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Obesity in adolescents with chronic fatigue syndrome: an observational study
  1. T Norris1,
  2. K Hawton2,
  3. J Hamilton-Shield2,
  4. E Crawley3
  1. 1School of Social & Community Medicine, University of Bristol, Bristol, UK
  2. 2NIHR Bristol Biomedical Research Unit in Nutrition and University of Bristol, Bristol, UK
  3. 3Centre for Child and Adolescent Health, School of Social and Community Medicine, University of Bristol, Bristol, UK
  1. Correspondence to Professor E Crawley, Centre for Child and Adolescent Health, School of Social and Community Medicine, University of Bristol, Oakfield house, Oakfield Grove, Clifton, Bristol BS8 2BN, UK; esther.crawley{at}


Objective Identify the prevalence of obesity in patients with chronic fatigue syndrome (CFS) compared with healthy adolescents, and those identified with CFS in a population cohort.

Design Cross-sectional analysis of multiple imputed data.

Setting Data from UK paediatric CFS/myalgic encephalomyelitis (CFS/ME) services compared with data collected at two time points in the Avon Longitudinal Study of Parents and Children (ALSPAC).

Patients 1685 adolescents who attended a CFS/ME specialist service between 2004 and 2014 and 13 978 adolescents aged approximately 13 years and 16 years participating in the ALSPAC study.

Main outcome measures Body mass index (BMI) (kg/m2), sex-specific and age-specific BMI Z-scores (relative to the International Obesity Task Force cut-offs) and prevalence of obesity (%).

Results Adolescents who had attended specialist CFS/ME services had a higher prevalence of obesity (age 13 years: 9.28%; age 16 years: 16.43%) compared with both adolescents classified as CFS/ME in ALSPAC (age 13 years: 3.72%; age 16 years: 5.46%) and those non-CFS in ALSPAC (age 13 years: 4.18%; age 16 years: 4.46%). The increased odds of obesity in those who attended specialist services (relative to non-CFS in ALSPAC) was apparent at both 13 years (OR: 2.31 (1.54 to 3.48)) and 16 years, with a greater likelihood observed at 16 years (OR: 4.07 (2.04 to 8.11)).

Conclusions We observed an increased prevalence of obesity in adolescents who were affected severely enough to be referred to a specialist CFS/ME service. Further longitudinal research is required in order to identify the temporal relationship between the two conditions.

  • Obesity
  • CFS/ME
  • Observational

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  • Contributors TN wrote the manuscript and performed all data management and analysis. EC and JH-S conceived the study, provided interpretation of results and contributed to the manuscript. KH provided interpretation of results and contributed to the manuscript. This study is the work of the authors and TN, KH, JH-S and EC will serve as guarantors of the work.

  • Funding The UK Medical Research Council and the Wellcome Trust (Grant ref: 102215/2/13/2) and the University of Bristol provide core support for ALSPAC. This research was specifically funded by an MRC research grant (MR/K020269/1). JH-S is supported through the National Institute for Health Research Biomedical Research Centre and Unit Funding Scheme. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health. EC is funded by an NIHR SRF (SRF-2013-06-013).

  • Competing interests EC is a medical advisor for the Association of Young People with ME (AYME) and the Sussex & Kent ME/CFS Society.

  • Ethics approval Ethical approval for the ALSPAC study was obtained from the ALSPAC Ethics and Law Committee (IRB00003312 and the Local Research Ethics Committees. The North Somerset and South Bristol Research Ethics Committee decided that the collection and analysis of CFS/ME specialist service patient data were part of service evaluation and as such did not require ethical review by a NHS Research Ethics Committee or approval by NHS Research and Development offices (Research Ethics Committee reference number 07/Q2006/48).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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