A Narrative Review of Medical and Genetic Risk Factors among Children Age 5 and Younger with Severe Obesity

Abstract

Severe obesity defined as an age- and gender-specific body mass index ≥120% of the 95th percentile in children younger than 5 years is well recognized as a significant challenge for prevention and treatment. This article provides an overview of the prevalence, classification of obesity severity, patterns of weight gain trajectory, medical and genetic risk factors, and comorbid disorders among young children with an emphasis on severe obesity. Studies suggest rapid weight gain trajectory in infancy, maternal smoking, maternal gestational diabetes, and genetic conditions are associated with an increased risk for severe obesity in early childhood. Among populations of young children with severe obesity seeking care, co-morbid conditions such as dyslipidemia and fatty liver disease are present and families report behavioral concerns and developmental delays. Children with severe obesity by age 5 represent a vulnerable population of children at high medical risk and need to be identified early and appropriately managed.

Keywords: genetics; medical complications; risk factors; severe obesity; young children.

Figure 1.

(A, B). Weight Trajectories. These graphs depict the weight trajectory of a child with early-onset obesity. Charts obtained from the U.S. Centers for Disease Control and Prevention (www.cdc.gov/growthcharts).⁴ *Note the child crosses percentile bands before 1 year of age (Fig. A), with continued accelerated BMI trajectory after 2 years of age (Fig. B). BMI, body mass index.

Figure 1.

(A, B). Weight Trajectories. These graphs depict the weight trajectory of a child with early-onset obesity. Charts obtained from the U.S. Centers for Disease Control and Prevention (www.cdc.gov/growthcharts).⁴ *Note the child crosses percentile bands before 1 year of age (Fig. A), with continued accelerated BMI trajectory after 2 years of age (Fig. B). BMI, body mass index.