ALwO’s weight-loss attempts.

Efforts had been made to try and lose weight in the past year by more than half (58%) of ALwO, with three-quarters (75%) being somewhat/very likely to attempt to lose weight in the next 6 months. However, fewer (41%) caregivers reported that their ‘linked’ ALwO attempted weight loss over the past year or that their ALwO was somewhat/very likely (63%) to attempt to lose weight in the next 6 months. Amongst HCPs, only about two out of five (38%) responded that their ALwO patients had made a serious weight loss attempt in the past year.

Motivation is a key component of successful weight reduction and wanting to be more fit/in better shape (40%), not being happy with their weight (37%), and wanting to feel more confident (35%) were the most common motivators for ALwO, and also the most common motivators reported by caregivers for their ALwO. For HCPs, though, things were somewhat different, with the top three motivators they reported for ALwO to lose weight were wanting the have more confidence/self-esteem (69%), improved social life and popularity (69%), and wanting to look like peers their age (65%).

The top three barriers to losing weight reported by ALwO and by caregivers for their ALwO were not being able to control hunger (38%), lack of motivation (34%), and enjoying eating unhealthy food (32%). For HCPs, the top three barriers they reported for ALwO losing weight were unhealthy eating habits (93%), lack of exercise (92%), and enjoying eating unhealthy food (91%).

“Key motivations and barriers for weight loss were not aligned between ALwO and HCPs,” said the authors. They pointed out that these disconnects may “negatively impact the level of support and effectiveness” of obesity care ALwO receive from caregivers and HCPs.

Prof. Halford said: “There is urgent need for governments and society to recognize and treat obesity as a disease, so that more teens can get the right support to help them live happier and healthier lives.”

The conference posters have yet to be published in a journal but were peer reviewed by the ECO selection committee.

The studies were sponsored by Novo Nordisk A/S.

A version of this article first appeared on Univadis.

Signs of cardiometabolic damage in children who are overweight appear as early as 6-8 years of age, but were not evident in preschoolers, providing a window of opportunity for intervention, show the latest results from a long-running Danish study of childhood weight.

The proportion of children who were overweight (nearly 14% in 2015) was similar between the two groups – those of preschool age (2-5 years) and school age (6-8 years) – but only the latter showed significant signs of cardiometabolic abnormalities.

The results, published in Obesity Research & Clinical Practice, are the latest in a series of many findings from the HOLBAEK study (formerly known as The Danish Childhood Obesity Biobank) that have emerged since it began in 2007. They were presented, along with a meta-analysis of much of their work, at the European Congress on Obesity (ECO) 2022.

“When comparing children with and without overweight, there were only barely significant differences among the preschool children,” said investigator Christine Frithioff-Bøjsøe, MD, but in contrast, “the school children with overweight exhibited significantly higher systolic blood pressure, glucose, insulin, and higher HDL cholesterol,” among other markers, she noted.

“Detection needs to start as early as age 2-5 years because if you wait just a few years longer these children will show early signs of disease starting to take hold. This could provide a critical window to detect and manage overweight,” said Frithioff-Bøjsøe, PhD, of the Children’s Obesity Clinic, Copenhagen University, Hospital Holbaek, Denmark.

Asked to comment, Aaron S. Kelly, PhD, professor of pediatrics, codirector, University of Minnesota Center for Pediatric Obesity Medicine in Minneapolis, said: “Recent results from HOLBAEK highlight the critical importance of identifying obesity early in life, before its complications spring up.

“Ideally, we should be in the business of managing and reducing excess adiposity as soon as it surfaces with the goal of preventing the onset of cardiometabolic risk factors, not watchful waiting and hoping for the best.”
 

Routine dental visits checked overweight

In the newest study, the researchers trained dental assistants to measure weight and height and carried out body mass index assessments during routine appointments.

A total of 335 preschool and 657 school-age children were recruited for the study. Of these, 40% attended additional hospital-based examinations including blood pressure measurement and a blood sample. Children were reexamined approximately 1 year later.

