Childhood obesity and its physical and psychological co-morbidities: a systematic review of Australian children and adolescents


Australia is predicted to have the highest overweight/obesity rate in the world by 2022 outranking the USA and UK. The purpose of this systematic review was to evaluate the associations between childhood obesity and physical and psychological health co-morbidities. Therefore, a systematic literature search was conducted from six databases (2004–2014). Studies were included if they investigated obesity-related co-morbidities with participants residing in Australia aged 0–18 years. Forty-seven studies fulfilled selection criteria. Evidence suggests that overweight/obese Australian children and adolescents, compared to normal-weight peers, had more cardio-metabolic risk factors and higher risk factors of non-alcohol fatty liver disease and were experiencing more negative psychological outcomes (depression, low self-esteem and lower scores of health-related quality of life). Many other health consequences have either not been investigated in Australia, or as frequently as in other countries.

Conclusions: Given Australia’s current overweight/obesity prevalence and trajectory, Australia-based studies are needed to identify the suspected co-morbidities, understand the range of individual, social and environmental mechanisms driving obesity, and help identify policies, interventions and strategies that will change the future trajectory and ‘disease burden’ both in Australia and internationally.

What is Known:
•Trend analyses have shown that obesity prevalence in Australia is increasing and will outrank UK and the USA by 2022.
•Every third Australian child/adolescent between 5 and 19 years old is predicted to be classified as overweight or obese by 2025.
•Childhood obesity is associated with multiple immediate physical and psychological health co-morbidities as well as co-morbidities in adulthood. These have often been identified and examined individually.
What is New:
•This paper presents a holistic picture of childhood obesity and the associated multiple co-morbidities in Australia.
•The extensive health-related outcomes from childhood obesity and those requiring further research are identified.
•The findings of this paper will influence the development of local/regional, state and national strategies to change Australia’s future trajectory.

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Fig. 1



Attention deficit hyperactivity disorder


Alanine transaminase


Acanthosis nigricans


Aspartate transaminase


Body mass index


Diastolic blood pressure


Gamma glutamyltransferase


High-density lipoprotein


Health-related quality of life


High-sensitivity C-reactive protein


Low-density lipoprotein


Non-alcohol fatty liver disease


Organisation for Economic Co-operation and Development


Obstructive sleep apnoea syndrome


Systolic blood pressure


Waist circumference


The World Health Organization


  1. 1.

    Al Mamun A, Cramb SM, O’Callaghan MJ, Williams GM, Najman JM (2009) Childhood Overweight Status Predicts Diabetes at Age 21 Years: A Follow-up Study. Obesity 17:1255–1261. doi:10.1038/oby.2008.660

    PubMed  Google Scholar 

  2. 2.

    Au N (2012) The health care cost implications of overweight and obesity during childhood. Health Serv Res 47:655–676. doi:10.1111/j.1475-6773.2011.01326.x

    PubMed Central  PubMed  Google Scholar 

  3. 3.

    Australia’s Physical Activity and Sedentary Behaviour Guidelines. Accessed: January 16 2015

  4. 4.

    Australian Bureau of Statistics. Australian Health Survey: Updated Results 2011-2012. Accessed: August 4 2014

  5. 5.

    Australian Institute of health and Welfare. Young Australians: Their Health and Wellbeing 2011. Accessed: September 14 2014

  6. 6.

    Ayonrinde OT, Olynyk JK, Beilin LJ, Mori TA, Pennell CE, de Klerk N, Oddy WH, Shipman P, Adams LA (2011) Gender-specific differences in adipose distribution and adipocytokines influence adolescent nonalcoholic fatty liver disease. Hepatology 53:800–809. doi:10.1002/hep.24097

    CAS  PubMed  Google Scholar 

  7. 7.

    Baker JL, Olsen LW, Sorensen TI (2007) Childhood body-mass index and the risk of coronary heart disease in adulthood. New Engl J Med 357:2329–2337. doi:10.1056/NEJMoa072515

    PubMed Central  CAS  PubMed  Google Scholar 

  8. 8.

    Bell L, Hung J, Knuiman M, Divitini M, Beilby J, Hunter M, Mollison L, Thompson P, McQuillan B, Davis E (2013) Body mass index and waist circumference: relationship to cardiometabolic risk factors in children--Busselton Health Study 2005-2007. J Paediatr Child Health 49:955–962. doi:10.1111/jpc.12298

    PubMed  Google Scholar 

  9. 9.

    Bell LM, Byrne S, Thompson A, Ratnam N, Blair E, Bulsara M, Jones TW, Davis EA (2007) Increasing body mass index z-score is continuously associated with complications of overweight in children, even in the healthy weight range. J Clin Endocrinol Metab 92:517–522. doi:10.1210/jc.2006-1714

    CAS  PubMed  Google Scholar 

  10. 10.

