Rethinking the “Adiposity Rebound”

For decades, doctors and researchers have relied on a concept known as the “adiposity rebound” to help explain childhood growth patterns and predict future obesity risk. But new research is now challenging that long-standing belief, suggesting that the rise in body mass index (BMI) seen in early childhood may have far less to do with body fat than previously thought.

The findings, presented by Andrew Agbaje at the European Congress on Obesity and published in The Journal of Nutrition, argue that the so-called adiposity rebound may actually reflect healthy muscle and lean tissue development rather than an increase in fat mass.

What is the “adiposity rebound”?

The adiposity rebound theory dates back to 1984, when French researcher Marie Françoise Rolland-Cachera and colleagues described a predictable pattern in childhood BMI growth. Typically, BMI rises rapidly during infancy, declines through the preschool years, and then begins increasing again around ages 4 to 6. Researchers believed this second rise, the “rebound,” represented a return of body fat accumulation.

Over time, studies suggested that children who experienced this rebound earlier in life were more likely to develop obesity during adolescence and adulthood. As a result, the timing of adiposity rebound became widely discussed in pediatric health and obesity prevention. Many clinicians viewed an early rebound as a warning sign that could justify lifestyle interventions focused on diet, physical activity, and weight management.

Why researchers are questioning the theory

According to Prof. Agbaje, the problem may lie in relying too heavily on BMI as a measure of body fat. BMI is a simple calculation based on height and weight, but it cannot distinguish between fat, muscle, bone, and other lean tissues. This limitation has long been recognized in adults, especially among athletes or muscular people whose BMI may appear elevated despite having low body fat levels.

Dr. Agbaje argues that the same issue may exist in children. He says:

Puberty is a defining moment in human biology that alters the whole body, but adiposity rebound is not; it is a natural growth process unattached to any problem, whether it is early rebound or late. So the previous associations relating early BMI-based adiposity rebound to later life obesity are misleading analyses. Positive statistical associations do not always equate to biological plausibility.

New evidence points to lean mass growth

To explore what is really happening during early childhood growth, researchers examined data from 2,410 children and adolescents between ages 2 and 19 using information from the National Health and Nutrition Examination Survey (NHANES), dated 2021-2023.

Instead of focusing only on BMI, the study also analyzed waist circumference-to-height ratio (WHtR), which researchers say is a more accurate indicator of body fat distribution. The results showed a striking difference between BMI patterns and WHtR patterns.

While BMI followed the familiar trajectory, declining in early childhood before increasing again, WHtR continued to decrease for several years and never returned to the higher levels seen during toddlerhood. Researchers say this finding suggests that the BMI rebound is not actually driven by increasing fat mass. Instead, it may reflect healthy gains in muscle, lean tissue, and overall body development.

In other words, what many experts once viewed as a warning sign of obesity could actually represent a normal and beneficial stage of growth.

A “body composition reset”

Dr. Agbaje describes this period as a kind of “body composition reset” that helps prepare children for later stages of development. Rather than indicating excess fat gain, the increase in BMI after early childhood may simply reflect the body building strength, muscle mass, and lean tissue needed for continued growth.

This interpretation could dramatically change how clinicians view childhood BMI trends. For years, some interventions attempted to delay or alter adiposity rebound in hopes of reducing future obesity risk. However, Dr. Agbaje points to long-term clinical trials that found dietary interventions did not change the timing or pattern of BMI rebound. That may be because the process is not a disease mechanism at all.

The study also adds to growing discussions about the limitations of BMI as a health tool. Researchers increasingly argue that BMI alone may oversimplify body composition, especially in children whose bodies are constantly developing.

Waist-to-height ratio, by contrast, may provide a clearer picture of unhealthy fat accumulation because it focuses more directly on central body fat. Dr. Agbaje believes WHtR could become a more useful screening tool for identifying excess fat in children and adolescents moving forward.

What this could mean for parents and pediatricians

The findings do not suggest that childhood obesity is unimportant or that healthy lifestyle habits should be ignored. Instead, the research highlights the importance of accurately understanding normal growth and avoiding unnecessary concern over biological processes that may simply reflect healthy development.

If future studies confirm these findings, it could reshape how pediatricians evaluate childhood growth patterns and obesity risk. Rather than treating early BMI rebounds as a condition requiring intervention, experts may begin focusing more on overall body composition, activity levels, nutrition quality, and long-term metabolic health.

