What Your Weight History Says About Your Future

Obesity as a teen increased health risks for obese adults seeking bariatric surgery

(RxWiki News) Being severely obese as an adult already presents various health concerns. Yet obese adults with a long history of being overweight may face greater challenges.

A recent study found that obese adults who had been obese, or even overweight, at age 18 had a higher risk of various health conditions than those who had been a healthy weight at 18.

Among the increased health risks that obese teens experienced as obese adults were abnormal kidney function and, in women, polycystic ovary syndrome.

They were also at higher risk for diabetes, obstructive sleep apnea, high blood pressure, walking limitations and a condition involving fluid swelling in the legs.

These increased risks were found in a study group preparing to undergo bariatric surgery for their obesity.

"Ask your doctor for help addressing your obesity."

This study, led by Thomas H. Inge, MD, PhD, of the Department of Pediatrics and Pediatric Surgery at Cincinnati Children’s Hospital Medical Center, looked at whether being obese as a teen influenced a person's health in adulthood.

The researchers included in the study 1,502 adults, with an average age of 47, who were about to undergo bariatric surgery for obesity. The average body mass index (BMI) of the participants was 46.

BMI is a ratio of a person's height to weight and is used to determine how healthy a person's weight is. A person with a BMI between 18.5 and 25 is considered of a normal weight while overweight is between 25 and 30.

A person with "class 1 obesity" has a BMI between 30 and 35, while "class 2 obesity" means a BMI between 35 and 40, and "class 3" means a BMI greater than 40.

The participants provided their height and weight at age 18, which researchers compared along with their risk of having other health conditions at the time of surgery.

As 18-year-olds, 42 percent of the participants had been a normal, healthy weight while 29 percent were overweight and 29 percent had been obese.

Those who were obese included the 16 percent who were class 1 obese and the 13 percent who were class 2 obese or greater.

The researchers found that those who had been class 2 obese or greater at age 18 were more likely to have a range of complicating conditions as adults than those who had a healthy weight at 18.

Class 2 obese 18-year-olds were more than five times more likely than healthy weight 18-year-olds to have a condition called "lower-extremity venous edema" in adulthood.

This condition refers to a collection of fluid in a person's legs, feet and ankles, also causing skin ulcers, because the veins have been damaged and cannot pump enough blood up to the heart.

Compared to adults who had a healthy weight at age 18, those who had been class 2 obese at 18 were:

  • More than four times more likely to have severe limitations in walking and to have abnormal kidney function;
  • 74 percent more likely to have polycystic ovary syndrome;
  • 48 percent more likely to have asthma in adulthood;
  • 42 percent more likely to have diabetes;
  • 25 percent more likely to have obstructive sleep apnea and high blood pressure.

These various increased health risks also existed for obese adults who had been class 1 obese as teenagers, though not with as high a risk as those who had been class 2 obese.

For example, venous edema was three times as likely among adults who had been class 1 obese as teens compared to those who had been a normal weight at 18.

Abnormal kidney function, polycystic ovary syndrome, diabetes, obstructive sleep apnea and high blood pressure were also more likely among those with class 1 obesity at age 18 than those with a healthy weight at 18.

Even overweight 18-year-olds who sought bariatric surgery as obese adults were more than twice as likely to have venous edema or walking limitations than those who had been a healthy weight at 18.

The researchers therefore concluded that an obese person's health conditions in middle adulthood were significantly influenced by their level of obesity as an older teenager.

This study was published November 18 in the journal Pediatrics. The research was funded by the National Institute of Diabetes and Digestive and Kidney Diseases.

One author has received a J&J Ethicon Endosurgery Research Grant, one received a Covidien educational grant and one received an honorarium from the Society for Surgery of the Alimentary Tract. Another author has consulted for and served on the scientific advisory board for J&J Ethicon Endosurgery.

Review Date: 
November 17, 2013