Associations between obesity severity and medical comorbidities for children with obesity in low intensity hospital intervention

Abstract

Background: Childhood obesity has increased dramatically in the United States. Most available research has followed obesity prevalence with little attention to medical comorbidities, which could guide prevention and intervention.

Methods: A retrospective chart review examined 2038 children referred to a Pediatric Weight Management Clinic providing low intensity (<26 contact hours) intervention. Linear regression examined associations between obesity severity level (I, II, III) and blood pressure percentile scores (systolic, diastolic) while controlling for gender, age group, and ethnicity. Logistical regression examined associations between obesity severity level and five medical diagnoses (hypertension, type 2 diabetes, elevated ALT, hyperlipidemia, obstructive sleep apnea), again controlling for demographics.

Results: Results revealed that children with Class III obesity severity had significantly greater risk for five of the seven medical conditions examined, with higher systolic and diastolic blood pressure scores, and higher odds for hypertension, type 2 diabetes, and obstructive sleep apnea.

Conclusion: The US Preventive Services Task Force has documented the effectiveness of intensive behavioral interventions (>26 contact hours for changes in diet, exercise, screen time) for reducing obesity severity in children. Additional research is required to determine whether more intensive behavioral approaches should be added before a child's obesity reaches the Class III level of severity in order to prevent medical comorbidities.

Keywords: Child obesity; Diabetes; Hypertension; Obesity severity; Obstructive sleep apnea.