Systolic blood pressure, for example, was significantly higher in 6- to 8-year-olds with overweight compared to those of normal weight (P = .001). There was no significant difference between systolic blood pressure of 2.5- to 5-year-olds without and with overweight.

Likewise, with insulin resistance, there was no significant difference between preschoolers with and without overweight. However, in schoolchildren, homoeostasis model of assessment–insulin resistance (HOMA-IR) was significantly higher in those with overweight, at 2.2, compared to those without, at 0.9 (P < .001).

Also, during follow-up (around a year later), the prevalence of overweight did not change in preschool children but increased from 13.7% to 17.0% in schoolchildren.

The researchers noted that, in Europe, it is the primary health care sector that has continuous contact with the pediatric population, with the potential for early evaluation of children at risk. Their decision to use dental health care assistants to assess weight in this particular study is novel, but feasible, they observed.
 

Danish model for treating overweight and obesity is ‘game-changing’

As part of the HOLBAEK initiative, clinical data and biological samples have been collected from children and adolescents receiving treatment at The Children’s Obesity Clinic, Holbaek Hospital, using a population-based cohort as a reference group. Data have been collected on about 8,000 children and adolescents so far.

Jens-Christian Holm, PhD, along with colleague and research assistant Maria Frauland, both from Copenhagen University, Hospital Holbaek, presented a review of the HOLBAEK studies (2007-2021) at ECO 2022. They said the results highlight the importance of taking an integrated approach to managing children and adolescents with obesity.

The review, which included 82 papers, found a wide variety of obesity-related complications already present at a young age in some of the cross-sectional studies, including dyslipidemia in 28% of children with obesity, hepatic steatosis in 31%, obstructive sleep apnea in 45%, and prehypertension or hypertension in 52%.

The family-based interventional weight management programs adopted by HOLBAEK showed a 75% reduction in the “degree of obesity,” which comprised a measure of dyslipidemia, hypertension, hepatic steatosis, sleep apnea, and parental obesity.

“The HOLBAEK method is a holistic approach where we integrate everything,” Dr. Holm told this news organization.

Ms. Frauland said: “The HOLBAEK study has provided important insights into childhood overweight. It has highlighted that obesity is a serious multisystem disease that can be managed and treated effectively, reducing the degree of overweight and improving overweight-related complications.”

Dr. Kelly, the U.S. pediatrician, applauded the HOLBAEK philosophy, which emphasizes that obesity is not the fault of the child or parent, but rather the manifestation of dysregulated energy metabolism. “The recognition that obesity is a biologically driven, chronic, refractory, and relapsing disease is interwoven into the approach, which shifts the responsibility to the care provider for ensuring positive outcomes of treatment.

“Highlighting this fact to the parents and child can be game-changing since it removes the blame and shame associated with obesity and unburdens the family by framing the problem in a different light,” Dr. Kelly stressed.

Dr. Frithioff-Bøjsøe has reported no relevant financial relationships. Dr. Holm has an obesity management company called Holm. Dr. Kelly serves as an unpaid consultant for Novo Nordisk, Vivus, Eli Lilly, and Boehringer Ingelheim and receives donated drug/placebo from Vivus for a clinical trial funded by the National Institutes of Health.

A version of this article first appeared on Medscape.com.

Signs of cardiometabolic damage in children who are overweight appear as early as 6-8 years of age, but were not evident in preschoolers, providing a window of opportunity for intervention, show the latest results from a long-running Danish study of childhood weight.

The proportion of children who were overweight (nearly 14% in 2015) was similar between the two groups – those of preschool age (2-5 years) and school age (6-8 years) – but only the latter showed significant signs of cardiometabolic abnormalities.

The results, published in Obesity Research & Clinical Practice, are the latest in a series of many findings from the HOLBAEK study (formerly known as The Danish Childhood Obesity Biobank) that have emerged since it began in 2007. They were presented, along with a meta-analysis of much of their work, at the European Congress on Obesity (ECO) 2022.

