Half of Youth in Obesity Care Have High Blood Pressure

Mother and ChildrenA new study in the Journal of Clinical Hypertension tells us that roughly half of youth seeking obesity care have high blood pressure. This medical fact puts us squarely in the middle of a sensitive subject that arouses strong emotions. These emotions have their roots in the bias attached to obesity and the stigma that children and their parents experience as a result.

In fact, bias, stigma, and the strong emotions in play serve to magnify the medical problems of these children and can get in the way of addressing them.

The POWER Working Group

The new data on high blood pressure in youth seeking obesity care comes from POWER – the Pediatric Obesity Weight Evaluation Registry. The POWER working group collects data from 28 sites providing pediatric obesity care. So it serves as a rich sources of data for research and quality improvement.

Helen Binns and colleagues analyzed data from 7,943 youth aged 3 to 17 years. Non-Hispanic White children were 39 percent of the sample. Hispanic children comprised 32 percent. Black non-Hispanic children were 19 percent.

Overall, 49 percent of these youth had high blood pressure at their first visit for obesity care. Children with class 3 (severe) obesity made up 37 percent of this sample. They were at the highest risk of high blood pressure – 60 percent of them had it on their first visit.

In fact, the best predictors for high blood pressure were severe obesity, older age, and being male.


The fact is that hypertension is consistently underdiagnosed in children, even though it is becoming more common. Of course, rising obesity prevalence is contributing to the rising prevalence of pediatric hypertension.

In the POWER study sample, the prevalence of high blood pressure was higher than reported in general population samples of children with obesity. This may be because hypertension can be a reason for referring to obesity care. In any event, Binns et al write that these new findings make “assessment and management of BP a key area of focus for PWM [pediatric weight management] programs.”

Meeting Both Medical and Psychological Needs

Clearly, the medical needs of youth seeking obesity care are important. Addressing them fully means that clinicians also have to pay attention to the psychological needs of these patients. Because if they do not, the bias, stigma, and bullying that youth with obesity experience can get in the way of care or even magnify the medical needs, as Andrea Haqq and colleagues described in a recent publication.

Sara Armstrong is a pediatrics professor and director of an obesity care program at Duke University. She explains why meeting both medical and psychological needs in pediatric obesity care is important:

“Weight bias has been shown to decrease the willingness of people to seek care when they need it.  Missing those visits because of a stigma is an important consequence that we need to think about.”

The rising prevalence of high blood pressure in kids because of obesity makes it clear. The medical need for obesity care is real. To deliver that care and achieve good outcomes requires addressing the psychological needs, too.

Click here for the new study by Binns et al, here for the paper by Haqq et al, and here for further perspective.

Mother and Children, painting by Max Weber / WikiArt

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March 12, 2022

2 Responses to “Half of Youth in Obesity Care Have High Blood Pressure”

  1. March 13, 2022 at 1:31 pm, Richard Atkinson said:

    Yet, according to the Wall St Journal, there are “woke” people, including physicians, who recommend that patients not be weighed because it may “trigger them.” When will obesity ever be treated like a real disease? I suppose the logical outcome of this story is that some people and physicians will stop taking blood pressure measurements because it will trigger some people.

    • March 13, 2022 at 2:42 pm, Ted said:

      I think I would take the Canadian Adult Obesity Clinical Practice Guidelines more seriously than a political commentary from the Wall Street Journal. They recommend: “Ask permission before weighing someone, and never weigh people in front of others; instead, place weighing scales in private areas.” This seems reasonable to me, especially given the unfortunate context of a history of HCPs humiliating patients living with obesity and contributing to body image issues.