Very few children with obesity transition to a healthy weight, finds study

More children with overweight move to a healthier weight over two years than do children with obesity, according to a study published online Sept. 20 in PLOS ONE.

Byron A. Foster, M.D., from the Oregon Health & Science University in Portland, and colleagues examined weight trajectories for school-aged children with a focus on obesity remission. The analysis included 11,247 children (6 to 11 years of age) with three or more valid height and weight measurements from an Oregon hospital system during Jan. 1, 2015, through Sept. 30, 2020, followed for a median of 2.1 years.

The researchers found that 14.4 percent of children were classified as overweight and 16.0 percent as obese. During follow-up, 1 percent of participants with obesity experienced remission, while 23 percent of those with overweight moved to within a healthy weight range. Three classes (flat trajectory, flat trajectory with a different intercept, flat then upward trajectory) within each weight-based stratum were identified over time.

Most children with overweight or obesity had a flat trajectory over time. A worsening trajectory was associated with lower socioeconomic status. Models using different adiposity metrics (body mass index [BMI], BMI z-scores, tri-ponderal mass index) differed substantially from each other.

"Further weight trajectory modeling work using distance from the median with longer periods of follow-up and incorporating additional clinical indicators in addition to BMI to characterize metabolic health are warranted using these types of data," the authors write.

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