“When comparing children with and without overweight, there were only barely significant differences among the preschool children,” said investigator Christine Frithioff-Bøjsøe, MD, but in contrast, “the school children with overweight exhibited significantly higher systolic blood pressure, glucose, insulin, and higher HDL cholesterol,” among other markers, she noted.

“Detection needs to start as early as age 2-5 years because if you wait just a few years longer these children will show early signs of disease starting to take hold. This could provide a critical window to detect and manage overweight,” said Frithioff-Bøjsøe, PhD, of the Children’s Obesity Clinic, Copenhagen University, Hospital Holbaek, Denmark.

Asked to comment, Aaron S. Kelly, PhD, professor of pediatrics, codirector, University of Minnesota Center for Pediatric Obesity Medicine in Minneapolis, said: “Recent results from HOLBAEK highlight the critical importance of identifying obesity early in life, before its complications spring up.

“Ideally, we should be in the business of managing and reducing excess adiposity as soon as it surfaces with the goal of preventing the onset of cardiometabolic risk factors, not watchful waiting and hoping for the best.”
 

Routine dental visits checked overweight

In the newest study, the researchers trained dental assistants to measure weight and height and carried out body mass index assessments during routine appointments.

A total of 335 preschool and 657 school-age children were recruited for the study. Of these, 40% attended additional hospital-based examinations including blood pressure measurement and a blood sample. Children were reexamined approximately 1 year later.

Systolic blood pressure, for example, was significantly higher in 6- to 8-year-olds with overweight compared to those of normal weight (P = .001). There was no significant difference between systolic blood pressure of 2.5- to 5-year-olds without and with overweight.

Likewise, with insulin resistance, there was no significant difference between preschoolers with and without overweight. However, in schoolchildren, homoeostasis model of assessment–insulin resistance (HOMA-IR) was significantly higher in those with overweight, at 2.2, compared to those without, at 0.9 (P < .001).

Also, during follow-up (around a year later), the prevalence of overweight did not change in preschool children but increased from 13.7% to 17.0% in schoolchildren.

The researchers noted that, in Europe, it is the primary health care sector that has continuous contact with the pediatric population, with the potential for early evaluation of children at risk. Their decision to use dental health care assistants to assess weight in this particular study is novel, but feasible, they observed.
 

Danish model for treating overweight and obesity is ‘game-changing’

As part of the HOLBAEK initiative, clinical data and biological samples have been collected from children and adolescents receiving treatment at The Children’s Obesity Clinic, Holbaek Hospital, using a population-based cohort as a reference group. Data have been collected on about 8,000 children and adolescents so far.

Jens-Christian Holm, PhD, along with colleague and research assistant Maria Frauland, both from Copenhagen University, Hospital Holbaek, presented a review of the HOLBAEK studies (2007-2021) at ECO 2022. They said the results highlight the importance of taking an integrated approach to managing children and adolescents with obesity.

The review, which included 82 papers, found a wide variety of obesity-related complications already present at a young age in some of the cross-sectional studies, including dyslipidemia in 28% of children with obesity, hepatic steatosis in 31%, obstructive sleep apnea in 45%, and prehypertension or hypertension in 52%.

The family-based interventional weight management programs adopted by HOLBAEK showed a 75% reduction in the “degree of obesity,” which comprised a measure of dyslipidemia, hypertension, hepatic steatosis, sleep apnea, and parental obesity.

“The HOLBAEK method is a holistic approach where we integrate everything,” Dr. Holm told this news organization.

Ms. Frauland said: “The HOLBAEK study has provided important insights into childhood overweight. It has highlighted that obesity is a serious multisystem disease that can be managed and treated effectively, reducing the degree of overweight and improving overweight-related complications.”

