Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comment
. 2025 Mar 1;179(3):302-309.
doi: 10.1001/jamapediatrics.2024.5552.

Effect of Pediatric Obesity Treatment on Long-Term Health

Resthie R Putri  1 , Pernilla Danielsson  1 , Nils Ekström  2 , Åsa Ericsson  2 , Louise Lindberg  1 , Claude Marcus  1 , Emilia Hagman  1
Affiliations
Comment

Effect of Pediatric Obesity Treatment on Long-Term Health

Resthie R Putri et al. JAMA Pediatr. .

Abstract

Importance: Data regarding the long-term impact of treating childhood obesity on the risk of obesity-related events, including premature mortality, are limited.

Objective: To evaluate the long-term effect of different responses to pediatric obesity treatment on critical health outcomes in young adulthood.

Design, setting, and participants: The study included a dynamic prospective cohort of children and adolescents with obesity within The Swedish Childhood Obesity Treatment Register (BORIS) and general population comparators, linked with national registers. Baseline data were collected between 1996 and 2019. Formal analyses for this study was conducted in 2023. Outcomes were assessed from individuals aged 18 to 30 years (2005 to 2020). Participants included children and adolescents aged 6 to 17 years receiving at least 1 year of obesity treatment. General population comparators were matched on a ratio of 1:5 on sex, year of birth, and geographical area.

Exposure: Pediatric obesity treatment response was based on changes in body mass index standard deviation score and categorized as poor, intermediate, and good response and obesity remission.

Main outcomes: Obesity-related events included type 2 diabetes (T2D), dyslipidemia, hypertension, depression or anxiety, and weight-loss bariatric surgery. Additionally, mortality was assessed.

Results: Of 6713 individuals (3777 male [56%] and 2936 female [44%]), the median age at obesity treatment initiation was 12.1 (quartile 1; quartile 3: 10.1; 14.3) years and treatment duration was 3.0 (1.8; 4.9) years. For T2D, hypertension, dyslipidemia, weight-loss bariatric surgery, and depression or anxiety outcomes, unadjusted incidence rates tended to decrease with better treatment response and the lowest estimate was observed among general population comparators. Compared with poor response, obesity remission or a good response in obesity treatment was associated with reduced risk of mortality (adjusted hazard ratio [HR], 0.12; 95% CI, 0.03-0.46). Good response was also associated with lower risk of TD2 (HR, 0.42; 95% CI, 0.23-0.77), dyslipidemia (HR, 0.31; 95% CI, 0.13-0.75), and bariatric surgery (HR, 0.42; 95% CI, 0.30-0.58). Obesity remission showed similar reduced risk, but also a reduced risk of hypertension (HR, 0.40; 95% CI, 0.24-0.65). Treatment response was not associated with depression or anxiety.

Conclusions and relevance: In this study, beneficial pediatric obesity treatment response yielded enduring health benefits, markedly lowering future morbidity and mortality risks in young adulthood.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest Disclosures: Dr Putri reported research and medical writing assistance from Novo Nordisk during the conduct of the study. Dr Danielsson reported research and medical writing assistance from Novo Nordisk during the conduct of the study. Dr Ekström reported stock ownership and employment from Novo Nordisk and stock ownership from Eli Lilly outside the submitted work. Dr Lindberg reported research and medical writing assistance from Novo Nordisk during the conduct of the study and employment and holding share rights from Evira AB. Dr Marcus reported research and medical writing assistance from Novo Nordisk during the conduct of this study; and chairman and shareholder in Evira AB. Dr Hagman reported research and medical writing assistance from Novo Nordisk during the conduct of the study and personal fees from Novo Nordisk outside the submitted work. No other disclosures were reported.

Figures

Figure 1.
Figure 1.. Study Design Schematic
BORIS indicates Swedish Childhood Obesity Treatment Register.
Figure 2.
Figure 2.. Participant Flow of the Inclusion and Exclusion Process
BORIS indicates Swedish Childhood Obesity Treatment Register.
See this image and copyright information in PMC

Comment on

References

    1. NCD Risk Factor Collaboration (NCD-RisC) . Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. Lancet. 2017;390(10113):2627-2642. doi:10.1016/S0140-6736(17)32129-3 - DOI - PMC - PubMed
    1. World Obesity Federation Global Obesity Observatory . World Obesity Atlas 2023. Accessed December 10, 2024. https://data.worldobesity.org/publications/?cat=19
    1. Hagman E, Ek AE, Marcus C. Insulin function in obese children within the low and high ranges of impaired fasting glycemia. Pediatr Diabetes. 2019;20(2):160-165. - PubMed
    1. Hagman E, Danielsson P, Elimam A, Marcus C. The effect of weight loss and weight gain on blood pressure in children and adolescents with obesity. Int J Obes (Lond). 2019;43(10):1988-1994. doi:10.1038/s41366-019-0384-2 - DOI - PubMed
    1. Hagman E, Reinehr T, Kowalski J, Ekbom A, Marcus C, Holl RW. Impaired fasting glucose prevalence in two nationwide cohorts of obese children and adolescents. Int J Obes (Lond). 2014;38(1):40-45. doi:10.1038/ijo.2013.124 - DOI - PMC - PubMed

MeSH terms