{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T22:20:12Z","timestamp":1793053212468,"version":"4.5.0"},"reference-count":33,"publisher":"American Medical Association (AMA)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Pediatr"],"published-print":{"date-parts":[[2025,3,1]]},"abstract":"<jats:sec id=\"ab-poi240098-4\"><jats:title>IMPORTANCE<\/jats:title><jats:p>Data regarding the long-term impact of treating childhood obesity on the risk of obesity-related events, including premature mortality, are limited.<\/jats:p><\/jats:sec><jats:sec id=\"ab-poi240098-5\"><jats:title>OBJECTIVE<\/jats:title><jats:p>To evaluate the long-term effect of different responses to pediatric obesity treatment on critical health outcomes in young adulthood.<\/jats:p><\/jats:sec><jats:sec id=\"ab-poi240098-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>The study included a dynamic prospective cohort of children and adolescents with obesity within The Swedish Childhood Obesity Treatment Register (BORIS) and general population comparators, linked with national registers. Baseline data were collected between 1996 and 2019. Formal analyses for this study was conducted in 2023. Outcomes were assessed from individuals aged 18 to 30 years (2005 to 2020). Participants included children and adolescents aged 6 to 17 years receiving at least 1 year of obesity treatment. General population comparators were matched on a ratio of 1:5 on sex, year of birth, and geographical area.<\/jats:p><\/jats:sec><jats:sec id=\"ab-poi240098-7\"><jats:title>EXPOSURE<\/jats:title><jats:p>Pediatric obesity treatment response was based on changes in body mass index standard deviation score and categorized as poor, intermediate, and good response and obesity remission.<\/jats:p><\/jats:sec><jats:sec id=\"ab-poi240098-8\"><jats:title>MAIN OUTCOMES<\/jats:title><jats:p>Obesity-related events included type 2 diabetes (T2D), dyslipidemia, hypertension, depression or anxiety, and weight-loss bariatric surgery. Additionally, mortality was assessed.<\/jats:p><\/jats:sec><jats:sec id=\"ab-poi240098-9\"><jats:title>RESULTS<\/jats:title><jats:p>Of 6713 individuals (3777 male [56%] and  2936 female [44%]), the median age at obesity treatment initiation was 12.1 (quartile 1; quartile 3: 10.1; 14.3) years and treatment duration was 3.0 (1.8; 4.9) years. For T2D, hypertension, dyslipidemia, weight-loss bariatric surgery, and depression or anxiety outcomes, unadjusted incidence rates tended to decrease with better treatment response and the lowest estimate was observed among general population comparators. Compared with poor response, obesity remission or a good response in obesity treatment was associated with reduced risk of mortality (adjusted hazard ratio [HR], 0.12; 95% CI, 0.03-0.46). Good response was also associated with lower risk of TD2 (HR, 0.42; 95% CI, 0.23-0.77), dyslipidemia (HR, 0.31; 95% CI, 0.13-0.75), and bariatric surgery (HR, 0.42; 95% CI, 0.30-0.58). Obesity remission showed similar reduced risk, but also a reduced risk of hypertension (HR, 0.40; 95% CI, 0.24-0.65). Treatment response was not associated with depression or anxiety.<\/jats:p><\/jats:sec><jats:sec id=\"ab-poi240098-10\"><jats:title>CONCLUSIONS AND RELEVANCE<\/jats:title><jats:p>In this study, beneficial pediatric obesity treatment response yielded enduring health benefits, markedly lowering future morbidity and mortality risks in young adulthood.