    Bell LM, Curran JA, Byrne S, Roby H, Suriano K, Jones TW, Davis EA (2011) High incidence of obesity co-morbidities in young children: a cross-sectional study. J Paediatr Child Health 47:911–917. doi:10.1111/j.1440-1754.2011.02102.x

    PubMed  Google Scholar 

  11. 11.

    Biro FM, Wien M (2010) Childhood obesity and adult morbidities. Am J Clin Nutr 91:1499S–1505S. doi:10.3945/ajcn.2010.28701B

    PubMed Central  PubMed  Google Scholar 

  12. 12.

    Bitsori M, Linardakis M, Tabakaki M, Kafatos A (2009) Waist circumference as a screening tool for the identification of adolescents with the metabolic syndrome phenotype. Int J Pediatr Obes : IJPO : Offic J Int Assoc Study Obes 4:325–331. doi:10.3109/17477160902914597

    Google Scholar 

  13. 13.

    Bjorge T, Tretli S, Engeland A (2004) Relation of height and body mass index to renal cell carcinoma in two million Norwegian men and women. Am J Epidemiol 160:1168–1176. doi:10.1093/aje/

    PubMed  Google Scholar 

  14. 14.

    Blackburn P, Lemieux I, Almeras N, Bergeron J, Cote M, Tremblay A, Lamarche B, Despres JP (2009) The hypertriglyceridemic waist phenotype versus the National Cholesterol Education Program-Adult Treatment Panel III and International Diabetes Federation clinical criteria to identify high-risk men with an altered cardiometabolic risk profile. Metab Clin Exp 58:1123–1130. doi:10.1016/j.metabol.2009.03.012

    CAS  PubMed  Google Scholar 

  15. 15.

    Bolton K, Kremer P, Rossthorn N, Moodie M, Gibbs L, Waters E, Swinburn B, de Silva A (2014) The effect of gender and age on the association between weight status and health-related quality of life in Australian adolescents. BMC Public Health 14:8. doi:10.1186/1471-2458-14-898

    Google Scholar 

  16. 16.

    Booth ML, Dobbins T, Okely AD, Denney-Wilson E, Hardy LL (2007) Trends in the Prevalence of Overweight and Obesity among Young Australians, 1985, 1997, and 2004. Obesity 15:1089–1095. doi:10.1038/oby.2007.586

    PubMed  Google Scholar 

  17. 17.

    Booth ML, George J, Denney-Wilson E, Okely AD, Hardy LL, Aitken R, Dobbins T (2008) The population prevalence of adverse concentrations and associations with adiposity of liver tests among Australian adolescents. J Paediatr Child Health 44:686–691. doi:10.1111/j.1440-1754.2008.01407.x

    PubMed  Google Scholar 

  18. 18.

    Burgess JA, Walters EH, Byrnes GB, Giles GG, Jenkins MA, Abramson MJ, Hopper JL, Dharmage SC (2007) Childhood adiposity predicts adult-onset current asthma in females: a 25-yr prospective study. Eur Respir J 29:668–675. doi:10.1183/09031936.00080906

    CAS  PubMed  Google Scholar 

  19. 19.

    Burke V, Beilin LJ, Dunbar D, Kevan M (2004) Associations between blood pressure and overweight defined by new standards for body mass index in childhood. Prev Med 38:558–564

    CAS  PubMed  Google Scholar 

  20. 20.

    Burke V, Beilin LJ, Simmer K, Oddy WH, Blake KV, Doherty D, Kendall GE, Newnham JP, Landau LI, Stanley FJ (2005) Predictors of body mass index and associations with cardiovascular risk factors in Australian children: a prospective cohort study. Int J Obesity 29:15–23. doi:10.1038/sj.ijo.0802750

    CAS  Google Scholar 

  21. 21.

    Chen G, Ratcliffe J, Olds T, Magarey A, Jones M, Leslie E (2014) BMI, health behaviors, and quality of life in children and adolescents: a school-based study. Pediatrics 133:e868–874. doi:10.1542/peds.2013-0622

    PubMed  Google Scholar 

  22. 22.

    Clark JM, Brancati FL, Diehl AM (2003) The prevalence and etiology of elevated aminotransferase levels in the United States. Am J Gastroenterol 98:960–967. doi:10.1111/j.1572-0241.2003.07486.x

    CAS  PubMed  Google Scholar 

  23. 23.

    Daniels SR (2009) Complications of obesity in children and adolescents. Int J Obes (Lond) 33(Suppl 1):S60–65. doi:10.1038/ijo.2009.20

    Google Scholar 

  24. 24.

    Denney-Wilson E, Cowell CT, Okely AD, Hardy LL, Aitken R, Dobbins T (2010) Associations between insulin and glucose concentrations and anthropometric measures of fat mass in Australian adolescents. BMC Pediatr 10:58. doi:10.1186/1471-2431-10-58

    PubMed Central  PubMed  Google Scholar 

  25. 25.

