ESPE Abstracts

Background: Childhood obesity starts in early childhood. The natural history of childhood obesity has not been reported and it is unknown how obese children in early childhood improve to become non-obese adolescents.

Objective and hypotheses: To investigate the natural history of obese children from early childhood to puberty and identify patterns and trends in this process.

Method: 1207 children (614 boys and 593 girls) born in Fujioka town and Otawara city in Tochigi prefecture, Japan, were enrolled in this study. Height and weight were measured at 5, 6, 8, and 12 years of age. Obesity was characterized by an excess of ≥+15 and ≥+20% standard body weight at 5 and ≥6 years of age respectively. We calculated the percentage of children who remained obese at 12 years of age.

Results: At the beginning of the study, 133 (11.0%), 152 (12.6%), 244 (20.2%), and 235 (19.5%) children were obese at age 5, 6, 8, and 12 respectively. 85 (63.9%) of 133, 110 (72.4%) of 152, and 166 (68.0%) of 244 children were still obese at age 12. 50% of the children who showed light obesity (≥+20 and <+30% excess body weight) at 5 years of age were not obese at 12 years of age, whereas only 10% of the children who were severely obese (≥+50% excess body weight) at age 5 were not obese at age 12. Interestingly, among children who were obese at 5 years of age, boys remained obese at 12 years in high prevalence compared to girls.

Conclusion: Greater than 60% of the obese children in early childhood remained obese at 12 years of age. This endorses the importance of prevention and intervention of obesity before age 5.