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamapediatrics.2024.5552","type":"journal-article","created":{"date-parts":[[2025,1,21]],"date-time":"2025-01-21T16:10:20Z","timestamp":1737475820000},"page":"302","source":"Crossref","is-referenced-by-count":62,"title":["Effect of Pediatric Obesity Treatment on Long-Term Health"],"prefix":"10.1001","volume":"179","author":[{"given":"Resthie R.","family":"Putri","sequence":"first","affiliation":[{"name":"Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pernilla","family":"Danielsson","sequence":"additional","affiliation":[{"name":"Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nils","family":"Ekstr\u00f6m","sequence":"additional","affiliation":[{"name":"Novo Nordisk Scandinavia AB, Malm\u00f6, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c5sa","family":"Ericsson","sequence":"additional","affiliation":[{"name":"Novo Nordisk Scandinavia AB, Malm\u00f6, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise","family":"Lindberg","sequence":"additional","affiliation":[{"name":"Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claude","family":"Marcus","sequence":"additional","affiliation":[{"name":"Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilia","family":"Hagman","sequence":"additional","affiliation":[{"name":"Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"10113","key":"poi240098r1","doi-asserted-by":"publisher","first-page":"2627","DOI":"10.1016\/S0140-6736(17)32129-3","article-title":"Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128\u00b79 million children, adolescents, and adults.","volume":"390","author":"NCD Risk Factor Collaboration (NCD-RisC)","year":"2017","journal-title":"Lancet"},{"issue":"2","key":"poi240098r3","first-page":"160","article-title":"Insulin function in obese children within the low and high ranges of impaired fasting glycemia.","volume":"20","author":"Hagman","year":"2019","journal-title":"Pediatr Diabetes"},{"issue":"10","key":"poi240098r4","doi-asserted-by":"publisher","first-page":"1988","DOI":"10.1038\/s41366-019-0384-2","article-title":"The effect of weight loss and weight gain on blood pressure in children and adolescents with obesity.","volume":"43","author":"Hagman","year":"2019","journal-title":"Int J Obes (Lond)"},{"issue":"1","key":"poi240098r5","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1038\/ijo.2013.124","article-title":"Impaired fasting glucose prevalence in two nationwide cohorts of obese children and adolescents.","volume":"38","author":"Hagman","year":"2014","journal-title":"Int J Obes (Lond)"},{"issue":"3","key":"poi240098r6","doi-asserted-by":"publisher","first-page":"396","DOI":"10.1111\/apt.17096","article-title":"Meta-analysis: global prevalence, trend and forecasting of non-alcoholic fatty liver disease in children and adolescents, 2000-2021.","volume":"56","author":"Li","year":"2022","journal-title":"Aliment Pharmacol Ther"},{"issue":"1","key":"poi240098r7","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1186\/s12916-020-1498-z","article-title":"Anxiety and depression in children and adolescents with obesity: a nationwide study in Sweden.","volume":"18","author":"Lindberg","year":"2020","journal-title":"BMC Med"},{"issue":"4","key":"poi240098r8","doi-asserted-by":"publisher","first-page":"402","DOI":"10.1007\/s13679-020-00408-8","article-title":"Weight stigma in youth: prevalence, consequences, and considerations for clinical practice.","volume":"9","author":"Puhl","year":"2020","journal-title":"Curr Obes Rep"},{"issue":"4","key":"poi240098r9","doi-asserted-by":"publisher","first-page":"531","DOI":"10.1016\/j.metabol.2011.08.010","article-title":"Childhood risk factors predict cardiovascular disease, impaired fasting glucose plus type 2 diabetes mellitus, and high blood pressure 26 years later at a mean age of 38 years: the Princeton-lipid research clinics follow-up study.","volume":"61","author":"Morrison","year":"2012","journal-title":"Metabolism"},{"issue":"25","key":"poi240098r10","doi-asserted-by":"publisher","first-page":"2430","DOI":"10.1056\/NEJMoa1503840","article-title":"Body-mass index in 2.3 million adolescents and cardiovascular death in adulthood.","volume":"374","author":"Twig","year":"2016","journal-title":"N Engl J Med"},{"issue":"3","key":"poi240098r11","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1003078","article-title":"Association of childhood obesity with risk of early all-cause and cause-specific mortality: a