Simulation of Growth Trajectories of Childhood Obesity into Adulthood

The authors developed a simulation model to estimate the risk of adult obesity at the age of 35 years for the current population of children in the United States. They used pooled height and weight data from five nationally representative longitudinal studies totaling 176,720 observations from 41,567 children and adults to simulate growth trajectories across the life course adjusted for secular trends.

Using 1,000 virtual populations of 1 million children through the age of 19 years, representative of the 2016 population of the United States, the authors projected their trajectories in height and weight up to the age of 35 years. Severe obesity was defined as a body-mass index (BMI, the weight in kilograms divided by the square of the height in meters) of 35 or higher in adults and 120% or more of the 95th percentile in children.

Given the current level of childhood obesity, the models predicted that a majority of today’s children (57.3%) will be obese at the age of 35 years, and roughly half of the projected prevalence will occur during childhood. Simulations indicated that the relative risk of adult obesity increased with age and BMI, from 1.17 for overweight 2-year-olds to 3.10 for 19-year-olds with severe obesity. For children with severe obesity, the chance they will no longer be obese at the age of 35 years fell from 21.0% at the age of 2 years to 6.1% at the age of 19 years.

On the basis of their simulation models, the authors predict that childhood obesity and overweight will continue to be a major health problem in the United States. Early development of obesity predicted obesity in adulthood, especially for children who were severely obese.

Access related video: Forecasting Trends in Child Obesity with Zach Ward (~3 min)