    Denney-Wilson E, Hardy LL, Dobbins T, Okely AD, Baur LA (2008) Body mass index, waist circumference, and chronic disease risk factors in Australian adolescents. Arch Pediatr Adolesc Med 162:566–573. doi:10.1001/archpedi.162.6.566

    PubMed  Google Scholar 

  26. 26.

    El-Metainy S, Ghoneim T, Aridae E, Abdel Wahab M (2011) Incidence of perioperative adverse events in obese children undergoing elective general surgery. Br J Anaesth 106:359–363. doi:10.1093/bja/aeq368

    CAS  PubMed  Google Scholar 

  27. 27.

    Engeland A, Tretli S, Bjorge T (2003) Height, body mass index, and ovarian cancer: a follow-up of 1.1 million Norwegian women. J Nat Cancer Inst 95:1244–1248

    PubMed  Google Scholar 

  28. 28.

    Falkstedt D, Hemmingsson T, Rasmussen F, Lundberg I (2007) Body mass index in late adolescence and its association with coronary heart disease and stroke in middle age among Swedish men. Int J Obes (Lond) 31:777–783. doi:10.1038/sj.ijo.0803480

    CAS  Google Scholar 

  29. 29.

    Field AE, Cook NR, Gillman MW (2005) Weight status in childhood as a predictor of becoming overweight or hypertensive in early adulthood. Obes Res 13:163–169. doi:10.1038/oby.2005.21

    PubMed Central  PubMed  Google Scholar 

  30. 30.

    Fishbein MH, Miner M, Mogren C, Chalekson J (2003) The spectrum of fatty liver in obese children and the relationship of serum aminotransferases to severity of steatosis. J Pediatr Gastroenterol Nutr 36:54–61

    CAS  PubMed  Google Scholar 

  31. 31.

    Franklin J, Denyer G, Steinbeck KS, Caterson ID, Hill AJ (2006) Obesity and risk of low self-esteem: a statewide survey of Australian children. Pediatrics 118:2481–2487

    PubMed  Google Scholar 

  32. 32.

    Franks PW, Hanson RL, Knowler WC, Sievers ML, Bennett PH, Looker HC (2010) Childhood obesity, other cardiovascular risk factors, and premature death. New Engl J Med 362:485–493. doi:10.1056/NEJMoa0904130

    PubMed Central  CAS  PubMed  Google Scholar 

  33. 33.

    The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses Accessed October 3, 2014

  34. 34.

    Gardin JM, McClelland R, Kitzman D, Lima JA, Bommer W, Klopfenstein HS, Wong ND, Smith VE, Gottdiener J (2001) M-mode echocardiographic predictors of six- to seven-year incidence of coronary heart disease, stroke, congestive heart failure, and mortality in an elderly cohort (the Cardiovascular Health Study). Am J Cardiol 87:1051–1057

    CAS  PubMed  Google Scholar 

  35. 35.

    Garnett SP, Baur LA, Cowell CT (2011) The prevalence of increased central adiposity in Australian school children 1985 to 2007. Obes Rev 12:887–896

    CAS  PubMed  Google Scholar 

  36. 36.

    Garnett SP, Baur LA, Srinivasan S, Lee JW, Cowell CT (2007) Body mass index and waist circumference in midchildhood and adverse cardiovascular disease risk clustering in adolescence. Am J Clin Nutr 86:549–555

    CAS  PubMed  Google Scholar 

  37. 37.

    Gibson LY, Byrne SM, Blair E, Davis EA, Jacoby P, Zubrick SR (2008) Clustering of psychosocial symptoms in overweight children. Aust N Z J Psychiatry 42:118–125. doi:10.1080/00048670701787560

    PubMed  Google Scholar 

  38. 38.

    Gopinath B, Baur LA, Garnett S, Pfund N, Burlutsky G, Mitchell P (2011) Body Mass Index and Waist Circumference Are Associated With Blood Pressure in Preschool-Aged Children. Ann Epidemiol 21:351–357. doi:10.1016/j.annepidem.2011.02.002

    PubMed  Google Scholar 

  39. 39.

    Haby M, Markwick A (2008) Future prevalence of overweight and obesity in Australian children and adolescents, 2005-2025. Victorian Government, Department of Human Services, Melbourne, Australia.$FILE/future_overweight_prevalence_report.pdf

  40. 40.

    Haby MM, Markwick A, Peeters A, Shaw J, Vos T (2012) Future predictions of body mass index and overweight prevalence in Australia, 2005-2025. Health Promot Int 27:250–260. doi:10.1093/heapro/dar036

    PubMed  Google Scholar 

  41. 41.

    Hardy LL, Cosgrove C, King L, Venugopal K, Baur LA, Gill T (2012) Shifting curves? Trends in thinness and obesity among Australian youth, 1985 to 2010. Pediatr Obes 7:92–100. doi:10.1111/j.2047-6310.2011.00016.x

    CAS  PubMed  Google Scholar 

  42. 42.

