New research to be presented at this year's European Congress on Obesity (ECO 2025, Malaga, Spain, 11-14 May) shows that the proportion of adolescents living with overweight or obesity in England has increased by 50% from 2008-2010 (22%) to 2021-2023 (33%). The research, presented in two studies, is by Dr Dinesh Giri, Consultant Paediatric Endocrinologist, Bristol Royal Hospital for Children and Honorary Senior Lecturer, University of Bristol, Bristol, UK, and Dr Senthil Senniappan, Consultant Paediatric Endocrinologist, Alder Hey Children's Hospital, Liverpool, UK, and colleagues.
Previous research has shown overweight and obesity during adolescence are associated with increased morbidity. In this study, the authors aimed to estimate the prevalence of overweight and obesity among adolescents in England using routinely collected healthcare data. They also investigated the association between adolescent body mass index (BMI) and the onset of comorbid conditions during adolescence.
The authors used linked primary (Clinical Practice Research Datalink [CPRD]) and secondary (Hospital Episode Statistics) care data for their analysis. Among adolescents aged 12-17 years registered at a CPRD contributing practice (around 20% of practices nationwide contribute) from 2008-2023 with BMI readings and using the UK 1990 growth reference centiles (a widely used reference for studies of this type). Overweight was defined as at or above the 91st centile and obesity as at or above the 98th centile [1].
Three-year rolling prevalences for overweight and obesity were calculated, since these provide more stable estimates, and a clearer picture of the longer-term trends rather than focusing on small year-to-year changes. The authors explain this helps to smooth out any random ups and downs that might happen in a single year.
Adolescents with a healthy weight BMI, at or above the 2nd and below the 91st centile, were included as a comparator. The sociodemographic and clinical characteristics for adolescents were described at first BMI recording. The incidence of new comorbidities (see figure 1 full abstract) during adolescence was compared between adolescents living with overweight or obesity and those with healthy weight using statistical modelling.
The period prevalence of overweight and obesity increased from 22% in 2008-2010 to 33% in 2021-2023. There was evidence of a steeper increase during / following the COVID-19 pandemic.
Among 139,258 adolescents living with overweight, 140,990 with obesity and 560,789 with healthy weight, higher proportions with overweight (26%) or obesity (31%) than healthy weight (22%) resided in the most deprived geographies (calculated by decile, or groups of 10%).
Higher proportions of those living with overweight (8%) and obesity (27%) had lived with obesity during childhood than those with healthy weight (1%). New onset of mental health (obesity: 8.6% vs overweight: 7.8% vs healthy weight: 7.1%), physical (11.6% vs 10.7% vs 9.3%) and cardiometabolic (3.1% vs 1.2% vs 0.5%) comorbidities during adolescence was higher in adolescents living with obesity than overweight and lowest in those with healthy weight
The second study investigated other comorbidities in more detail. Out of the 15 comorbidities investigated, the risks of 14 were significantly higher in adolescents living with overweight or obesity compared to those with healthy weight.
Over a mean follow-up of 6 years, the risk (Figure 1 of second abstract) of many comorbidities was higher in adolescents living with overweight (n=139,258) or obesity (n=140,990) than those with healthy weight (n=560,789), specifically; obstructive sleep apnoea (3 times higher [overweight] and 8 times higher [obesity]), type 2 diabetes (3 and 11 times higher) and metabolic dysfunction-associated steatotic liver disease (3 and 12 times higher), prediabetes (2 and 4 times higher)and polycystic ovary syndrome (PCOS) (2 and 4 times higher).
The authors conclude: "The burden of overweight and obesity among adolescents in England is substantial and increased between 2008-2023. There is a significantly higher risk of early onset of many, particularly cardiometabolic, comorbidities among adolescents living with overweight or obesity, with risk increasing as BMI increases."
They add: "Over the past 15 years, obesity in adolescents has risen significantly due to a combination of increased consumption of ultra-processed foods, sedentary lifestyles driven by excessive screen time, inadequate sleep, and rising mental health challenges. Additionally, reduced opportunities for physical activity and socioeconomic disparities have further contributed to an environment that promotes unhealthy lifestyles."
On comorbidities, they say: "For many weight-related comorbidities, overweight and obesity in adolescence are associated with a higher risk during both adolescence and adulthood. Change of BMI in adolescence may have long-term impact on the risk of developing comorbidities. Increased focus on weight-management in adolescence could lead to long-term improvement in overall health."
