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The proportion of adolescents with overweight and obesity in England increased by 50% over 15 years, accompanied by significant increases in many related comorbidities, according to research in two studies to be presented at the European Congress on Obesity in May.

“While we anticipated some increase in adolescent overweight and obesity over time, the scale of the rise is striking,” said coauthor Dr Dinesh Giri, consultant paediatric endocrinologist at Bristol Royal Hospital for Children and honorary senior lecturer at the University of Bristol.

“A 50% relative increase over 15 years highlights a rapidly growing public health issue,” he told Medscape News UK.

“Particularly concerning is the significant risk of developing serious health conditions, including type 2 diabetes, liver disease, and obstructive sleep apnoea during the teenage years,” Giri continued. “These risks increase steeply with higher BMI, underscoring the urgency for early intervention.”

‘Substantial Burden’ of Overweight and Obesity

For the two studies, researchers analysed linked primary (Clinical Practice Research Datalink [CPRD]) and secondary (Hospital Episode Statistics) care data. 

Eligible participants were adolescents aged 12-17 years registered at a CPRD practice from 2008 to 2023 with recorded BMI readings. 

Overweight was defined as a BMI at or above the 91st centile, and obesity at or above the 98th centile, based on the UK 1990 growth reference charts.

Three-year rolling prevalence rates were used to provide stable estimates.

Adolescents with a healthy weight BMI (at or above the second and below the 91st centile) were included as a comparator group.

Researchers compared the incidence of new comorbidities during adolescence between adolescents with overweight or obesity and those with healthy weight using Cox proportional hazards regression. 

The prevalence of overweight and obesity increased from 22% in 2008-2010 to 33% in 2021-2023. 

Among 139,258 adolescents with overweight, 140,990 with obesity, and 560,789 with healthy weight, higher proportions with overweight (26%) and obesity (31%) were found in those living in the most deprived areas compared with healthy-weight peers (22%). 

Additionally, 8% of adolescents with overweight and 27% with obesity had a history of childhood obesity compared with 1% among healthy-weight adolescents.

Comorbidities Increasing With Higher BMI

New-onset comorbidities were more common in adolescents with obesity than overweight and lowest in those with healthy weight. 

Mental health conditions were reported in 8.6% of adolescents with obesity, 7.8% with overweight, and 7.1% with healthy weight. Physical health conditions affected 11.6%, 10.7%, and 9.3%, respectively.

“Globally, the prevalence of overweight among children and adolescents aged 5-19 years has risen from around 8% in 1990 to nearly 20% in 2022,” Giri said. “While this study focuses on England, similar trends have been reported across many developed nations.

“Widespread access to ultraprocessed foods, declining physical activity, and increasing screen time are common contributing factors,” he noted. “However, the scale and specific drivers can vary depending on local policies, healthcare systems, socioeconomic disparities, and cultural norms.”

Long-Term Health Risks

In the second study, the team investigated the long-term risks of developing specific comorbidities. 

Participants were followed from their first adolescent BMI recording during adolescence until transfer out of primary care practice or to the end of 2023, whichever was earlier, up to a maximum age of 33 years.

Over a mean follow-up of 6 years, the risk of many comorbidities was higher in adolescents with overweight (n = 139,258) or obesity (n = 140,990) than in those with healthy weight (n = 560,789).

As an example, for obstructive sleep apnoea, the risk was three times higher among adolescents with overweight and eight times higher among those with obesity. For type 2 diabetes, the risks were three and 11 times higher, respectively. 

For metabolic dysfunction–associated steatotic liver disease, the risks were three and 12 times higher, respectively. For prediabetes, they were two and four times higher, and for polycystic ovary syndrome (PCOS), two and four times higher. 

Changes in BMI during adolescence were also linked to risks: Reductions suggested lower risks, whereas increases suggested higher risks, particularly for cardiometabolic conditions and PCOS.

How Clinicians Can Help 

“Clinicians should recognise that BMI changes during adolescence are highly predictive of long-term health outcomes,” Giri said. “Early intervention can have a lasting impact, particularly when it addresses not only physical health, but also the psychological effects of weight-related issues. Adolescents facing weight challenges often experience stigma, low self-esteem, or anxiety, which can further impact their health. 

“A compassionate, whole-person approach is essential to support positive and sustainable change.”

Giri also emphasised the importance of screening for early signs of comorbidities. “In England, Tier 3 weight-management services (Complications of Excess Weight [CEW] services) were established in parts of the country in 2021. These services provide multidisciplinary care, including input from dietitians, psychologists, doctors, and physical activity specialists, he said, and they are “promising models for adolescent care.”

The findings “confirm our suspicions that the prevalence of overweight and obesity continues to rise, but these numbers are really concerning,” Dr Reshmi Srinath, associate professor and obesity medicine director at the Icahn School of Medicine at Mount Sinai, New York, told Medscape News UK. 

“Primary care providers are the first line for screening, evaluating, and diagnosing weight gain and obesity and need to monitor and raise awareness if an adolescent is gaining weight,” said Srinath, who was not involved in the study.

Like the CEW services approach in England, Mount Sinai Pediatrics has a healthy lifestyle clinic with a multidisciplinary team, she said. In the clinic, “endocrinologists, cardiologists, geneticists, and liver and sleep specialists all see patients in the same location. Care is coordinated, optimising lifestyle modification, use of weight-loss medications as needed, and bariatric surgery.”

The studies were funded by Novo Nordisk. Giri has not received payments from Novo Nordisk or other sources for authorship of the abstracts. Two coauthors of the abstracts are employees of Novo Nordisk. Srinath reported collaborating on research with Eli Lilly with no financial compensation, and a $50,000 research grant from Dexcom to Mount Sinai for an investigator-initiated study in obesity. 

Marilynn Larkin, MA, is an award-winning medical writer and editor whose work has appeared in numerous publications, including Medscape Medical News and its sister publication MDedge,  The Lancet (where she was a contributing editor), and Reuters Health.