Obesity, overweight in adolescence tied to risk of serious morbidity in early adulthood

Overweight or obesity during adolescence appears to come with an increased risk of developing serious morbidity before age 25, according to a retrospective study.

Researchers looked at 1,264,355 Israeli conscripts between 17 and 21 years of age who were assessed for military service. Some Of these, 145,702 participants were excluded, of which 144,705 were considered ineligible for service for nonmedical (n=133,112) or medical (n=11,593) reasons, and 2,867 had missing height or weight data. A total of 1,118,653 individuals (55.7 percent male) were included in the analysis.

The primary outcome was the incidence of serious morbidity leading to disqualification from completing mandatory service. Baseline BMI was standardized to age- and sex-specific percentiles and categorized according to the US Centers for Disease Control and Prevention categories. Cox models were applied to estimate the risk of serious morbidity across the BMI categories.

A total of 23,347 cases of serious morbidity were documented over 2,534,873 person-years. Of note, the incidence increased across BMI groups in both sexes.

Among male participants, the hazard ratios (HRs) for serious morbidity relative to normal BMI were 0.89 (95 percent confidence interval [CI], 0.83–0.95) with underweight, 1.21 (95 percent CI, 1.16–1.27) with overweight, 1.39 (95 percent CI, 1.32–1.47) with obesity class 1, 2.82 (95 percent CI, 2.60–3.06) with obesity class 2, and 5.14 (95 percent CI, 4.37–6.04) with obesity class 3.

Among female participants, the corresponding HRs were 0.95 (95 percent CI, 0.84–1.09) with underweight, 1.27 (95 percent CI, 1.17–1.37) with overweight, 1.63 (95 percent CI, 1.45–1.82) with obesity class 1, 4.00 (95 percent CI, 3.46–4.61) with obesity class 2, and 7.30 (95 percent CI, 5.65–9.43) with obesity class 3.

Sensitivity analyses restricted to those with unimpaired health at baseline or those in civilian-equivalent office employments yielded consistent results.

The findings suggest that reducing adolescent obesity may have substantial short-term and long-term health benefits in young adults.