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Weight development in children with obesity without treatment: A Danish cohort study with long-term follow-up

Rasmus Møller Jørgensen1,2,3, Jens Meldgaard Bruun1,2,3, Mette Fogh1,2,3

  • 1Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark.

Pediatric Obesity
|February 4, 2025
PubMed

Insights

Higher initial BMI z-scores predict lower chances of weight normalization and obesity remission in untreated children. This suggests focusing on interventions for those not improving naturally.

Area of Science:

  • Pediatric Endocrinology
  • Public Health
  • Obesity Research

Background:

  • Limited understanding of weight trajectory in untreated obese children.
  • Obesity in childhood poses long-term health risks.
  • Need for data on natural weight development in pediatric obesity.

Purpose of the Study:

  • To investigate weight development in Danish children with obesity not receiving treatment.
  • To identify predictors of BMI normalization and obesity remission.
  • To inform future intervention strategies for pediatric obesity.

Main Methods:

  • Cohort study of 467 Danish children aged 5-10 years with obesity (iso-BMI >30 kg/m²).
  • Utilized mandatory health check-up data (height, weight) merged with national registries.
  • Employed multivariable logistic regression weighted for follow-up duration to assess predictors of BMI normalization and obesity remission.

Main Results:

  • Over a median 6-year follow-up, 7.9% normalized BMI and 45.4% achieved obesity remission.
  • Higher baseline BMI z-score was a significant inverse predictor for both BMI normalization (OR 0.14) and obesity remission (OR 0.17).
  • No other significant predictors were identified in the weighted multivariable models.

Conclusions:

  • Elevated BMI z-scores at baseline are associated with reduced likelihood of spontaneous BMI normalization and obesity remission in untreated children.
  • A significant proportion of children experience natural improvement, highlighting the need to understand maintenance barriers.
  • Resources should target effective strategies for children who do not show spontaneous improvement.
Abstract

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