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TOPLINE:

Large proportions of obesity-related conditions (ORCs) among US adolescents and young adults may be attributable to obesity and, to a lesser extent, overweight, a cross-sectional study suggested.

METHODOLOGY:

• Researchers conducted a cross-sectional study of pooled data from the 2013-2023 National Health and Nutrition Examination Survey (NHANES) that included adolescents aged 12-17 years and young adults aged 18-25 years.
• Using logistic regression, they calculated the adjusted relative risk of having specific ORCs in participants with obesity and in participants with overweight compared with participants with normal BMI, after controlling for age, sex, NHANES cycle, insurance status, and self-reported routine healthcare.
• They then calculated population attributable factors (PAFs) due to obesity (ie, the proportion of cases for each ORC that is attributable to obesity) and due to overweight.

TAKEAWAY:

• The study sample included 4199 adolescents, representing 25,171,549 adolescents (weighted mean age, 14.5 years; 50% women; 6% Asian, 24% Black individuals, 14% Hispanic individuals, 51% White individuals, and 6% other), and 3200 young adults, representing 30,957,997 young adults (weighted mean age, 21.7 years; 47% women; 5% Asian, 23% Black individuals, 12% Hispanic individuals, 54% White individuals, and 5% other/multiracial).
• Among adolescents, 18.7% had overweight and 22.3% had obesity, whereas among young adults, 25.8% had overweight and 29.7% had obesity.
• Among adolescents, six of the seven measured ORCs had statistically significant PAFs due to obesity, ranging from 0.2% for asthma to 49.6% for liver steatosis; statistically significant PAFs due to overweight ranged from 6.2% for asthma to 13.1% for liver steatosis.
• Among young adults, eight of nine measured ORCs had statistically significant PAFs due to obesity, ranging from 10.4% for asthma to 78.9% for type 2 diabetes; statistically significant PAFs due to overweight ranged from 10.0% for hypertension to 21.0% for liver steatosis.

IN PRACTICE:

“ORCs during youth increase the risk of more severe disease in the future, and treating and preventing obesity may reduce ORCs and associated costs,” the authors wrote. “These PAFs can inform estimates of the potential impact of expanding access to behavioral, surgical, and pharmacotherapeutic interventions, including glucagon-like peptide-1 receptor agonists, on reducing ORCs in US youth.”

SOURCE:

This study was led by Ashwin Chetty of Yale School of Medicine, New Haven, Connecticut, and published online in JAMA Pediatrics.

LIMITATIONS:

Study limitations include the assumption of a causal relationship between obesity and ORCs in a cross-sectional analysis; self-reported data, including for race/ethnicity, which is subject to recall bias; potential misclassification of diabetes subtype; and potential confounding by other, independent precursors of both obesity and ORCs.

DISCLOSURES:

The researchers were funded individually by different sources. Chetty reported personal fees from Close Concerns outside the submitted work.

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.