Yael Avnieli Velfer1, Moshe Phillip1,2, Shlomit Shalitin3,4. 1. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 2. The Jesse Z and Lea Shafer Institute of Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petach Tikva, Israel. 3. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel, shalitin@netvision.net.il. 4. The Jesse Z and Lea Shafer Institute of Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petach Tikva, Israel, shalitin@netvision.net.il.
Abstract
BACKGROUND: Childhood obesity is a major health concern worldwide. This study examined prevalence trends in severe obesity and related comorbidities among patients referred to a tertiary pediatric obesity clinic in Israel. METHODS: The medical files of patients aged 2-18 years with BMI >95th percentile at initial referral to our obesity clinic in 2008-2017 were reviewed for demographic, anthropometric, and cardiometabolic data. Findings were compared between patients with 2.3 > BMI-SDS ≥1.645 and BMI-SDS ≥2.33 (severe obesity), and yearly rates of severe obesity were calculated. RESULTS: The cohort included 1,027 children (median age 10.8 years, 41.8% male) of whom 55% were severely obese. The rate of severe obesity among referrals increased from 54% in 2008 to 69% in 2017, but it seemed to plateau during the last 3 years. In between-group comparison, the severe obesity group had a significantly greater predominance of males (p = 0.002), younger age at obesity onset in males (p <0.001), higher rate of a family history of obesity (overall and in males; p = 0.002 and p = 0.01, respectively), and higher rates of obesity-related comorbidities (systolic hypertension, dyslipidemia, obstructive sleep apnea, and nonalcoholic fatty liver disease; p < 0.001). CONCLUSIONS: Our data show an increased prevalence of severe obesity over the last decade among Israeli children and adolescents referred to an obesity clinic. This finding may reflect the trend in the general pediatric population or a change in the policy of referral to obesity clinics of pediatricians. The high rate of obesity-related comorbidities emphasizes the importance of early intervention to prevent their devastating consequences, especially in patients with severe obesity.
BACKGROUND: Childhood obesity is a major health concern worldwide. This study examined prevalence trends in severe obesity and related comorbidities among patients referred to a tertiary pediatric obesity clinic in Israel. METHODS: The medical files of patients aged 2-18 years with BMI >95th percentile at initial referral to our obesity clinic in 2008-2017 were reviewed for demographic, anthropometric, and cardiometabolic data. Findings were compared between patients with 2.3 > BMI-SDS ≥1.645 and BMI-SDS ≥2.33 (severe obesity), and yearly rates of severe obesity were calculated. RESULTS: The cohort included 1,027 children (median age 10.8 years, 41.8% male) of whom 55% were severely obese. The rate of severe obesity among referrals increased from 54% in 2008 to 69% in 2017, but it seemed to plateau during the last 3 years. In between-group comparison, the severe obesity group had a significantly greater predominance of males (p = 0.002), younger age at obesity onset in males (p <0.001), higher rate of a family history of obesity (overall and in males; p = 0.002 and p = 0.01, respectively), and higher rates of obesity-related comorbidities (systolic hypertension, dyslipidemia, obstructive sleep apnea, and nonalcoholic fatty liver disease; p < 0.001). CONCLUSIONS: Our data show an increased prevalence of severe obesity over the last decade among Israeli children and adolescents referred to an obesity clinic. This finding may reflect the trend in the general pediatric population or a change in the policy of referral to obesity clinics of pediatricians. The high rate of obesity-related comorbidities emphasizes the importance of early intervention to prevent their devastating consequences, especially in patients with severe obesity.