A prospective cohort analysis from Germany shows transition into adulthood is an underestimated vulnerable period for children with overweight/obesity.

BACKGROUND

Even though the transition from adolescence to adulthood is a vulnerable and crucial period for young individuals with chronic conditions, it remains poorly studied in obesity. We comprehensively characterized the transition of children with overweight/obesity from childhood to adult care.

METHODS

Data from an adulthood follow-up of the Leipzig childhood obesity cohort (N = 209, mean age at follow-up 24.9 years) were analyzed and related to the respective childhood data. Assessments comprised anthropometrics, oral glucose tolerance testing, carotid ultrasonography, 24 h blood pressure monitoring, liver elastography and questionnaires on psychosocial background, quality of life and transition process.

RESULTS

Here we show that childhood onset overweight/obesity persists in 93.3% until adulthood. However, most patients (55.6%) who move into a higher BMI category during transition still report that things are going better with their weight during adulthood. Complications are frequent among young adults (overall 83.7%, (pre)diabetes 11.4%, hypertension 24.5%, elevated intima-media thickness 82.2%, fatty liver disease 10.2%, regular intake of medication 45%) and deteriorate with progressing weight gain from childhood to adulthood. 87% of adults have not been aware of one or more of these complications before. Most participants report physical complaints (57.3%) and symptoms of depression/anxiety (52.0%). The majority (94.3%) lose contact with specialized obesity care during transition with lack of knowledge being the most frequent reason. Instead, general practitioners are regularly consulted by 50.7%, but obesity is seldom addressed as a topic (22.6%). Better management of the transition process is desired by 26.7% of participants.

CONCLUSIONS

Children with overweight/obesity carry a substantial health burden into adulthood which is often not perceived. Structured transition approaches are needed to address obesity as a chronic condition.