    Harriger JA, Thompson JK (2012) Psychological consequences of obesity: weight bias and body image in overweight and obese youth. Int Rev Psychiatry 24:247–253. doi:10.3109/09540261.2012.678817

    PubMed  Google Scholar 

  43. 43.

    Harris KM, Gordon-Larsen P, Chantala K, Udry JR (2006) Longitudinal trends in race/ethnic disparities in leading health indicators from adolescence to young adulthood. Arch Pediatr Adolesc Med 160:74–81. doi:10.1001/archpedi.160.1.74

    PubMed  Google Scholar 

  44. 44.

    Haysom L, Williams RE, Hodson EM, Lopez-Vargas P, Roy L, Lyle DM, Craig JC (2009) Cardiovascular risk factors in Australian indigenous and non-indigenous children: A population-based study. J Paediatr Child Health 45:20–27. doi:10.1111/j.1440-1754.2008.01426.x

    PubMed  Google Scholar 

  45. 45.

    Hesketh K, Wake M, Waters E (2004) Body mass index and parent-reported self-esteem in elementary school children: evidence for a causal relationship. Int J Obes Relat Metab Disord 28:1233–1237

    CAS  PubMed  Google Scholar 

  46. 46.

    Hoare E, Millar L, Fuller-Tyszkiewicz M, Skouteris H, Nichols M, Jacka F, Swinburn B, Chikwendu C, Allender S (2014) Associations between obesogenic risk and depressive symptomatology in Australian adolescents: a cross-sectional study. J Epidemiol Community Health 68:767–772. doi:10.1136/jech-2013-203562

    CAS  PubMed  Google Scholar 

  47. 47.

    Hooley M, Skouteris H, Millar L (2012) The relationship between childhood weight, dental caries and eating practices in children aged 4-8 years in Australia, 2004-2008. Pediatr Obes 7:461–470. doi:10.1111/j.2047-6310.2012.00072.x

    CAS  PubMed  Google Scholar 

  48. 48.

    Huang RC, de Klerk NH, Smith A, Kendall GE, Landau LI, Mori TA, Newnham JP, Stanley FJ, Oddy WH, Hands B, Beilin LJ (2011) Lifecourse Childhood Adiposity Trajectories Associated With Adolescent Insulin Resistance. Diabetes Care 34:1019–1025. doi:10.2337/dc10-1809

    PubMed Central  PubMed  Google Scholar 

  49. 49.

    James S, Pezic A, Ponsonby AL, Lafferty A, Glasgow N, Ciszek K, Kljakovic M, Douglas K (2013) Obesity and asthma at school entry: co-morbidities and temporal trends. J Paediatr Child Health 49:E273–280. doi:10.1111/jpc.12160

    PubMed  Google Scholar 

  50. 50.

    Jansen P, Mensah F, Clifford S, Nicholson J, Wake M (2013) Bidirectional associations between overweight and health-related quality of life from 4-11 years: Longitudinal Study of Australian Children. Int J Obes 37:1307–1313. doi:10.1038/ijo.2013.71

    CAS  Google Scholar 

  51. 51.

    Jansen PW, Mensah FK, Clifford SA, Tiemeier H, Nicholson JM, Wake M (2013) Development of mental health problems and overweight between ages 4 and 11 years: a population-based longitudinal study of Australian children. Acad Pediatr 13:159–167. doi:10.1016/j.acap.2012.12.001

    PubMed  Google Scholar 

  52. 52.

    Kalra G, De Sousa A, Sonavane S, Shah N (2012) Psychological issues in pediatric obesity. Ind Psychiatry J 21:11–17. doi:10.4103/0972-6748.110941

    PubMed Central  PubMed  Google Scholar 

  53. 53.

    Ke L, Brock KE, Cant RV, Li Y, Morrell SL (2009) The relationship between obesity and blood pressure differs by ethnicity in Sydney school children. Am J Hypertens 22:10.1038/ajh.2008.308–58

    Google Scholar 

  54. 54.

    Keating CL, Moodie ML, Bulfone L, Swinburn BA, Stevenson CE, Peeters A (2012) Healthcare utilization and costs in severely obese subjects before bariatric surgery. Obesity 20:2412–2418

    PubMed  Google Scholar 

  55. 55.

    Keating CL, Moodie ML, Richardson J, Swinburn BA (2011) Utility-based quality of life of overweight and obese adolescents. Value Health 14:752–758. doi:10.1016/j.jval.2011.02.1181

    PubMed  Google Scholar 

  56. 56.

    Keating CL, Moodie ML, Swinburn BA (2011) The health-related quality of life of overweight and obese adolescents--a study measuring body mass index and adolescent-reported perceptions. Int J Pediatr Obes 6:434–441. doi:10.3109/17477166.2011.590197

    PubMed  Google Scholar 

  57. 57.

