New model shows that some children can outgrow obesity without losing weight

July 29, 2013

Developed by a team of researchers led by Dr Kevin Hall of National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, USA, the new model is the first to differentiate between the healthy weight gain that is normal in childhood, and the excessive weight gain that results in overweight and obesity. The model provides an accurate representation of how children's energy balance (the difference between consumed and expended energy) affects their weight gain.

Existing models may have greatly underestimated the number of calories overweight or obese children are eating. For example, models currently used by clinicians predict that a 10-year-old girl who is 10 kg overweight but was a healthy weight at age 5 has an excess calorie intake of around 40 kcal per day (about the calorie content of a small apple). The new model, which is based on a more sophisticated understanding of how children's metabolism, growth, and energy expenditure change as they gain weight, estimates that the same overweight 10-year-old is actually eating around 400 kcal per day more than a healthy-weight peer, about the equivalent of a beef burger or medium serving of French fries [1].

The new model also indicates that some children may be able to 'outgrow' obesity during periods of rapid growth, for example between the ages of 11 and 16, without changing their bodyweight. Obese boys who maintain the same bodyweight over this period will tend to normalise their body fat while continuing to grow taller and adding lean tissue mass. However, this effect is much less pronounced in girls, mainly because they lose less body fat during this period than do boys, who have a higher growth potential.

By testing the model against real life data from studies that assessed the effects of various weight loss interventions, the researchers showed that their model provides the most accurate tool developed thus far to predict the effect of calorie intake on weight loss in children. With roughly a third of children in the UK and US [2] thought to be overweight or obese, the new model may provide policy makers and clinicians with a greatly improved understanding of how weight loss interventions -- such as calorie-controlled diets and physical activity programmes -- can most effectively be used to address the childhood obesity epidemic.

According to Dr Hall, "One of the most disconcerting aspects of the global obesity epidemic is the high prevalence of childhood obesity, which carries both health and economic consequences. The model we have developed is a substantial step forward in fighting this rising tide of childhood obesity. It allows us to accurately predict how a child's energy intake affects his or her likelihood of becoming overweight or obese.*

"Though the model doesn't apply perfectly to all children -- for instance, those who start adolescence late, or who undergo particularly rapid weight gain -- it provides an accurate representation of the average effect of reducing or increasing calorie intake on the weight of children. Our future research will adapt the model to individual children as well as study the effects of increasing physical activity along with diet changes."*

Writing in a linked Comment, Professor Claudio Maffeis, of the University of Verona, Italy, points out that the new model suggests that the best time for implementing weight loss plans in children is likely to be before puberty, especially for girls. However, even with the improvements offered by the new model, awareness of children and their parents about their calorie intake must be improved if childhood obesity is to be effectively tackled.

"The accuracy of parents' awareness of children's portion sizes and reporting of children's food intake is only moderate," says Professor Maffeis, adding that, "Reduced awareness of food intake in obese or preobese children and their parents is an important limiting factor in the modification of nutritional behaviour, and associated under-reporting of food intake adversely affects clinicians' planning of adequate dietary strategies...to translate into practice these desired changes in energy balance, it will be necessary to increase families' knowledge and awareness of energy content and composition of childrens' diets by designing effective and sustainable educational programmes about nutrition."
-end-
NOTES TO EDITORS

* Quotes direct from author and cannot be found in text of Article

[1] eg, http://www.mcdonalds.co.uk/ukhome/meal_builder.html

[2] http://www.cdc.gov/healthyyouth/obesity/facts.htm and http://www.noo.org.uk/NOO_about_obesity/child_obesity/UK_prevalence

Lancet

Related Obesity Articles from Brightsurf:

11 years of data add to the evidence for using testosterone therapy to treat obesity, including as an alternative to obesity surgery
New research covering 11 years of data presented at this year's European and International Congress on Obesity (ECOICO 2020) show that, in obese men suffering from hypogonadism (low testosterone), treatment with testosterone injections lowers their weight and improves a wide range of other metabolic parameters.

Overlap between immunology of COVID-19 and obesity could explain the increased risk of death in people living with obesity, and also older patients
Data presented in a special COVID-19 session at the European and International Congress on Obesity (ECOICO 2020) suggests that there are overlaps between the immunological disturbances found in both COVID-19 disease and patients with obesity, which could explain the increased disease severity and mortality risk faced by obese patients, and also elderly patients, who are infected by the SARS-CoV-2 virus that causes COVID-19 disease.

New obesity guideline: Address root causes as foundation of obesity management
besity management should focus on outcomes that patients consider to be important, not weight loss alone, and include a holistic approach that addresses the root causes of obesity, according to a new clinical practice guideline published in CMAJ (Canadian Medical Association Journal) http://www.cmaj.ca/lookup/doi/10.1503/cmaj.191707.

Changing the debate around obesity
The UK's National Health Service (NHS) needs to do more to address the ingrained stigma and discrimination faced by people with obesity, says a leading health psychologist.

Study links longer exposure to obesity and earlier development of obesity to increased risk of type 2 diabetes
Cumulative exposure to obesity could be at least as important as actually being obese in terms of risk of developing type 2 diabetes (T2D), concludes new research published in Diabetologia (the journal of the European Association for the Study of Diabetes [EASD]).

How much do obesity and addictions overlap?
A large analysis of personality studies has found that people with obesity behave somewhat like people with addictions to alcohol or drugs.

Should obesity be recognized as a disease?
With obesity now affecting almost a third (29%) of the population in England, and expected to rise to 35% by 2030, should we now recognize it as a disease?

Is obesity associated with risk of pediatric MS?
A single-center study of 453 children in Germany with multiple sclerosis (MS) investigated the association of obesity with pediatric MS risk and with the response of first-line therapy in children with MS.

Women with obesity prior to conception are more likely to have children with obesity
A systematic review and meta-analysis identified significantly increased odds of child obesity when mothers have obesity before conception, according to a study published June 11, 2019 in the open-access journal PLOS Medicine by Nicola Heslehurst of Newcastle University in the UK, and colleagues.

Obesity medicine association announces major updates to its adult obesity algorithm
The Obesity Medicine Association (OMA) announced the immediate availability of the 2019 OMA Adult Obesity Algorithm, with new information for clinicians including the relationship between Obesity and Cardiovascular Disease, Diabetes Mellitus, Dyslipidemia, and Cancer; information on investigational Anti-Obesity Pharmacotherapy; treatments for Lipodystrophy; and Pharmacokinetics and Obesity.

Read More: Obesity News and Obesity Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.