ESPE Abstracts

Background: The prevalence of childhood and adulthood obesity as a chronic condition is rising worldwide with comorbidities and impairment of psychosocial development starting already early in life. The transition from adolescence to adulthood is a vulnerable period for young individuals with chronic conditions, yet the transition of children with obesity remains poorly studied. We aimed to characterize the transition of children with overweight/obesity from a comprehensive perspective.

Methods: Data from the Leipzig childhood obesity cohort were analyzed for 209 children who had reached adulthood (mean age: 24.91 years, range 18 – 36 years). Comprehensive clinical and metabolic assessments were conducted with n = 135 individuals attending in person and n = 74 subjects completing an online survey and were compared with respective childhood data. Furthermore, probands were asked to complete questionnaires regarding their psychosocial background, quality of life, health burden, continuity in medical care and the transition process.

Results: Most children with overweight/obesity maintained this condition during adulthood (93.3%). However, this was only perceived by 46% of the weight gainers. Among on-site participants during early adulthood, 11.4% were affected by (pre)diabetes, 24.5% by hypertension, 82.2% had an elevated intima-media thickness, 10.2% had fatty liver disease and 45% had regular medication intake. Of note, 5 subjects from the childhood cohort were lost to follow-up because of premature death. Most participants reported an impaired quality of life with 57.3% suffering from physical complaints and daily pain and 52.0% from symptoms of depression and anxiety. The majority of participants lost contact to specialized medical care during transition, 30.6% did not engage in regular healthcare visits at all, while 50.7% maintained regular consultations with a general practitioner (GP). During GP visits, obesity was seldomly addressed as a topic (77.4% irregularly or not at all). The majority stated commendable levels of self-responsibility in managing adult healthcare, while 42.9% reported initial challenges. Regarding the transition process in medical care, 26.7% of patients desired a better management, suggesting simple measures such as joint consultations with the pediatrician and adult physician or providing specific contacts/information after coming of age.

Conclusion: Children with overweight/obesity carry a substantial health burden into adulthood which is only partially perceived by the patients. Transition of those patients is also associated with structural changes, such as loss to specialized medical care and more emphasis on primary medical care. Hence, there is a need for structured transition approaches addressing childhood obesity as a chronic disease.