ESPE Abstracts

Background/Aims: Childhood obesity has increased markedly during the past decades.

The aim of the study was to examine the changes in trends of severe obesity and related comorbidities among children and adolescents referred for evaluation at the obesity clinic in a tertiary care center in Israel.

Methods: The study included patients aged 2-18 years referred for evaluation due to obesity (BMI > 95th percentile) between 2008-2017. Their medical files at their first visit at the obesity clinic were reviewed for demographic, anthropometric, and cardiometabolic data. The study cohort was divided into two subgroups: those with severe obesity (BMI-SDS≥2.33) and those with 2.33 >BMI-SDS≥1.645. The anthropometric and obesity related comorbidities were compared between these two subgroups, and the yearly rate of severe obesity was evaluated.

Results: Of the 1027 children (median age 10.8 years, 41.8% males) fulfilling study inclusion criteria, 565 (55%) were classified with severe obese. The rate of severe obesity has increased during the years 2010-2017, although it seems that rates are plateauing during the last 2 years.

On comparison between the subgroups: in those with severe obesity there was a significant male predominance (60.6% vs.51%, P=0.002) with a significantly younger age of onset of obesity, and significantly higher prevalence of family history of obesity, although statistically significant only in males (P<0.001 and P=0.01, respectively). The rates of obesity related comorbidities (systolic hypertension, obstructive sleep apnea and non-alcoholic fatty liver disease) were significantly higher in the subgroup with severe obesity (P<0.001).

Conclusions: Our data demonstrate that the rate of severe obesity among the Israeli pediatric population referred for evaluation at the obesity clinic is in rise, that may reflect the rising rate of pediatric severe obesity in Israel, or a change in the policy of referral by the general pediatrician. Also, the rate of obesity related comorbidities in our cohort was significantly higher in those with severe obesity. These findings should emphasize the importance of prevention of severe obesity to prevent devastating obesity related comorbidities in children and adolescents.