Abstract

ObjectiveChildren with severe obesity have greater risk of adverse health outcomes. The purpose of this study was to assess trends in the prevalence of morbid and severe obesity in Australian children between 1985 and 2012.MethodsSecondary analysis of four national Australian cross-sectional surveys of measured height/weight in 7–15 year olds: Australian Health and Fitness Survey 1985 (n = 8,486), National Nutrition Survey 1995 (n = 1,541), the National Children’s Nutrition and Physical Activity Survey 2007 (n = 2,585) and the National Health Survey 2012 (n = 2,940). International Obesity Taskforce cut-point was used for morbid obesity (equivalent to a BMI ≥35kg/m2 at age 18 years). Severe obesity class 2 was defined as BMI ≥120% and <140% of the 95th percentile of the CDC 2000 growth charts or a BMI ≥35 and <40, and severe obesity class 3 as BMI ≥140% of the 95th percentile or a BMI ≥40.ResultsBetween 1985 and 2012 the prevalence of morbid obesity increased from 0.2% to 1.8%, class 2 severe obesity from 0.3% to 2.0%, and class 3 from 0.1% to 0.5%. Children with morbid obesity represented 11.3% of children with obesity in 1985 and increased to 22.5% in 2012 (P = 0.005). Children with severe obesity represented 19.3% of children with obesity in 1985 and increased to 32.0% in 2012 (P = 0.016). The greatest increase was observed between 1995 and 2007. The proportion of children who were classified as morbidly or severely obese was not significantly different between 2007 and 2012, nor was it significantly different between age and sex groups.ConclusionPrevalence of morbid and severe obesity among children is low, but has significantly increased between 1985 and 2012. In contrast to overweight and obese children, children with morbid obesity require tertiary intervention. Failure to treat these children will have significant implications for the individual child and community.

Highlights

  • Emerging evidence suggests that the increasing rates of obesity in children and adolescents, as measured by body mass index (BMI), may be slowing or even plateauing in several countries, including Australia and the US [1]

  • This study is the first to describe the temporal trends over 27 years in morbid and severe obesity in Australian children

  • An increased prevalence of children with morbid obesity has been observed elsewhere, with higher rates reported among certain population groups

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Summary

Introduction

Emerging evidence suggests that the increasing rates of obesity in children and adolescents, as measured by body mass index (BMI), may be slowing or even plateauing in several countries, including Australia and the US [1]. There is concern that the BMI distribution curve has shifted further to the right, indicating that the proportion of children with morbid obesity (equivalent to age and sex adjusted BMI 35 kg/m2 at 18 years [2] and severe obesity (BMI 120% of the 95th percentile or a BMI 35 kg/m2 of CDC 2000 growth charts) is increasing [3]. In the US, severe obesity is one of the fastest growing subcategories of obesity in children age 2–19 years, with rates of severe obesity increasing from 4.7% to 8.0% between 1999/2000 and 2011/2012 [4]. The prevalence rates of morbid and severe obesity in Australian children have not been reported previously. The aim of this study was to report changes in morbid and severe obesity in Australian children age 7 to 15 years between 1985 and 2012

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