Two Babies, 1948

Looking for Clues in Remissions of Childhood Obesity

Childhood obesity generates a lot of talk. But it might surprise you to learn how little we actually know about the natural history of this disease. And what little we know has been a bit discouraging. However, a new study by Danny Luan and colleagues offers some important new insight.

Remissions, Though Not Typical, Are Possible

Senior author Katherine Bauer explained:

We found that obesity is not something kids just grow out of by spurting up in height. But these findings suggest that hope is not lost.

Some children are able to experience remission even if they don’t participate in clinic-based weight management programs, which may be hard for some families to access. By continuing to understand children who experience obesity remission, we can identify creative ways to give children and families the support they need.

These researchers followed a total of 812 children with obesity in kindergarten for a total of eight years. Overall, about a third of them experienced at least some remission in obesity. And 22% of them had remissions that persisted through eighth grade.

They did not, however, find that any particular demographic characteristics predicted a higher likelihood of remission. Nor was there any correlation with spurts of growth in height. That debunks a popular myth that children can “grow out” of obesity just by getting taller. Nor did these children need to lose weight to have a remission.

What did predict a remission, though, was a slower rate of weight gain. Kids having a remission might gain one-half or one-third as much weight as their peers over a two year period.

Obesity in Infancy

In a similar vein, Charlotte Wright and colleagues studied the natural history of obesity in earlier childhood. They followed infants from three months to eight years of age.

Infants with obesity at three months were more likely than others to have it at eight years. But those infants with obesity did not account for the majority of eight-year-olds with obesity. Almost 80% of eight-year-olds with obesity didn’t have it as infants. And furthermore, half of them still didn’t have it when they were five.

Finally, Wright et al looked at infants with excess weight – but not obesity. And they found most of them (64%) returned to a weight in the normal range by the time they were eight.

Related to Wright’s findings, it’s interesting to note that Luan et al looked at birth weights as a predictor of obesity remissions. They found that low birth weights predicted lower odds for an obesity remission than moderate birthweights.

Bauer noted that “These two studies are very complimentary. Clearly not all children with high BMIs will continue to have obesity – regardless of the age at which you first identify obesity.”

Clearly, we have much more to learn about how childhood obesity progresses or goes into remission. But with better knowledge, we can provide better care.

Click here for the study by Luan et al and here for the study by  Wright et al.

Two Babies, 1948, photograph © Doc Searls / flickr

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August 7, 2018

One Response to “Looking for Clues in Remissions of Childhood Obesity”

  1. August 09, 2018 at 4:09 pm, Allen Browne said:

    Yup! Children are heterogeneous, dynamic and plastic. Within the natural history lies some important clues for both prevention and treatment of the disease of obesity.