Dr. Kelly, the U.S. pediatrician, applauded the HOLBAEK philosophy, which emphasizes that obesity is not the fault of the child or parent, but rather the manifestation of dysregulated energy metabolism. “The recognition that obesity is a biologically driven, chronic, refractory, and relapsing disease is interwoven into the approach, which shifts the responsibility to the care provider for ensuring positive outcomes of treatment.

“Highlighting this fact to the parents and child can be game-changing since it removes the blame and shame associated with obesity and unburdens the family by framing the problem in a different light,” Dr. Kelly stressed.

Dr. Frithioff-Bøjsøe has reported no relevant financial relationships. Dr. Holm has an obesity management company called Holm. Dr. Kelly serves as an unpaid consultant for Novo Nordisk, Vivus, Eli Lilly, and Boehringer Ingelheim and receives donated drug/placebo from Vivus for a clinical trial funded by the National Institutes of Health.

A version of this article first appeared on Medscape.com.

Signs of cardiometabolic damage in children who are overweight appear as early as 6-8 years of age, but were not evident in preschoolers, providing a window of opportunity for intervention, show the latest results from a long-running Danish study of childhood weight.

The proportion of children who were overweight (nearly 14% in 2015) was similar between the two groups – those of preschool age (2-5 years) and school age (6-8 years) – but only the latter showed significant signs of cardiometabolic abnormalities.

The results, published in Obesity Research & Clinical Practice, are the latest in a series of many findings from the HOLBAEK study (formerly known as The Danish Childhood Obesity Biobank) that have emerged since it began in 2007. They were presented, along with a meta-analysis of much of their work, at the European Congress on Obesity (ECO) 2022.

“When comparing children with and without overweight, there were only barely significant differences among the preschool children,” said investigator Christine Frithioff-Bøjsøe, MD, but in contrast, “the school children with overweight exhibited significantly higher systolic blood pressure, glucose, insulin, and higher HDL cholesterol,” among other markers, she noted.

“Detection needs to start as early as age 2-5 years because if you wait just a few years longer these children will show early signs of disease starting to take hold. This could provide a critical window to detect and manage overweight,” said Frithioff-Bøjsøe, PhD, of the Children’s Obesity Clinic, Copenhagen University, Hospital Holbaek, Denmark.

Asked to comment, Aaron S. Kelly, PhD, professor of pediatrics, codirector, University of Minnesota Center for Pediatric Obesity Medicine in Minneapolis, said: “Recent results from HOLBAEK highlight the critical importance of identifying obesity early in life, before its complications spring up.

“Ideally, we should be in the business of managing and reducing excess adiposity as soon as it surfaces with the goal of preventing the onset of cardiometabolic risk factors, not watchful waiting and hoping for the best.”
 

Routine dental visits checked overweight

In the newest study, the researchers trained dental assistants to measure weight and height and carried out body mass index assessments during routine appointments.

A total of 335 preschool and 657 school-age children were recruited for the study. Of these, 40% attended additional hospital-based examinations including blood pressure measurement and a blood sample. Children were reexamined approximately 1 year later.

Systolic blood pressure, for example, was significantly higher in 6- to 8-year-olds with overweight compared to those of normal weight (P = .001). There was no significant difference between systolic blood pressure of 2.5- to 5-year-olds without and with overweight.

Likewise, with insulin resistance, there was no significant difference between preschoolers with and without overweight. However, in schoolchildren, homoeostasis model of assessment–insulin resistance (HOMA-IR) was significantly higher in those with overweight, at 2.2, compared to those without, at 0.9 (P < .001).

Also, during follow-up (around a year later), the prevalence of overweight did not change in preschool children but increased from 13.7% to 17.0% in schoolchildren.

The researchers noted that, in Europe, it is the primary health care sector that has continuous contact with the pediatric population, with the potential for early evaluation of children at risk. Their decision to use dental health care assistants to assess weight in this particular study is novel, but feasible, they observed.
 