Swedish prospective cohort study.","volume":"17","author":"Lindberg","year":"2020","journal-title":"PLoS Med"},{"issue":"6","key":"poi240098r12","doi-asserted-by":"publisher","first-page":"870","DOI":"10.1111\/joim.13547","article-title":"Pediatric obesity-long-term consequences and effect of weight loss.","volume":"292","author":"Marcus","year":"2022","journal-title":"J Intern Med"},{"issue":"24","key":"poi240098r13","doi-asserted-by":"publisher","first-page":"2245","DOI":"10.1056\/NEJMoa2208601","article-title":"Once-weekly semaglutide in adolescents with obesity.","volume":"387","author":"Weghuber","year":"2022","journal-title":"N Engl J Med"},{"issue":"3","key":"poi240098r14","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1016\/S2213-8587(16)30424-7","article-title":"Laparoscopic Roux-en-Y gastric bypass in adolescents with severe obesity (AMOS): a prospective, 5-year, Swedish nationwide study.","volume":"5","author":"Olbers","year":"2017","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"22","key":"poi240098r15","doi-asserted-by":"publisher","first-page":"2117","DOI":"10.1056\/NEJMoa1916038","article-title":"A randomized, controlled trial of liraglutide for adolescents with obesity.","volume":"382","author":"Kelly","year":"2020","journal-title":"N Engl J Med"},{"issue":"7","key":"poi240098r16","doi-asserted-by":"publisher","DOI":"10.1111\/ijpo.12626","article-title":"Paediatric obesity treatment during 14 years in Sweden: lessons from the Swedish Childhood Obesity Treatment Register-BORIS.","volume":"15","author":"Hagman","year":"2020","journal-title":"Pediatr Obes"},{"key":"poi240098r17","doi-asserted-by":"publisher","DOI":"10.1016\/j.soard.2020.09.017","article-title":"High estimated prevalence of bariatric surgery in young adults treated for pediatric obesity.","author":"Brissman","year":"2021","journal-title":"Surg Obes Relat Dis"},{"issue":"1","key":"poi240098r18","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1004165","article-title":"The association between perinatal factors and cardiometabolic risk factors in children and adolescents with overweight or obesity: a retrospective two-cohort study.","volume":"20","author":"Prinz","year":"2023","journal-title":"PLoS Med"},{"issue":"4","key":"poi240098r19","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1111\/j.2047-6310.2012.00064.x","article-title":"Extended international (IOTF) body mass index cut-offs for thinness, overweight and obesity.","volume":"7","author":"Cole","year":"2012","journal-title":"Pediatr Obes"},{"issue":"11","key":"poi240098r20","doi-asserted-by":"publisher","first-page":"659","DOI":"10.1007\/s10654-009-9350-y","article-title":"The Swedish personal identity number: possibilities and pitfalls in healthcare and medical research.","volume":"24","author":"Ludvigsson","year":"2009","journal-title":"Eur J Epidemiol"},{"key":"poi240098r21","doi-asserted-by":"publisher","first-page":"450","DOI":"10.1186\/1471-2458-11-450","article-title":"External review and validation of the Swedish national inpatient register.","volume":"11","author":"Ludvigsson","year":"2011","journal-title":"BMC Public Health"},{"issue":"7","key":"poi240098r22","doi-asserted-by":"publisher","first-page":"726","DOI":"10.1002\/pds.1294","article-title":"The new Swedish Prescribed Drug Register\u2013opportunities for pharmacoepidemiological research and experience from the first six months.","volume":"16","author":"Wettermark","year":"2007","journal-title":"Pharmacoepidemiol Drug Saf"},{"issue":"9","key":"poi240098r23","doi-asserted-by":"publisher","first-page":"765","DOI":"10.1007\/s10654-017-0316-1","article-title":"The Swedish cause of death register.","volume":"32","author":"Brooke","year":"2017","journal-title":"Eur J Epidemiol"},{"issue":"2","key":"poi240098r24","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1007\/s10654-016-0117-y","article-title":"Registers of the Swedish total population and their use in medical