A new study from Karolinska Institutet, published in JAMA Pediatrics, reveals that weight-loss treatment in children with obesity has lasting health benefits, reducing the risk of serious conditions and premature death in young adulthood. However, the same positive effects do not extend to mental health, particularly depression and anxiety.
The study found that children and adolescents who responded well to obesity treatment were less likely to develop obesity-related diseases such as type 2 diabetes, hypertension, and dyslipidemia (elevated blood fat levels) later in life.
The treatment examined in the study focused on behavioral lifestyle therapy, which provides support to children with obesity and their families, encouraging healthy eating, exercise, and sleep habits.
“The results are very good news,” says Emilia Hagman, docent at the Department of Clinical Science, Intervention and Technology. “Whether or not the treatment of obesity in childhood has long-term health benefits have been debated, since weight-loss is hard to maintain.”
The study reveals that children with obesity who respond well to treatment also have a lower risk of premature death. A previous study by the same research group, published in PLOS Medicine, found that children with obesity face a significantly higher risk of early adulthood mortality, with suicide and physical health conditions being major contributing factors. Notably, over a quarter of these deaths were directly linked to obesity.
“This emphasises the importance of providing early treatment, as we know that timely intervention increases the likelihood of success and helps mitigate the long-term health risks associated with obesity” says Dr Hagman.
However, the JAMA Pediatrics study found that obesity treatment in childhood had no impact on the risk of depression and anxiety later in life. Regardless of treatment outcomes, the likelihood of developing anxiety and depression in young adulthood remained unchanged.
“It has been believed that weight loss could decrease symptoms of depression and anxiety, but we can now show that it’s not the case,” says Dr Hagman. “Even though there’s a link between the two comorbidities, they must be treated in parallel.”
The study analyzed data from over 6,700 individuals who underwent childhood obesity treatment, identified through the BORIS register (Swedish Childhood Obesity Treatment Register). These individuals were tracked into young adulthood using the Swedish Patient Register, the Prescribed Drugs Register, and the Cause of Death Register. A matched control group from the general population, based on age, sex, and place of residence, was also included.
GLP-1 analogues, now widely used for obesity treatment, were not part of the study, as they had not yet been approved when the participants received treatment. Dr. Hagman notes that even today, these medications are rarely prescribed to children.
“I’m in favour of their use as these drugs eases feelings of hunger, which is something that some children struggle with” she says. “That said, lifestyle therapy is still the foundation of all treatments for childhood obesity.”
The research team now aims to identify the most effective therapy options for different individuals and determine key health and risk markers that influence long-term outcomes.
Conflict of Interest Disclosures: The study was sponsored by Novo Nordisk A/S, which contributed to study design and data interpretation but was not involved in data collection or analysis. The funder also covered article writing and editorial support. Two co-authors are employed by Novo Nordisk, with one holding shares in Novo Nordisk and another pharmaceutical company. Additionally, two co-authors own shares in Evira AB, a company providing digital care for pediatric obesity. The study also received funding from the Åke Wiberg Foundation and the Ollie and Elof Ericsson’s Foundation. Emilia Hagman has conducted contract research for Novo Nordisk.
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