Danish model for treating overweight and obesity is ‘game-changing’

As part of the HOLBAEK initiative, clinical data and biological samples have been collected from children and adolescents receiving treatment at The Children’s Obesity Clinic, Holbaek Hospital, using a population-based cohort as a reference group. Data have been collected on about 8,000 children and adolescents so far.

Jens-Christian Holm, PhD, along with colleague and research assistant Maria Frauland, both from Copenhagen University, Hospital Holbaek, presented a review of the HOLBAEK studies (2007-2021) at ECO 2022. They said the results highlight the importance of taking an integrated approach to managing children and adolescents with obesity.

The review, which included 82 papers, found a wide variety of obesity-related complications already present at a young age in some of the cross-sectional studies, including dyslipidemia in 28% of children with obesity, hepatic steatosis in 31%, obstructive sleep apnea in 45%, and prehypertension or hypertension in 52%.

The family-based interventional weight management programs adopted by HOLBAEK showed a 75% reduction in the “degree of obesity,” which comprised a measure of dyslipidemia, hypertension, hepatic steatosis, sleep apnea, and parental obesity.

“The HOLBAEK method is a holistic approach where we integrate everything,” Dr. Holm told this news organization.

Ms. Frauland said: “The HOLBAEK study has provided important insights into childhood overweight. It has highlighted that obesity is a serious multisystem disease that can be managed and treated effectively, reducing the degree of overweight and improving overweight-related complications.”

Dr. Kelly, the U.S. pediatrician, applauded the HOLBAEK philosophy, which emphasizes that obesity is not the fault of the child or parent, but rather the manifestation of dysregulated energy metabolism. “The recognition that obesity is a biologically driven, chronic, refractory, and relapsing disease is interwoven into the approach, which shifts the responsibility to the care provider for ensuring positive outcomes of treatment.

“Highlighting this fact to the parents and child can be game-changing since it removes the blame and shame associated with obesity and unburdens the family by framing the problem in a different light,” Dr. Kelly stressed.

Dr. Frithioff-Bøjsøe has reported no relevant financial relationships. Dr. Holm has an obesity management company called Holm. Dr. Kelly serves as an unpaid consultant for Novo Nordisk, Vivus, Eli Lilly, and Boehringer Ingelheim and receives donated drug/placebo from Vivus for a clinical trial funded by the National Institutes of Health.

A version of this article first appeared on Medscape.com.

Counting calories, joining a gym, and taking part in exercise programs are popular methods used by people in the United Kingdom who want to shed some pounds, but they seem to be fairly ineffective strategies, according to an investigation.

A survey of adults with obesity from six countries in western Europe found that most who set out to reduce a meaningful amount of weight failed in their attempt.

The preliminary results, presented in two posters at the European Congress on Obesity, underlined the need for better support and solutions for weight management, the authors suggested.

Marc Evans, MB, BCh, a consultant physician in diabetes and endocrinology, from University Hospital, Cardiff, Wales, who led the analysis, said that, “while obesity’s impact on health is well known, our finding that a sizable proportion of adults with obesity appear at elevated risk of hospitalization or surgery due to multiple underlying illnesses, undoubtedly adds a sense of urgency to tackling Europe’s growing obesity epidemic.”

The study, which also involved analytics consultancy firm Lane Clark & Peacock, conducted a cross-sectional survey of 1,850 adults. Of those 500 were from the UK, and the remainder from France, Germany, Italy, Spain, and Sweden.

All participants had a body mass index of 30 kg/m², or higher. More specifically, 56.3%; were classified as obesity class I, 26.8% obesity class II, and 16.9% obesity class III.
 

Obesity-related conditions

In total, 25.7% of participants reported no obesity-related health conditions, 28.4% had one condition, 19.6% had two, and 26.3% had three or more. The most common comorbidities were hypertension, dyslipidemia, and type 2 diabetes.