Your responses and feedback are welcome!

Source: “Scientists Say a 40-Year-Old Childhood Obesity Warning May Be Completely Wrong,” SciTechDaily, 5/15/26
Source: “Early Adiposity Rebound and the Risk of Adult Obesity,” AAP.org, 3/1/98
Source: “Effects of 20-year infancy-onset dietary counselling on cardiometabolic risk factors in the Special Turku Coronary Risk Factor Intervention Project (STRIP): 6-year post-intervention follow-up,” The Lancet, May 2020
Source: “Waist-circumference-to-height-ratio had better longitudinal agreement with DEXA-measured fat mass than BMI in 7237 children,” Nature.com, 3/5/24
Source: “Adiposity Rebound or Fat-Free Mass Anabolism in Children—Challenging a 42-Year-Old BMI Puzzle with Waist-to-Height Ratio: The ASNF-NNF 2025 Inaugural Flemming Quaade Award for Innovation in Childhood Obesity Lecture,” The Journal of Nutrition, May 2026
Image by Los Muertos Crew/Pexels

Cherished Belief Bites the Dust — Or Not

Bats are blind; seeing red infuriates a bull; freezing prolongs battery life; rice can dry out a wet cell phone? No way.

When Columbus set sail, people believed the Earth was flat, and the Jonestown Massacre victims were killed by poisoned Kool-Aid. Nope.

Does marijuana cause users to “get the munchies” and consequently grow obese? It ain’t necessarily so, because grass “could actually have surprising effects on your waistline,” as Lester Black recently reported for SFGATE.

This news emerged from work done at the University of California, Riverside. The subjects of these experiments were not humans, but mice, whose metabolisms were remarkably affected by ingesting concentrated cannabis oil, with results that included weight loss.

Say whut?

Prof. Nicholas DiPatrizio led a team in tinkering with molecules, as researchers will often do in efforts to bend nature to our will. They obtained results that encouraged them to believe this is only the beginning of a totally unexpected series of beneficial discoveries.

At first, this all sounds as heretical as believing that the sun rises in the west. Everyone knows the correct answer is east.

But it only rises in the east because humans decided to give that name to the sunrise side of the sky. If we had named it “west” instead, that is where the sun would absolutely rise.

Only, it doesn’t rise at all. That is only another myth, one that was eventually debunked when people finally figured that the sun stays in relatively the same place, while the Earth actually revolves. In defining scientific truth, many factors are involved.

Anyway, the scholars obtained some obese mice and divided them into two teams. Some were fed an isolated form of THC, while others received cannabis oil containing “a broad spectrum of cannabis compounds.”

Head to head

Both teams lost some weight, but “the outcomes differed noticeably on other metabolic functions.” The THC mice “still had impaired metabolic function that mirrored diabetes.” The cannabis oil mice “saw their metabolic function return to normal.”

Obviously, much work remains to be done, but the expectation exists that “targeting this widespread system could unlock new therapies.” Some products are already on the market, resulting from earlier work done by other researchers. For example,

Tetrahydrocannabivarin, a natural cannabis compound shortened to THCV, has been shown to cause reduced appetite and increased stimulation.

Of course, Dr. DiPatrizio’s team specifies, just because a new discovery looks promising when tested on animals, there are no guarantees about eventual human benefit. No guarantees, but plenty of hope that obesity and/or diabetes in humans will eventually be defeated by new discoveries. Meanwhile, the scientists involved in the quest are feeling the intoxication that may match or exceed any sensation available from cannabis.

Are they a bunch of deluded hallucinators? Not hardly! According to a recent Cleveland Clinic page, medical marijuana is already in use for more than 20 medical conditions, including Alzheimer’s disease, cancer, fibromyalgia, multiple sclerosis, glaucoma, Tourette syndrome, intractable pain, and the list goes on.

Many questions remain about why cannabinoids can do what they do, and also why different people react in unexpected ways. Factors include age, genetic predisposition, gender, dosage, method of consumption, possible conflict with other meds, and more.

But the verdict so far is that the gains outweigh the difficulties. Another problem, of course, is getting the law on the appropriate side of any issues that are involved.

Your responses and feedback are welcome!

