ESPE Yearbook of Paediatric Endocrinology

To read the full abstract: N Engl J Med 2018;378:1302-1312.

While it is well known that being overweight in childhood and early adulthood is linked to a higher risk of T2DM later in life, the question arises as to whether diabetes risk would change if overweight children lose weight. This large-scale longitudinal study demonstrated that men who had remission of overweight between ages 7 and 13 years, and subsequently maintained a normal weight in early adulthood, had no increase in T2DM risk compared to men who were never overweight. This message is of utmost importance, as chubbiness in young children is often viewed as a sign of good health. Indeed, in the National Health and Nutrition Examination Survey, parents were asked whether they considered their children, ages 2-5 years, to be overweight, underweight, or just about the right weight. The proportion of parents who inappropriately perceived their overweight children as just about the right weight was 95%, and as high as 78% of parents perceived their obese child as being just about the right weight.¹ Furthermore, a recent study found that while providers recognize the importance of addressing weight during a well-child visit, they prefer not to conduct obesity management on their own.² The findings, that remission of overweight before puberty and maintenance of a normal weight until early adulthood can attenuate the increased risk of T2DM posed by childhood overweight at 7 years of age, suggest that weight-loss interventions should target overweight children before puberty. Hopefully, these researchers will provide data on females as well.

1. T. DD, R. HA, Wei W, Fei Y, Jian Z. Change in Misperception of Child’s Body Weight among Parents of American Preschool Children. Childhood Obesity 2015; 11(4): 384-393.

2. Rhee KE, Kessl S, Lindback S, Littman M, El-Kareh RE. Provider views on childhood obesity management in primary care settings: a mixed methods analysis. BMC Health Services Research 2018; 18: 55.