Certain risk factors in childhood can identify those who are more likely to suffer severe obesity in adulthood, a new study finds.

The research included more than 12,000 participants from different countries who were followed from childhood in the 1970s and 1980s into adulthood.

In childhood, 82% of the participants had normal weight, 11% were overweight, 5% were obese and 2% were severely obese. About 20 years later, 41% had normal weight, 32% were overweight, 15% were obese and 12% were severely obese, the findings showed.

Obesity rates were higher among Americans than participants from other nations, according to the study, which was led by researchers at Cincinnati Children’s Hospital Medical Center.

Severe obesity is defined as having a body mass index (BMI) of 35 or higher. In the study, those who were severely obese as children had the highest risk of severe obesity as adults. But the researchers noted that more than one-third of severely obese adults had normal weight as children.

“The risk of severe obesity in adulthood was substantially higher for girls than boys, for black participants than white, and for those with lower education levels,” study leader Jessica Woo said in a medical center news release.

“Early prevention and treatment are critical, because severe adult obesity has significant adverse health outcomes, such as diabetes and heart disease,” Woo added. “And unfortunately, severe obesity is rarely reversible, even with bariatric surgery.”

The researchers created charts that can be used by doctors to assess a child’s chances of being obese as an adult. For example, a 5-year-old white girl with obesity has a 60% chance of being severely obese by age 35, and an 80% chance of being severely obese by age 45.

The study was published online Oct. 9 in the International Journal of Obesity.

More information

The U.S. Centers for Disease Control and Prevention has more on obesity prevention.

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