Source: “15 Common Science Myths and Misconceptions — Busted,” RD.com, undated
Source: “13 Widely Believed History Myths,” BuzzFeed.com, 3/23/26
Source: “New Calif. study finds evidence cannabis could treat obesity, diabetes,” SFGATE.com, 05/14/26
Image by Erin Hinterland/Pixabay

CDC Updates Its Childhood Obesity Facts

Last week, the Centers for Disease Control and Prevention (CDC) released its childhood obesity facts, updated with some recent research data. While there are no shocking revelations to be glimpsed, especially by the readers of this blog, it’s always useful to try seeing the big picture backed up by reliable research. The numbers reveal a growing issue that touches nearly every part of society. No big surprise there, either. Here are some highlights (or, shall we say, lowlights).

Obesity in numbers

Between 2017 and March 2020, obesity affected 19.7% of children and adolescents in the United States. That translates to approximately 14.7 million young people between the ages of 2 and 19. For children, obesity is measured using Body Mass Index (BMI), with obesity defined as having a BMI at or above the 95th percentile for a child’s age and sex.

The climbing rates

One of the most concerning trends is how obesity rates increase as children get older. Among children ages 2 to 5, the obesity rate was 12.7%. However, the percentage climbed significantly among older age groups, reaching 20.7% for children ages 6 to 11 and 22.2% for adolescents ages 12 to 19. These statistics suggest that unhealthy habits and lifestyle challenges may intensify as children grow older, making early intervention especially important.

Racial and ethnic disparities

The data also highlights major disparities among racial and ethnic groups. Hispanic children experienced the highest obesity prevalence at 26.2%, followed closely by non-Hispanic Black children at 24.8%. In comparison, obesity rates were 16.6% among non-Hispanic white children and 9.0% among non-Hispanic Asian children. These differences point to broader social and environmental factors that can influence access to nutritious food, safe places to exercise, healthcare resources, and education about healthy living.

Obesity by gender

Gender differences also appear within these statistics. Among girls, obesity rates were highest in non-Hispanic Black girls, with nearly one-third affected. Among boys, Hispanic boys experienced the highest obesity prevalence at 29.3%. These patterns demonstrate that childhood obesity does not affect all groups equally and that targeted community-based solutions may be necessary.

Family income

Family income plays a significant role as well. Children from lower-income households were more likely to experience obesity than those from higher-income families. Obesity affected 25.8% of children living at or below 130% of the Federal Poverty Level, compared to just 11.5% of children from families earning more than 350% of the poverty level. Financial limitations can make it harder for families to purchase healthier foods, participate in recreational activities, or access preventive healthcare services.

Healthcare costs

Beyond the physical health concerns, childhood obesity also creates a major financial burden. Healthcare costs related to obesity among U.S. children reached an estimated $1.3 billion annually in 2019 dollars. On average, children with obesity incurred $116 more in medical expenses each year compared to children with healthy weight. For children with severe obesity, those costs rose to $310 more per year. These expenses reflect increased medical visits, treatments, and long-term health risks associated with obesity-related conditions.

It takes a village

Addressing childhood obesity requires a collaborative effort from families, schools, healthcare systems, and policymakers. Encouraging healthy eating habits, increasing opportunities for physical activity, improving access to affordable nutritious foods, and supporting preventive healthcare can all play a role in reducing obesity rates. While the statistics are serious, they also provide an opportunity to focus on meaningful solutions that can improve the health and well-being of future generations.

Your responses and feedback are welcome!

Source: “Childhood Obesity Facts,” CDC, 5/6/26
Source: “National Health and Nutrition Examination Survey 2017–March 2020 prepandemic data files development of files and prevalence estimates for selected health outcomes,” National Health Statistics Report, 2021
Source: “Association of body mass index with health care expenditures in the United States by age and sex,” PLOS One, 3/24/21
Image by U.S. Centers for Disease Control and Prevention, via Wikimedia Commons/Public Domain

GLP-1 Coverage Cuts by Medicaid

As demand for GLP-1 medications continues to surge across the United States, a growing number of states are reevaluating whether they can afford to cover these drugs for obesity treatment under Medicaid. Recent proposals in Massachusetts and Rhode Island highlight a broader national trend: balancing access to innovative but expensive therapies with the realities of state budgets.

A shrinking list of states offering coverage

Just a year ago, 16 state Medicaid programs covered GLP-1 medications specifically for weight loss. That number has now dropped to 13. States like California, New Hampshire, Pennsylvania, and South Carolina have already eliminated this benefit, citing unsustainable costs.

