Juvenile obesity

Abstract

Though the literature contains many accounts describing dramatic short-term successes in the treatment of childhood obesity, there exist only a few systematic studies dealing with the long-term prognosis. Here I should like to mention two recent papers. Mullins (2), working in an adult medical out-patient department, found that about one third of all out-patients were obese and that in one third of these obese adults the obesity dated from childhood. He makes the important point that patients who are fat in childhood but grow up into adults of normal weight are usually of above-average intelligence. In other words, with which most paediatricians would agree, long term success in the treatment of childhood obesity can only be achieved when there is intelligent co-operation. This paper then stresses that adult obesity is commonly preceded by juvenile obesity but gives no indication as to the frequency with which juvenile obesity persists into adult life. An answer to this question, which to the paediatrician is of even greater importance, comes from a recent paper (1); this study is based on 335 overweight children seen between 1936 and 1954. Fifty of the patients who first attended hospital between 1936 and 1940 were re-examined after the war, when most of them were between 20 and 36 years of age. At re-examination no patient was below average weight for height and only 11 patients were less than 20 %overweight; i. e. four-fifths of the patients were still grossly overweight. While at the first examination no patient had been more than 80% overweight, at the follow-up examination three patients were more than 80% overweight. The authors conclude that spontaneous recovery is the exception rather than the rule.