Severe Childhood Obesity: A Ticking Clock

Children are our future, and their health is paramount. However, the increasing prevalence of childhood obesity presents a rising threat to their health. Recent studies reveal concerning findings, emphasizing the significant consequences of severe childhood obesity and its potential to markedly reduce life expectancy (1^✔ ✔Trusted Source
Association of childhood obesity with risk of early all-cause and cause-specific mortality: A Swedish prospective cohort study

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Understanding BMI and BMI Z-scores

Body Mass Index (BMI) is a widely used measure to assess body weight relative to height. In children and adolescents, BMI is interpreted using BMI Z-scores, which indicate how a child’s BMI deviates from the average BMI for their age and sex. BMI Z-scores are typically used for individuals aged 2 to 19 years (2^✔ ✔Trusted Source
Will Rising Childhood Obesity Decrease U.S. Life Expectancy?

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BMI Z-score Ranges

• Normal Weight (BMI Z-score = 0): Indicates a weight that is considered healthy for a child’s age and height.
• Overweight (BMI Z-score = 1 to 1.9): Indicates a weight above the healthy range but not yet obese.
• Obese (BMI Z-score = 2 to 2.9): Indicates a weight that falls into the obesity range.
• Severe Obesity (BMI Z-score ≥ 3): Indicates a weight significantly above the obesity threshold, posing serious health risks.

For example, a 4-year-old boy with an average height of 103 cm and a "normal" weight of about 16.5 kg will have a BMI Z-score of 0. A boy of the same age and height who weighs 19.5 kg will have a BMI Z-score of 2, and one who weighs 22.7 kg will have a BMI Z-score of 3.5, indicating severe obesity.

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The Impact of Childhood Obesity on Life Expectancy

Profound Impact of Early Onset Severe Obesity

Recent research presented at the European Congress on Obesity (ECO) has shown that severe obesity in childhood can drastically reduce life expectancy. The study, conducted by Stradoo GmbH and supported by Rhythm Pharmaceuticals, quantified for the first time the impact of age of onset, severity, and duration of childhood obesity on long-term health outcomes.

Severe Obesity Defined: BMI Z-score of 3 or More

Severe obesity in children is characterized by a BMI Z-score of 3 or more. This metric indicates that the child’s BMI is significantly above the average for their age and sex. For example, a 4-year-old boy with an average height of 103 cm who weighs 22.7 kg will have a BMI Z-score of 3.5, which is well into the severe obesity range.

Halving of Life Expectancy

The findings are particularly alarming for children who develop severe obesity at a very young age. The research indicates that for example if a child with a BMI Z-score of 3.5 at age 4 who does not lose weight is projected to have a life expectancy of just 39 years. This represents a reduction of approximately half the average life expectancy, which is around 80 years for the general population.

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Risk Accumulation and Co-morbidities

Duration and Irreversible Risk Accumulation

The duration of obesity plays a crucial role in the severity of long-term health outcomes. Prolonged obesity leads to irreversible risk accumulation, meaning that the health damage caused by severe obesity persists even if the child later loses weight. This highlights the importance of early intervention to prevent the development and continuation of severe obesity.

Increased Likelihood of Co-morbidities

Children with severe obesity are at a significantly higher risk of developing serious health conditions. For instance, a child with a BMI Z-score of 3.5 at age 4 has a 27% chance of developing type 2 diabetes (T2D) by age 25 and a 45% chance by age 35. In comparison, a child with a BMI Z-score of 2 has a 6.5% chance of developing T2D by age 25 and a 22% chance by age 35. The increased risk of T2D, along with other co-morbidities such as cardiovascular disease and fatty liver disease, contributes to the significant reduction in life expectancy.

The Role of Weight Loss

Effect of Early Weight Loss

The research highlights that weight loss, particularly at an early age, can significantly improve life expectancy and reduce the risk of developing co-morbidities. For example, a child with a BMI Z-score of 4 at age 4 who reduces their BMI Z-score to 2 by age 6 can increase their life expectancy from 37 to 64 years and reduce their risk of developing T2D by age 35 from 55% to 29%.

Importance of Early Intervention

Early intervention is crucial for mitigating the long-term health impacts of childhood obesity. Delaying treatment until the development of co-morbidities like T2D or high blood pressure reduces the effectiveness of interventions and can lead to irreversible health damage.

In conclusion, Childhood obesity, especially severe obesity, is a growing public health concern. By understanding the dramatic impact it has on life expectancy and the importance of early intervention, we can take steps to promote healthy weight management in children and ensure they live long and healthy lives.

References:

1. Association of childhood obesity with risk of early all-cause and cause-specific mortality: A Swedish prospective cohort study - (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7080224/)
2. Will Rising Childhood Obesity Decrease U.S. Life Expectancy? - (https://www.prb.org/resources/will-rising-childhood-obesity-decrease-u-s-life-expectancy/)

Source-Medindia