Comorbidities of overweight/obesity experienced in adolescence: longitudinal study
- Melissa Wake1,2,3,
- Louise Canterford1,2,
- George C Patton2,4,
- Kylie Hesketh5,
- Pollyanna Hardy1,2,6,
- Joanne Williams2,4,
- Elizabeth Waters7,
- John B Carlin2,3,6
- 1Centre for Community Child Health, Royal Children's Hospital, Melbourne, Australia
- 2Murdoch Childrens Research Institute, Melbourne, Australia
- 3Department of Paediatrics, The University of Melbourne, Melbourne, Australia
- 4Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia
- 5Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
- 6Clinical Epidemiology and Biostatistics Unit, Royal Children's Hospital, Melbourne, Australia
- 7The McCaughey Centre, School of Population Health, The University of Melbourne, Melbourne, Australia
- Correspondence to Professor Melissa Wake, Centre for Community Child Health, Royal Children's Hospital, Flemington Road, Parkville 3052, Australia;
- Accepted 18 May 2009
- Published Online First 15 June 2009
Objectives Adolescent obesity is linked to metabolic and cardiovascular risk, but its associations with adolescents' experienced health and morbidity are less clear. Morbidities experienced by overweight/obese adolescents and associations between morbidities and timing of overweight/obesity were examined.
Methods Data were from the Health of Young Victorians Study (HOYVS; 1997, 2000, 2005), a school-based longitudinal study. Outcomes were blood pressure, health status (Pediatric Quality of Life Inventory 4.0 (PedsQL), global health), mental health (Strengths and Difficulties Questionnaire), psychological distress (Kessler-10), physical symptoms, sleep, asthma, dieting, and healthcare needs and visits. Regression methods assessed associations with body mass index status and timing of overweight/obesity.
Results Of the 923 adolescents (20.2% overweight, 6.1% obese), 63.5% were classified as “never” overweight/obese, 8.5% as “childhood only”, 7.3% as “adolescence only” and 20.8% as “persistent”. Compared to non-overweight, current obesity was associated with lower PedsQL physical summary scores (mean −6.58, 95% CI −9.52 to −3.63) and good/fair/poor global health (OR 3.52, 95% CI 1.95 to 6.36), hypertension (systolic 8.86, 95% CI 4.70 to 16.71; diastolic 5.29, 95% CI 2.74 to 10.20) and dieting (OR 5.79, 95% CI 3.28 to 10.23), with intermediate associations for overweight. Associations with psychosocial morbidity were weaker and inconsistent and there were few associations with health symptoms and problems. Only dieting (OR 2.30, 95% CI 1.36 to 3.89) was associated with resolved childhood overweight/obesity.
Conclusions Despite poorer overall health, overweight/obese adolescents were not more likely to report specific problems that might prompt health intervention. Morbidity was mainly associated with concurrent, rather than earlier, overweight/obesity.
Funding The third wave of the Health of Young Victorians Study was funded by Australian National Health and Medical Research Council (NHMRC) Project Grant 334303. Earlier waves were supported by the Victorian Department of Human Services, the National Heart Foundation, Murdoch Childrens Research Foundation and the Financial Markets Foundation for Children. MW is supported by an NHMRC Career Development Award, KH by an NHMRC/National Heart Foundation Postdoctoral Fellowship, GPC by an NHMRC Research Fellowship and EW by a VicHealth Public Health Research Fellowship. The researchers were independent of the funders and do not have any relevant financial interests in the manuscript. The funding organisations did not have a role in the design and conduct of the study; collection, management, analysis and interpretation of the data; or in the preparation, review, or approval of the manuscript.
Competing interests None.
Ethics approval This study was conducted with the approval of the Royal Children's Hospital Ethics in Human Research Committee.
Provenance and peer review Not commissioned; externally peer reviewed.
Patient consent Obtained.