Overall, 78.6% of respondents reported having tried to lose weight in the previous year. Asked in a questionnaire about how they had tried to achieve this, the responses indicated that the most common strategies were:

• Calorie-controlled/restricted diet (71.9%)
• Exercise program course (21.9%)
• Pharmaceutical treatment/medication (12.3%)
• Joined a gym (12%)
• Digital health app (9.7%)

Among other participants, 8.1% said they had used alternative treatments, 7.6% a weight loss service, and 2.1% cognitive-behavioral therapy.

Analysis of the survey results showed that 78% of the individuals who attempted to lose weight did not achieve a clinically meaningful loss of 5% or more of their body weight, while some actually weighed more afterward.

Exercise and restricted diet

Notably, while exercise and calorie-controlled or restricted diets were among the most popular weight-loss methods in U.K. participants, they were amongst the least successful strategies. For instance, while 26.5% of adults who controlled their diet said they had lost weight, 17.1% reported their weight had increased. For those who took part in an exercise program, 33.3% said they lost weight, but 15.5% said they gained weight.

Signing up for gym membership also scored poorly, with 27% shedding weight, compared with 32.4% who put weight on.

“Our survey results indicate that, while the majority of adults with obesity are actively trying to reduce their weight, using a variety of strategies, most are unsuccessful,” said Dr. Evans.

Further studies were needed to assess whether people who lose weight succeed in maintaining their weight loss, the authors said.

The conference posters have yet to be published in a journal but were peer reviewed by the ECO selection committee.

The studies were sponsored by Novo Nordisk, a researcher into and manufacturer of diabetes and obesity medications, and employer of several of the coauthors.

A version of this article first appeared on Medscape UK/Univadis.

Counting calories, joining a gym, and taking part in exercise programs are popular methods used by people in the United Kingdom who want to shed some pounds, but they seem to be fairly ineffective strategies, according to an investigation.

A survey of adults with obesity from six countries in western Europe found that most who set out to reduce a meaningful amount of weight failed in their attempt.

The preliminary results, presented in two posters at the European Congress on Obesity, underlined the need for better support and solutions for weight management, the authors suggested.

Marc Evans, MB, BCh, a consultant physician in diabetes and endocrinology, from University Hospital, Cardiff, Wales, who led the analysis, said that, “while obesity’s impact on health is well known, our finding that a sizable proportion of adults with obesity appear at elevated risk of hospitalization or surgery due to multiple underlying illnesses, undoubtedly adds a sense of urgency to tackling Europe’s growing obesity epidemic.”

The study, which also involved analytics consultancy firm Lane Clark & Peacock, conducted a cross-sectional survey of 1,850 adults. Of those 500 were from the UK, and the remainder from France, Germany, Italy, Spain, and Sweden.

All participants had a body mass index of 30 kg/m², or higher. More specifically, 56.3%; were classified as obesity class I, 26.8% obesity class II, and 16.9% obesity class III.
 

Obesity-related conditions

In total, 25.7% of participants reported no obesity-related health conditions, 28.4% had one condition, 19.6% had two, and 26.3% had three or more. The most common comorbidities were hypertension, dyslipidemia, and type 2 diabetes.

Overall, 78.6% of respondents reported having tried to lose weight in the previous year. Asked in a questionnaire about how they had tried to achieve this, the responses indicated that the most common strategies were:

• Calorie-controlled/restricted diet (71.9%)
• Exercise program course (21.9%)
• Pharmaceutical treatment/medication (12.3%)
• Joined a gym (12%)
• Digital health app (9.7%)

Among other participants, 8.1% said they had used alternative treatments, 7.6% a weight loss service, and 2.1% cognitive-behavioral therapy.

Analysis of the survey results showed that 78% of the individuals who attempted to lose weight did not achieve a clinically meaningful loss of 5% or more of their body weight, while some actually weighed more afterward.

Exercise and restricted diet

Notably, while exercise and calorie-controlled or restricted diets were among the most popular weight-loss methods in U.K. participants, they were amongst the least successful strategies. For instance, while 26.5% of adults who controlled their diet said they had lost weight, 17.1% reported their weight had increased. For those who took part in an exercise program, 33.3% said they lost weight, but 15.5% said they gained weight.

