A “Strong” Study Looks at Pediatric Obesity Treatment

Children who respond positively to pediatric obesity treatment show significantly lower risks of health problems and early death in young adulthood, according to a study published on January 21 in JAMA Pediatrics.

The gist of the study

Led by Resthie R. Putri, Ph.D., and a team from the Karolinska Institutet in Stockholm, Sweden, the researchers analyzed data from 6,713 children and adolescents with obesity, drawn from Sweden’s Childhood Obesity Treatment Register (BORIS) and compared them to general population data. The study used baseline information collected between 1996 and 2019 and analyzed outcomes in 2023.

Study’s results

The study tracked health outcomes for young adults, ages 18-30, from 2005 to 2020. The participants included children aged 6-17 who had received at least one year of obesity treatment. These individuals were compared to a group from the general population matched for sex, birth year, and geographic location.

The research team categorized the participants’ responses to obesity treatment based on changes in their body mass index (BMI) standard deviation scores. These categories included poor, intermediate, good, or remission of obesity. Health outcomes in young adulthood that were assessed included type 2 diabetes, dyslipidemia, hypertension, depression or anxiety, and the need for bariatric surgery.

The findings showed that compared to a poor treatment response, those who achieved obesity remission or had a good treatment response were at much lower risk for early death. Additionally, a good response was linked to a lower likelihood of developing type 2 diabetes, dyslipidemia, and requiring bariatric surgery. Only the remission group showed a reduced risk for hypertension. However, treatment response did not appear to influence the risk of depression or anxiety, a noteworthy observation as it suggests that these mental health conditions need to be addressed separately from obesity.

The study’s large sample size and Sweden’s universal healthcare system, which facilitated continuous data tracking, were key strengths. The authors noted that the results may not be applicable to other countries, as the study’s findings are based on Swedish data.

The commentary

One of the study’s authors, Emilia Hagman, who is a principal researcher at the Department of Clinical Science, Intervention and Technology, Karolinska Institutet, commented:

The results are very good news. Whether or not the treatment of obesity in childhood has long-term health benefits has been debated, since weight-loss is hard to maintain… This emphasizes the importance of providing early treatment, as we know that timely intervention increases the likelihood of success and helps mitigate the long-term health risks associated with obesity.

In an accompanying commentary, Leonard H. Epstein, Ph.D., and colleagues praised the study for its robust design and the insights it offers into how much weight change is needed for significant health improvements, which could inform future treatment guidelines. However, they pointed out that the study didn’t specify the types or intensity of treatment provided to the children, which makes it difficult to compare with U.S. guidelines from the American Academy of Pediatrics (AAP).

The commentary also highlighted a key finding: Younger children (ages 6-11) had a higher rate of achieving good responses or remission compared to adolescents (ages 12-17). This suggests that earlier intervention in childhood may lead to better outcomes, emphasizing the importance of starting obesity treatment early rather than waiting to see if the child will “outgrow” the condition.

The bottom line

The study also found no strong connection between obesity treatment response and anxiety or depression, thus suggesting that these conditions should be treated independently of obesity. The study provides important evidence on how pediatric obesity treatment affects long-term health, including risks for cardiometabolic diseases, the need for bariatric surgery, and even mortality. This information is vital for refining clinical guidelines and improving obesity treatment strategies.

Your responses and feedback are welcome!

Source: “Successful Pediatric Obesity Treatment Linked With Long-Term Health,” Medscape, 1/22/25
Source: “Effect of Pediatric Obesity Treatment on Long-Term Health,” JAMA Network, 1/21/25
Source: “Weight-loss treatment for children with obesity has lasting effects, finds study,” MedicalXPress, 1/21/25
Image by Ketut Subiyanto/Pexels

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About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
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Presentations

Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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