Only 1% of children experienced obesity remission and lower socioeconomic status was connected to a worsened trajectory.
Researchers have shifted their aim to focus on the rate of remission for childhood obesity, rather than risk and development factors. This shift is expected to provide knowledge to facilitate remission in children with obesity.
Published in Plos One, investigators conducted a study to assess weight trajectories in school-aged children. The results found only 1% of children experienced obesity remission and lower socioeconomic status was connected to a worsened trajectory.
Focused on overweight or obese children aged 6 to 11 years, the researchers used an appropriate measure for trajectory modeling in obesity. The study noted that the first goal was to find the trajectories of children moving towards remission, then to find the factors that contributed to remission and transitioning to a healthy weight.
“The school-age period of development is distinct from the pre-school level of influence on feeding behaviors and level of activity with marked increases in independence, and is also markedly different from adolescence and the growth acceleration associated with puberty,” said the study authors.
The study used different measures of adiposity in the trajectory analysis that focused on body mass index (BMI) and baseline weight groups that were established by the CDC. The BMI was calculated in kg/m2 and measured using the distance from median BMI and percent distance from the median BMI to regulate to age.
The researchers included sex of the children, extracted from medical records, and parent-reported race and ethnicity of the children. Using the rural-urban community area code, geographic categories were calculated to deem if a community was urban or rural.
The study involved 11,247 children between the ages of 6 and 11 years who had greater or equal to 3 valid height and weight measurements pulled from data from the Pacific Northwest hospital system in Portland, Oregon. Using a latent class analysis and linear mixed models, the researchers categorized the children based on their weight trajectory.
“We also examined the proportion in each weight stratum that changed to a different weight stratum over the observation period using the last observed follow-up time point at less than 12 years of age. A multinomial regression model was fit for each baseline weight status group examining the factors associated with being in a different weight stratum at the end of the cohort, with age, race/ethnicity, rural versus urban status, and private versus public insurance included in the models,” said the study authors.
After a 2.1-year follow-up, the results concluded that out of the 11,247 children, 14.4% were deemed overweight and 16% were deemed obese. Of the 1614 children with obesity, only 1% reported remission in the follow up, compared to 23% of the 1794 overweight children reported to move to a healthy weight range. The researchers also found that individuals with lower socioeconomic status had a worse trajectory.
“We found low rates of obesity remission overall, with race and [socioeconomic status] having an association with weight trajectory and outcomes, using a school-aged cohort derived from medical record data. Further weight trajectory modeling work using distance from the median with longer periods of follow-up and incorporating additional clinical indicators in addition to BMI to characterize metabolic health are warranted using these types of data,” said the study authors.
Weight trajectories and obesity remission among school-aged children. Plos One. News Release. September 20, 2023. Accessed September 22, 2023. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0290565.