    Kohler M, Lushington K, Couper R, Martin J, van den Heuvel C, Pamula Y, Kennedy D (2008) Obesity and risk of sleep related upper airway obstruction in Caucasian children. J Clin Sleep Med 4:129–136

    PubMed Central  PubMed  Google Scholar 

  58. 58.

    Kohler MJ, Thormaehlen S, Kennedy JD, Pamula Y, van den Heuvel CJ, Lushington K, Martin AJ (2009) Differences in the association between obesity and obstructive sleep apnea among children and adolescents. J Clin Sleep Med : JCSM : Offic Publ Am Acad Sleep Med 5:506–511

    Google Scholar 

  59. 59.

    Koletzko B, von Kries R, Monasterolo RC, Subias JE, Scaglioni S, Giovannini M, Beyer J, Demmelmair H, Anton B, Gruszfeld D, Dobrzanska A, Sengier A, Langhendries JP, Cachera MF, Grote V, European Childhood Obesity Trial Study G (2009) Infant feeding and later obesity risk. Adv Exp Med Biol 646:15–29. doi:10.1007/978-1-4020-9173-5_2

    Google Scholar 

  60. 60.

    Latzer Y, Stein D (2013) A review of the psychological and familial perspectives of childhood obesity. J Eat Disord 1:7. doi:10.1186/2050-2974-1-7

    PubMed Central  PubMed  Google Scholar 

  61. 61.

    Lazorick S, Peaker B, Perrin EM, Schmid D, Pennington T, Yow A, DuBard CA (2011) Prevention and treatment of childhood obesity: care received by a state medicaid population. Clin Pediatr 50:816–826. doi:10.1177/0009922811406259

    Google Scholar 

  62. 62.

    Levy D, Garrison RJ, Savage DD, Kannel WB, Castelli WP (1990) Prognostic implications of echocardiographically determined left ventricular mass in the Framingham Heart Study. New Engl J Med 322:1561–1566. doi:10.1056/NEJM199005313222203

    CAS  PubMed  Google Scholar 

  63. 63.

    Li L, Law C, Power C (2007) Body mass index throughout the life-course and blood pressure in mid-adult life: a birth cohort study. J Hypertens 25:1215–1223. doi:10.1097/HJH.0b013e3280f3c01a

    CAS  PubMed  Google Scholar 

  64. 64.

    Libbey HP, Story MT, Neumark-Sztainer DR, Boutelle KN (2008) Teasing, disordered eating behaviors, and psychological morbidities among overweight adolescents. Obesity (Silver Spring, Md) 16(Suppl 2):S24–29. doi:10.1038/oby.2008.455

    Google Scholar 

  65. 65.

    Lloyd LJ, Langley-Evans SC, McMullen S (2012) Childhood obesity and risk of the adult metabolic syndrome: a systematic review. Int J Obes (Lond) 36:1–11. doi:10.1038/ijo.2011.186

    CAS  Google Scholar 

  66. 66.

    Mamun AA, Lawlor DA, Alati R, O’Callaghan MJ, Williams GM, Najman JM (2007) Increasing body mass index from age 5 to 14 years predicts asthma among adolescents: evidence from a birth cohort study. Int J Obes 31:578–583

    CAS  Google Scholar 

  67. 67.

    Moretto N, Kendall E, Whitty J, Byrnes J, Hills AP, Gordon L, Turkstra E, Scuffham P, Comans T (2014) Yes, The Government Should Tax Soft Drinks: Findings from a Citizens’ Jury in Australia. Int J Environ Res Public Health 11:2456–2471. doi:10.3390/ijerph110302456

    PubMed Central  PubMed  Google Scholar 

  68. 68.

    Neovius M, Sundstrom J, Rasmussen F (2009) Combined effects of overweight and smoking in late adolescence on subsequent mortality: nationwide cohort study. BMJ 338:b496. doi:10.1136/bmj.b496

    PubMed Central  PubMed  Google Scholar 

  69. 69.

    Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, Mullany EC, Biryukov S, Abbafati C, Abera SF, Abraham JP, Abu-Rmeileh NM, Achoki T, AlBuhairan FS, Alemu ZA, Alfonso R, Ali MK, Ali R, Guzman NA, Ammar W, Anwari P, Banerjee A, Barquera S, Basu S, Bennett DA, Bhutta Z, Blore J, Cabral N, Nonato IC, Chang JC, Chowdhury R, Courville KJ, Criqui MH, Cundiff DK, Dabhadkar KC, Dandona L, Davis A, Dayama A, Dharmaratne SD, Ding EL, Durrani AM, Esteghamati A, Farzadfar F, Fay DF, Feigin VL, Flaxman A, Forouzanfar MH, Goto A, Green MA, Gupta R, Hafezi-Nejad N, Hankey GJ, Harewood HC, Havmoeller R, Hay S, Hernandez L, Husseini A, Idrisov BT, Ikeda N, Islami F, Jahangir E, Jassal SK, Jee SH, Jeffreys M, Jonas JB, Kabagambe EK, Khalifa SE, Kengne AP, Khader YS, Khang YH, Kim D, Kimokoti RW, Kinge JM, Kokubo Y, Kosen S, Kwan G, Lai T, Leinsalu M, Li Y, Liang X, Liu S, Logroscino G, Lotufo PA, Lu Y, Ma J, Mainoo NK, Mensah GA, Merriman TR, Mokdad AH, Moschandreas J, Naghavi M, Naheed A, Nand D, Narayan KM, Nelson EL, Neuhouser ML, Nisar MI, Ohkubo T, Oti SO, Pedroza A, Prabhakaran D, Roy N, Sampson U, Seo H, Sepanlou SG, Shibuya K, Shiri R, Shiue I, Singh GM, Singh JA, Skirbekk V, Stapelberg NJ, Sturua L, Sykes BL, Tobias M, Tran BX, Trasande L, Toyoshima H, van de Vijver S, Vasankari TJ, Veerman JL, Velasquez-Melendez G, Vlassov VV, Vollset SE, Vos T, Wang C, Wang SX, Weiderpass E, Werdecker A, Wright JL, Yang YC, Yatsuya H, Yoon J, Yoon SJ, Zhao Y, Zhou M, Zhu S, Lopez AD, Murray CJ, Gakidou E (2014) Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. doi:10.1016/s0140-6736(14)60460-8

    Google Scholar 

  70. 70.

    NSW Ministry of Health. SPANS 2010 Executive Summary. Physical Activity, Nutrition and Obesity Research Group, Sydney University Accessed: July 25 2014

  71. 71.

    O’Dea JA (2008) Gender, ethnicity, culture and social class influences on childhood obesity among Australian schoolchildren: implications for treatment, prevention and community education. Health Social Care Community 16:282–290. doi:10.1111/j.1365-2524.2008.00768.x

    Google Scholar 

  72. 72.

    Oddy WH, Sherriff JL, de Klerk NH, Kendall GE, Sly PD, Beilin LJ, Blake KB, Landau LI, Stanley FJ (2004) The Relation of Breastfeeding and Body Mass Index to Asthma and Atopy in Children: A Prospective Cohort Study to Age 6 Years. Am J Public Health 94:1531–1537

    PubMed Central  PubMed  Google Scholar 

  73. 73.

    Ogden CL, Carroll MD, Flegal KM (2008) High body mass index for age among US children and adolescents, 2003-2006. JAMA : J Am Med Assoc 299:2401–2405. doi:10.1001/jama.299.20.2401

    CAS  Google Scholar 

  74. 74.

    Olutoye OA, Watcha MF, Andropoulos DB (2011) Pediatric obesity: observed impact in the ambulatory surgery setting. J Nat Med Assoc 103:27–30

    Google Scholar 

  75. 75.

    Park MH, Falconer C, Viner RM, Kinra S (2012) The impact of childhood obesity on morbidity and mortality in adulthood: a systematic review. Obes Rev : Off J Int Assoc Study Obes 13:985–1000. doi:10.1111/j.1467-789X.2012.01015.x

    CAS  Google Scholar 

  76. 76.

    Patro B, Liber A, Zalewski B, Poston L, Szajewska H, Koletzko B (2013) Maternal and paternal body mass index and offspring obesity: a systematic review. Ann Nutr Metab 63:32–41. doi:10.1159/000350313

    CAS  PubMed  Google Scholar 

  77. 77.

    Peneau S, Salanave B, Maillard-Teyssier L, Rolland-Cachera MF, Vergnaud AC, Mejean C, Czernichow S, Vol S, Tichet J, Castetbon K, Hercberg S (2009) Prevalence of overweight in 6- to 15-year-old children in central/western France from 1996 to 2006: trends toward stabilization. Int J Obes 33:401–407

    CAS  Google Scholar 

  78. 78.

    Pfeiffer M, Kotz R, Ledl T, Hauser G, Sluga M (2006) Prevalence of flat foot in preschool-aged children. Pediatrics 118:634–639. doi:10.1542/peds.2005-2126

    PubMed  Google Scholar 

  79. 79.

    Pulgaron ER (2013) Childhood obesity: a review of increased risk for physical and psychological comorbidities. Clin Ther 35:A18–32. doi:10.1016/j.clinthera.2012.12.014

    PubMed Central  PubMed  Google Scholar 

  80. 80.

    Reilly JJ, Kelly J (2011) Long-term impact of overweight and obesity in childhood and adolescence on morbidity and premature mortality in adulthood: systematic review. Int J Obesa 35:891–898

    CAS  Google Scholar 

  81. 81.

    Reilly JJ, Methven E, McDowell ZC, Hacking B, Alexander D, Stewart L, Kelnar CJ (2003) Health consequences of obesity. Arch Dis Child 88:748–752

    PubMed Central  CAS  PubMed  Google Scholar 

  82. 82.