GLP-1 drugs, originally developed for diabetes management, have gained widespread attention for their effectiveness in promoting weight loss. However, their high price tag has made them a significant financial burden for publicly funded programs like Medicaid.

Proposed changes in Massachusetts and Rhode Island

In Massachusetts, Governor Maura Healey’s proposed fiscal 2028 budget would remove coverage of GLP-1 drugs for weight loss under MassHealth, the state’s Medicaid program. Importantly, coverage would remain intact for patients using these medications to treat diabetes or other medical conditions. The proposal is still under legislative review, leaving room for potential revisions.

Similarly, Rhode Island’s governor has proposed eliminating Medicaid coverage for GLP-1 medications when prescribed solely for obesity treatment. These decisions reflect a growing concern among policymakers: how to prioritize limited healthcare dollars while still addressing widespread chronic conditions.

Despite these cutbacks, several states continue to provide coverage for GLP-1 drugs for obesity. These include Delaware, Kansas, Michigan, Minnesota, Mississippi, Missouri, Tennessee, Utah, Virginia, and Wisconsin.

However, even among these states, access is often limited. For example, Michigan has restricted eligibility to patients with morbid obesity, excluding those who are overweight or moderately obese. This policy adjustment alone is projected to save the state an estimated $240 million, illustrating the scale of financial pressure these medications create.

Louisiana’s ongoing debate

In Louisiana, lawmakers are considering a middle-ground approach. Rather than offering broad coverage, the state may allow Medicaid to cover GLP-1 medications for obesity only when patients also have a related chronic condition, such as prediabetes, hypertension, or cardiovascular disease.

This strategy aims to target patients at the highest risk while controlling costs, but it also raises questions about equity and early intervention. Should treatment be limited to those already experiencing complications, or should it be expanded to prevent them?

The cost challenge

The financial strain driving these decisions is substantial. Medicaid spending on GLP-1 prescriptions (covering both diabetes and weight loss) has skyrocketed from about $1 billion in 2019 to nearly $9 billion in 2024, according to KFF.

For those without insurance, affordability remains a major barrier. In response, Novo Nordisk announced plans to lower the list price of its GLP-1 medications to $675 per month by 2027. While this reduction may improve access, it is still a significant expense for many patients and for state-funded programs.

High need, limited access

The debate over GLP-1 coverage comes at a time when obesity rates remain high. Nearly 40% of adults and about 25% of children enrolled in Medicaid have obesity, suggesting a large population could potentially benefit from these medications. Yet, as states tighten coverage, a pattern emerges: Innovative treatments are becoming more effective and more popular, but not necessarily more accessible.

The kids are also affected

As Philadelphia’s WHYY reported, the Children’s Hospital of Philadelphia (CHOP) did some research about the coverage specifically for children:

CHOP researchers found that only a fraction of eligible kids ultimately get a GLP-1 prescription. Even after they do, families struggle with cost and insurance coverage issues that make it hard for their children to stay on the medication.

Side effects and gaps in follow-up care are also causing disruptions in medication use, according to CHOP’s findings, recently published in the journal Pediatrics.

Looking ahead

The future of GLP-1 coverage under Medicaid is far from settled. As more states weigh the costs and benefits, policies will likely continue to evolve, creating a patchwork system where access depends heavily on geography.

For patients, providers, and policymakers alike, the challenge is clear: how to expand access to life-changing treatments without overwhelming already stretched healthcare budgets. Whether through pricing reforms, eligibility adjustments, or alternative treatment strategies, the decisions made today will shape obesity care for years to come.

Your responses and feedback are welcome!

Source: “Philly pediatricians are using GLP-1 drugs to treat childhood obesity, but cost can be a major barrier, CHOP doctors find,” WHYY, 5/4/26
Source: “Only 13 States’s Medicaid Still Cover GLP-1 Drugs to Treat Obesity, and More Are Dropping Out,” FlaglerLive.com, 4/30/26
Source: “Rhode Island considers ending Medicaid coverage of GLP-1 drugs for weight loss,” Rhode Island Current, 6/10/25
Source: “Louisiana Medicaid might add coverage for popular obesity treatment drugs,” Louisiana Illuminator, 4/16/26
Source: “Medicaid Coverage of and Spending on GLP-1s,” KFF, 1/16/26
Image by SHVETS production/Pexels