Early intervention in childhood obesity treatment yields long-term benefits, study finds

A recent study from researchers at Karolinska Institutet, published in JAMA Pediatrics, has revealed that effective weight-loss treatment during childhood for young individuals with obesity has enduring positive impacts on their health in adulthood. The findings indicate a reduced risk of severe obesity-related health conditions and premature mortality. However, the study also shows that such treatment does not appear to affect the likelihood of developing depression or anxiety later in life.

Long-term Health Benefits

The research demonstrates that children and adolescents who respond successfully to obesity treatment experience lower rates of obesity-related diseases, including type 2 diabetes, hypertension, and dyslipidaemia (elevated levels of fats in the blood), by the time they reach young adulthood. These conditions are commonly associated with long-term complications of obesity, highlighting the importance of early intervention.

The treatment studied, referred to as “behavioural lifestyle therapy,” focuses on encouraging healthy eating, regular physical activity, and proper sleep hygiene in children and their families.

“These results are very good news,” said Dr Emilia Hagman, principal researcher at the Department of Clinical Science, Intervention and Technology, Karolinska Institutet. “Whether or not the treatment of obesity in childhood has long-term health benefits has been debated, since weight loss is hard to maintain.”

Reduced Risk of Premature Mortality

In addition to improved health outcomes, the study found that young people who responded well to obesity treatment had a lower risk of premature death. A previous study by the same research group, published in PLOS Medicine, highlighted that children living with obesity face a significantly increased risk of mortality in early adulthood. This earlier research revealed that over one-quarter of deaths among young adults with obesity were directly related to obesity, with causes including somatic conditions and suicide.

“This emphasises the importance of providing early treatment,” said Dr Hagman. “We know that timely intervention increases the likelihood of success and helps mitigate the long-term health risks associated with obesity.”

Mental Health Outcomes

The researchers also explored the relationship between obesity treatment outcomes and mental health. The findings showed that the risk of depression and anxiety in young adulthood remained unaffected, regardless of whether the participants had successfully managed their weight during childhood.

“It has been believed that weight loss could decrease symptoms of depression and anxiety, but we can now show that’s not the case,” said Dr Hagman. “Even though there’s a link between the two comorbidities, they must be treated in parallel.”

Study Methodology

The study followed more than 6,700 individuals who received treatment for obesity during childhood. These participants were identified through the Swedish Childhood Obesity Treatment Register (BORIS) and were monitored into young adulthood using data from the Swedish Patient Register, the Prescribed Drugs Register, and the Cause of Death Register. A matched control group from the general population, selected based on age, sex, and geographic location, was also included in the study.

One limitation noted in the study was the exclusion of GLP-1 receptor agonists, a class of medications that has recently gained prominence in obesity care. These drugs were not approved for use in children during the period when the study participants were undergoing treatment.

“I’m in favour of their use as these drugs ease feelings of hunger, which is something that some children struggle with,” said Dr Hagman. “That said, lifestyle therapy is still the foundation of all treatments for childhood obesity.”

Future Directions

Building on this research, the team at Karolinska Institutet plans to focus on identifying the most effective therapy options for individuals with obesity. They aim to pinpoint key health and risk markers that predict long-term outcomes.

The findings underscore the critical importance of early and sustained intervention in addressing childhood obesity, not only to mitigate immediate health risks but also to support long-term well-being. While the study highlights significant progress, it also emphasises the need for comprehensive strategies to address the physical and mental health challenges faced by individuals with obesity.