    Samartzis D, Karppinen J, Mok F, Fong DY, Luk KD, Cheung KM (2011) A population-based study of juvenile disc degeneration and its association with overweight and obesity, low back pain, and diminished functional status. J Bone Joint Surg Am 93:662–670. doi:10.2106/JBJS.I.01568

    PubMed  Google Scholar 

  83. 83.

    Sanderson K, Patton GC, McKercher C, Dwyer T, Venn AJ (2011) Overweight and obesity in childhood and risk of mental disorder: a 20-year cohort study. Aust N Z J Psychiatry 45:384–392. doi:10.3109/00048674.2011.570309

    PubMed  Google Scholar 

  84. 84.

    Sassi F (2010) Obesity and the economics of prevention: fit not fat. OECD Publishing, Paris, France. doi:10.1787/9789264084865-en or

  85. 85.

    Sassi F (2014) Obesity and the Economics of Prevention: Fit not Fat. OBESITY update. OECD Publishing.

  86. 86.

    Sawyer MG, Harchak T, Wake M, Lynch J (2011) Four-year prospective study of BMI and mental health problems in young children. Pediatrics 128:677–684. doi:10.1542/peds.2010-3132

    PubMed  Google Scholar 

  87. 87.

    Sawyer MG, Miller-Lewis L, Guy S, Wake M, Canterford L, Carlin JB (2006) Is there a relationship between overweight and obesity and mental health problems in 4- to 5-year-old Australian children? Ambul Pediatr 6:306–311

    PubMed  Google Scholar 

  88. 88.

    Schmidt MD, Dwyer T, Magnussen CG, Venn AJ (2011) Predictive associations between alternative measures of childhood adiposity and adult cardio-metabolic health. Int J Obes 35:38–45. doi:10.1038/ijo.2010.205

    CAS  Google Scholar 

  89. 89.

    Schneider H, Dietrich ES, Venetz WP (2010) Trends and stabilization up to 2022 in overweight and obesity in Switzerland, comparison to France, UK, US and Australia. Int J Environ Res Public Health 7:460–472

    PubMed Central  PubMed  Google Scholar 

  90. 90.

    Sellers EA, Singh GR, Sayers SM (2008) Large waist but low body mass index: the metabolic syndrome in Australian Aboriginal children. J Pediatr 153:222–227. doi:10.1016/j.jpeds.2008.02.006

    PubMed  Google Scholar 

  91. 91.

    Sjoberg A, Lissner L, Albertsson-Wikland K, Marild S (1992) Recent anthropometric trends among Swedish school children: evidence for decreasing prevalence of overweight in girls. Acta Paediatr (Oslo, Norway : 1992) 97:118–123. doi:10.1111/j.1651-2227.2007.00613.x

    Google Scholar 

  92. 92.

    Stamatakis E, Wardle J, Cole TJ (2009) Childhood obesity and overweight prevalence trends in England: evidence for growing socioeconomic disparities. Int J Obes 34:41–47

    Google Scholar 

  93. 93.

    Stevens GA, Singh GM, Lu Y, Danaei G, Lin JK, Finucane MM, Bahalim AN, McIntire RK, Gutierrez HR, Cowan M, Paciorek CJ, Farzadfar F, Riley L, Ezzati M, Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating G, (2012) National, regional, and global trends in adult overweight and obesity prevalences. Popul Health Metrics 10:22. doi:10.1186/1478-7954-10-22

    Google Scholar 

  94. 94.

    Stordal K, Johannesdottir GB, Bentsen BS, Carlsen KC, Sandvik L (2006) Asthma and overweight are associated with symptoms of gastro-oesophageal reflux. Acta Paediatr (Oslo, Norway: 1992) 95:1197–1201. doi:10.1080/08035250600589041

    Google Scholar 

  95. 95.

    Suriano K, Curran J, Byrne SM, Jones TW, Davis EA (2010) Fatness, Fitness, and Increased Cardiovascular Risk in Young Children. J Pediatr 157:552–558. doi:10.1016/j.jpeds.2010.04.042

    PubMed  Google Scholar 

  96. 96.

    Tai A, Volkmer R, Burton A (2009) Association between asthma symptoms and obesity in preschool (4-5 year old) children. J Asthma 46:362–365. doi:10.1080/02770900902759260

    PubMed  Google Scholar 

  97. 97.

    Tapp RJ, Venn A, Huynh QL, Raitakari OT, Ukoumunne OC, Dwyer T, Magnussen CG (2014) Impact of adiposity on cardiac structure in adult life: the childhood determinants of adult health (CDAH) study. BMC Cardiovasc Disord 14:79. doi:10.1186/1471-2261-14-79

    PubMed Central  PubMed  Google Scholar 

  98. 98.

    Taylor A, Wilson C, Slater A, Mohr P (2012) Self-esteem and body dissatisfaction in young children: Associations with weight and perceived parenting style. Clin Psychol 16:25–35. doi:10.1111/j.1742-9552.2011.00038.x

    Google Scholar 

  99. 99.