Signing up for gym membership also scored poorly, with 27% shedding weight, compared with 32.4% who put weight on.

“Our survey results indicate that, while the majority of adults with obesity are actively trying to reduce their weight, using a variety of strategies, most are unsuccessful,” said Dr. Evans.

Further studies were needed to assess whether people who lose weight succeed in maintaining their weight loss, the authors said.

The conference posters have yet to be published in a journal but were peer reviewed by the ECO selection committee.

The studies were sponsored by Novo Nordisk, a researcher into and manufacturer of diabetes and obesity medications, and employer of several of the coauthors.

A version of this article first appeared on Medscape UK/Univadis.

Counting calories, joining a gym, and taking part in exercise programs are popular methods used by people in the United Kingdom who want to shed some pounds, but they seem to be fairly ineffective strategies, according to an investigation.

A survey of adults with obesity from six countries in western Europe found that most who set out to reduce a meaningful amount of weight failed in their attempt.

The preliminary results, presented in two posters at the European Congress on Obesity, underlined the need for better support and solutions for weight management, the authors suggested.

Marc Evans, MB, BCh, a consultant physician in diabetes and endocrinology, from University Hospital, Cardiff, Wales, who led the analysis, said that, “while obesity’s impact on health is well known, our finding that a sizable proportion of adults with obesity appear at elevated risk of hospitalization or surgery due to multiple underlying illnesses, undoubtedly adds a sense of urgency to tackling Europe’s growing obesity epidemic.”

The study, which also involved analytics consultancy firm Lane Clark & Peacock, conducted a cross-sectional survey of 1,850 adults. Of those 500 were from the UK, and the remainder from France, Germany, Italy, Spain, and Sweden.

All participants had a body mass index of 30 kg/m², or higher. More specifically, 56.3%; were classified as obesity class I, 26.8% obesity class II, and 16.9% obesity class III.
 

Obesity-related conditions

In total, 25.7% of participants reported no obesity-related health conditions, 28.4% had one condition, 19.6% had two, and 26.3% had three or more. The most common comorbidities were hypertension, dyslipidemia, and type 2 diabetes.

Overall, 78.6% of respondents reported having tried to lose weight in the previous year. Asked in a questionnaire about how they had tried to achieve this, the responses indicated that the most common strategies were:

• Calorie-controlled/restricted diet (71.9%)
• Exercise program course (21.9%)
• Pharmaceutical treatment/medication (12.3%)
• Joined a gym (12%)
• Digital health app (9.7%)

Among other participants, 8.1% said they had used alternative treatments, 7.6% a weight loss service, and 2.1% cognitive-behavioral therapy.

Analysis of the survey results showed that 78% of the individuals who attempted to lose weight did not achieve a clinically meaningful loss of 5% or more of their body weight, while some actually weighed more afterward.

Exercise and restricted diet

Notably, while exercise and calorie-controlled or restricted diets were among the most popular weight-loss methods in U.K. participants, they were amongst the least successful strategies. For instance, while 26.5% of adults who controlled their diet said they had lost weight, 17.1% reported their weight had increased. For those who took part in an exercise program, 33.3% said they lost weight, but 15.5% said they gained weight.

Signing up for gym membership also scored poorly, with 27% shedding weight, compared with 32.4% who put weight on.

“Our survey results indicate that, while the majority of adults with obesity are actively trying to reduce their weight, using a variety of strategies, most are unsuccessful,” said Dr. Evans.

Further studies were needed to assess whether people who lose weight succeed in maintaining their weight loss, the authors said.

The conference posters have yet to be published in a journal but were peer reviewed by the ECO selection committee.

The studies were sponsored by Novo Nordisk, a researcher into and manufacturer of diabetes and obesity medications, and employer of several of the coauthors.

A version of this article first appeared on Medscape UK/Univadis.