Childhood obesity — an important challenge

Prevalence

There are approximately 160 million children and adolescents (ages 5–19) living with obesity worldwide. That figure is expected to rise to roughly 250 million by 2030. Childhood obesity is also common in Sweden — existing data suggests 4–10% of children are affected, though documentation is incomplete. In England, 26% of children aged 2–15 are overweight or living with obesity.

Obesity in childhood and premature death

Childhood obesity is associated with a shortened life expectancy. Obesity reduces lifespan at all ages, but the effect is more pronounced when it develops at a young age. Research shows that essentially every organ system in the body can be affected.

Effect on weight development

Childhood obesity is mainly treated with behavioural support to drive lifestyle change and weight reduction. The more frequent the support, the better the results. The Swedish national quality register BORIS describes outcomes achieved across the country, and several scientific articles confirm the effect of treatment. Treatment should start early — younger children respond significantly better than older ones, and the effect is stronger before the degree of obesity becomes too high. Bariatric surgery has been used in adolescents with relatively good results, and the diabetes drug liraglutide has been evaluated in young people with promising outcomes; approvals for adolescent obesity treatment have been submitted in both the US and the EU.

Effect on school performance

There is a direct relationship between weight development and school performance, independent of socio-economic status. Children who reduce their degree of obesity perform significantly better in school. 46% of children with obesity who do not lose weight do not graduate from high school with passing grades; the figure drops to 33% when treatment is effective and at least 0.25 BMI SDS units are lost.

Effect on future morbidity

A substantial weight reduction dramatically lowers almost all risk markers for future morbidity. Anyone who had obesity as a child but enters adulthood without obesity has the same future cardiovascular risk as someone who was never obese as a child. Even moderate weight loss reduces the risk of early-onset type 2 diabetes.

Why conventional treatment is hard to scale

The US Preventive Services Task Force has calculated that families need around 26 hours of contact with healthcare per year for treatment to lead to a clinically significant reduction in obesity. That is rarely achievable — many families cannot take that much time off work, travel can make intensive treatment impossible, and healthcare systems often lack the resources required. New innovative supports are emerging which, alongside medication and surgery, will help more children with obesity to a healthier life.

In Sweden, the additional cost for a child with obesity compared with a child of normal weight has been calculated at SEK 780,000 per individual up to the age of 65. That makes early treatment a long-term financial gain for society, even when only a small proportion of children respond strongly. The cognitive and psychosocial effects also carry a large societal cost: half of young people who do not graduate with passing grades end up in social exclusion, with a cost estimated at SEK 20 million per individual. Based on improved school results, the social gain has been calculated at roughly SEK 1.4 million per effectively treated child.