research.","volume":"31","author":"Ludvigsson","year":"2016","journal-title":"Eur J Epidemiol"},{"issue":"4","key":"poi240098r25","doi-asserted-by":"publisher","first-page":"423","DOI":"10.1007\/s10654-019-00511-8","article-title":"The longitudinal integrated database for health insurance and labour market studies (LISA) and its use in medical research.","volume":"34","author":"Ludvigsson","year":"2019","journal-title":"Eur J Epidemiol"},{"issue":"8","key":"poi240098r26","doi-asserted-by":"publisher","first-page":"3171","DOI":"10.1210\/jc.2016-1885","article-title":"Which amount of BMI-SDS reduction is necessary to improve cardiovascular risk factors in overweight children?","volume":"101","author":"Reinehr","year":"2016","journal-title":"J Clin Endocrinol Metab"},{"issue":"12","key":"poi240098r27","doi-asserted-by":"publisher","first-page":"1103","DOI":"10.1001\/2013.jamapediatrics.319","article-title":"Response of severely obese children and adolescents to behavioral treatment.","volume":"166","author":"Danielsson","year":"2012","journal-title":"Arch Pediatr Adolesc Med"},{"issue":"5","key":"poi240098r28","doi-asserted-by":"publisher","first-page":"e94","DOI":"10.1111\/j.2047-6310.2014.00217.x","article-title":"Defining morbid obesity in children based on BMI 40 at age 18 using the extended international (IOTF) cut-offs.","volume":"9","author":"Bervoets","year":"2014","journal-title":"Pediatr Obes"},{"issue":"7","key":"poi240098r29","doi-asserted-by":"publisher","DOI":"10.1111\/obr.13566","article-title":"The effects of weight change from childhood to adulthood on depression and anxiety risk in adulthood: a systematic review.","volume":"24","author":"Gallagher","year":"2023","journal-title":"Obes Rev"},{"issue":"3","key":"poi240098r30","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1016\/S2352-4642(20)30024-9","article-title":"5-year mental health and eating pattern outcomes following bariatric surgery in adolescents: a prospective cohort study.","volume":"4","author":"J\u00e4rvholm","year":"2020","journal-title":"Lancet Child Adolesc Health"},{"issue":"7","key":"poi240098r31","doi-asserted-by":"publisher","first-page":"742","DOI":"10.1111\/obr.12535","article-title":"Exploring the association between childhood and adolescent obesity and depression: a meta-analysis.","volume":"18","author":"Quek","year":"2017","journal-title":"Obes Rev"},{"issue":"8","key":"poi240098r32","doi-asserted-by":"publisher","first-page":"1266","DOI":"10.1038\/s42255-023-00864-1","article-title":"Differential mechanisms affecting weight loss and weight loss maintenance.","volume":"5","author":"Rosenbaum","year":"2023","journal-title":"Nat Metab"},{"issue":"9","key":"poi240098r33","doi-asserted-by":"publisher","first-page":"2575","DOI":"10.1016\/j.numecd.2021.05.020","article-title":"The effect of weight regain on cardiometabolic health in children with obesity: a systematic review of clinical studies.","volume":"31","author":"Vermeiren","year":"2021","journal-title":"Nutr Metab Cardiovasc Dis"},{"key":"poi240098r2","unstructured":"World Obesity Federation Global Obesity Observatory. World Obesity Atlas 2023. Accessed December 10, 2024. https:\/\/data.worldobesity.org\/publications\/?cat=19"}],"container-title":["JAMA Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamapediatrics\/articlepdf\/2829443\/jamapediatrics_putri_2025_oi_240098_1739908539.05014.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,3]],"date-time":"2025-03-03T16:04:27Z","timestamp":1741017867000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamapediatrics\/fullarticle\/2829443"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,1]]},"references-count":33,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,3,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamapediatrics.2024.5552","relation":{},"ISSN":["2168-6203"],"issn-type":[{"value":"2168-6203","type":"print"}],"subject":[],"published":{"date-parts":[[2025,3,1]]}}}