    Teitelbaum JE, Sinha P, Micale M, Yeung S, Jaeger J (2009) Obesity is related to multiple functional abdominal diseases. J Pediatr 154:444–446. doi:10.1016/j.jpeds.2008.09.053

    PubMed  Google Scholar 

  100. 100.

    Thivel D, Tremblay MS, Chaput JP (2013) Modern Sedentary Behaviors Favor Energy Consumption in Children and Adolescents. Curr Obes Rep 2:50–57

    Google Scholar 

  101. 101.

    Tie HT, Xia YY, Zeng YS, Zhang Y, Dai CL, Guo JJ, Zhao Y (2014) Risk of childhood overweight or obesity associated with excessive weight gain during pregnancy: a meta-analysis. Arch Gynecol Obstet 289:247–257. doi:10.1007/s00404-013-3053-z

    PubMed  Google Scholar 

  102. 102.

    Tsiros M, Buckley J, Howe P, Olds T, Walkley J, Taylor L, Mallows R, Hills A, Kagawa M, Coates A (2013) Day-to-day physical functioning and disability in obese 10- to 13-year-olds. Pediatr Obes 8:31–41. doi:10.1111/j.2047-6310.2012.00083.x

    CAS  PubMed  Google Scholar 

  103. 103.

    Valery PC, Moloney A, Cotterill A, Harris M, Sinha AK, Green AC (2009) Prevalence of obesity and metabolic syndrome in Indigenous Australian youths. Obes Rev 10:255–261. doi:10.1111/j.1467-789X.2008.00545.x

    CAS  PubMed  Google Scholar 

  104. 104.

    Varni JW, Seid M, Kurtin PS (2001) PedsQL 4.0: reliability and validity of the Pediatric Quality of Life Inventory version 4.0 generic core scales in healthy and patient populations. Med Care 39:800–812

    CAS  PubMed  Google Scholar 

  105. 105.

    Wake M, Canterford L, Patton GC, Hesketh K, Hardy P, Williams J, Waters E, Carlin JB (2010) Comorbidities of overweight/obesity experienced in adolescence: Longitudinal study. Arch Dis Child 95:162–168

    PubMed  Google Scholar 

  106. 106.

    Wake M, Clifford SA, Patton GC, Waters E, Williams J, Canterford L, Carlin JB (2013) Morbidity patterns among the underweight, overweight and obese between 2 and 18 years: population-based cross-sectional analyses. Int J Obes 37:86–93. doi:10.1038/ijo.2012.86

    CAS  Google Scholar 

  107. 107.

    Wake M, Hardy P, Sawyer MG, Carlin JB (2008) Comorbidities of overweight/obesity in Australian preschoolers: a cross-sectional population study. Arch Dis Child 93:502–507. doi:10.1136/adc.2007.128116

    CAS  PubMed  Google Scholar 

  108. 108.

    Watts K, Bell LM, Byrne SM, Jones TW, Davis EA (2008) Waist circumference predicts cardiovascular risk in young Australian children. J Paediatr Child Health 44:709–715. doi:10.1111/j.1440-1754.2008.01411.x

    PubMed  Google Scholar 

  109. 109.

    Williams J, Wake M, Hesketh K, Maher E, Waters E (2005) Health-related quality of life of overweight and obese children. JAMA : J Am Med Assoc 293:70–76

    CAS  Google Scholar 

  110. 110.

    World Health Oraganization. Global Strategy on Diet, Physical Activity and Health. Accessed: March 24 2015

  111. 111.

    World Health Organization. Global Health Observatory (GHO): Overweight and obesity. Accessed: July 16 2014

  112. 112.

    World Health Organization. Obesity and Overweight- updated 2014. vol 2014. Accessed: July 16 2014

  113. 113.

    World Health Organization. Population-based approaches to CHILDHOOD OBESITY PREVENTION.Accessed: March 24 2015

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Conflict of interest

There was no funding or sponsorship of this research. The authors declare that they have no conflict of interest.

Author contributions

This research was conceived and directed by RS and SC as part of a series of studies on adolescent obesity at The University of Sydney. AH conducted a comprehensive systematic literature search, study selection and data extraction. All authors contributed to writing and reviewing the document at all stages, reviewed and approved the manuscript prior to submission. Each of our authors meets the standard criteria for authorship.

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The manuscript does not contain clinical studies or patient data.

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Correspondence to Ross H. Sanders.

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Communicated by Beat Steinmann

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Sanders, R.H., Han, A., Baker, J.S. et al. Childhood obesity and its physical and psychological co-morbidities: a systematic review of Australian children and adolescents. Eur J Pediatr 174, 715–746 (2015).

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  • Obesity
  • Overweight
  • Co-morbidity
  • Systematic review
  • Childhood
  • Adolescents
  • Australia