Even in the absence of symptoms, a study urges treatment for childhood obesity.

Children who are obese but do not show signs of metabolic complications are at increased risk of developing type 2 diabetes, high blood pressure, and abnormal blood lipid levels later in life. 

But treating obesity early may benefit these children, according to a new study by the Karolinska Institute, published in the journal JAMA Pediatrics . 

The study included just over 7,200 children aged between 7 and 17, who began obesity treatment in Sweden and were followed up until the age of 30.

Healthy obesity and the risk of developing diseases

According to the Karolinska Institute , researchers compared children with so-called metabolically healthy obesity (MHO), children with obesity and abnormal metabolic cardiorespiratory risk indicators (MUO), and their peers from the general population.

By age 30, 9% of children with metabolically healthy obesity developed type 2 diabetes, compared with 17% of obese children with abnormal cardiometabolic risk indicators, and 0.5% in the control group. 

Similar patterns were observed for hypertension (11% in the metabolically healthy obesity group, 18% in the obesity group with abnormal metabolic cardiorespiratory risk indicators, and 4% in the control group) and dyslipidemia (5% and 13% respectively, compared with 1% in the general population).

“Children who are obese and show no signs of cardiometabolic effects are clearly more likely to develop future diseases,” says Emilia Hagman, associate professor in the Department of Clinical Sciences, Intervention and Technology at the Karolinska Institute and lead author of the study. “This means that normal blood pressure and the absence of abnormal blood test results do not provide sufficient protection against future diseases.” 

Treating childhood obesity is essential

All children participating in the study received support to adopt healthy habits, and the researchers investigated whether the treatment response affected the risk of future disease in the different groups. 

A good response to treatment during childhood was associated with a reduced risk of all the diseases studied. This effect was equally significant in both groups: the healthy obesity group (MHO) and the unhealthy obesity group (MUO).

Claude Marcus says: “Our results indicate that all obese children need treatment, even if they appear perfectly healthy upon examination.”

The study is based on data from the national quality register BORIS and several Swedish health data registers.