When children who are obese go through weight-loss treatment, it can lead to long-term benefits, reducing their chances of serious health issues and early death as they enter young adulthood. However, the same cannot be said for mental health conditions like depression and anxiety, according to a study from Karolinska Institutet published in JAMA Pediatrics.
Children suffering from obesity who receive weight-loss treatment experience long-term gains, such as a decreased risk of severe health issues and untimely death as they reach early adulthood. Yet, a study from Karolinska Institutet published in JAMA Pediatrics highlights that this does not apply to mental health, particularly regarding depression and anxiety.
The research indicates that children and teenagers who show positive responses to obesity treatment are less likely to develop related health issues in adulthood, including type 2 diabetes, high blood pressure, and dyslipidaemia (elevated blood fat levels).
The treatment examined consisted of a supportive approach for both children with obesity and their families, focused on encouraging healthy eating, physical activity, and better sleep habits, known as “behavioral lifestyle therapy.”
“The findings are encouraging,” comments Emilia Hagman, a lecturer at the Department of Clinical Science, Intervention, and Technology. “There has been ongoing debate about whether addressing obesity early in life yields long-term health benefits, given the challenges of maintaining weight loss.”
The study further reveals that children with obesity who successfully undergo treatment face a decreased risk of untimely death. A prior study by the same research team, published in PLOS Medicine, indicated that adults who were once obese have a significantly higher risk of mortality in early adulthood, as well as increased likelihood of dying from suicide and various physical illnesses. It was noted that just over a quarter of these deaths were linked to obesity.
“This highlights the necessity of providing timely interventions, as early treatment enhances the likelihood of success and helps reduce the long-term health risks related to obesity,” states Dr. Hagman.
Nonetheless, the research indicates that the treatment does not alleviate the risks of depression and anxiety in young adulthood, regardless of any successful outcomes regarding obesity management during childhood, according to the JAMA Pediatrics study.
“It has been thought that shedding weight could lessen depression and anxiety symptoms, but we have now demonstrated otherwise,” says Dr. Hagman. “There is a connection between these two conditions, but they require parallel treatment.”
This research included over 6,700 individuals who were treated for obesity in childhood, sourced from the BORIS register (the Swedish Childhood Obesity Treatment Register), and subsequently tracked as they transitioned into young adulthood, utilizing the Swedish Patient Register, the Prescribed Drugs Register, and the Cause of Death Register. There was also a control group from the general population that was matched by factors like age, gender, and location.
The study did not include GLP-1 analogues, which have gained popularity as obesity treatments in recent years, as they were not yet approved when the participants received their obesity treatments. Dr. Hagman notes that it remains relatively rare for this type of medication to be prescribed to children.
“I support their use, as these medications can help manage hunger, a common struggle for some children,” she explains. “Nevertheless, lifestyle therapy continues to be the cornerstone of treatments for childhood obesity.”
The research team plans to continue exploring the most effective therapy options for various individuals, as well as identifying vital health risk markers important for long-term health outcomes.
Conflict of Interest Disclosures: The study was funded by Novo Nordisk A/S, which was involved in the design and data interpretation but not in data collection or analysis. Writing and editorial assistance were provided by the sponsor. Two co-authors work for Novo Nordisk; one possesses shares in Novo Nordisk and another pharmaceutical firm, while two others own shares in Evira AB, a company that offers digital care for pediatric obesity. Additional support came from the Åke Wiberg Foundation and the Ollie and Elof Ericsson’s Foundation. Emilia Hagman has engaged in contract research for Novo Nordisk.
