{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T06:19:43Z","timestamp":1792045183041,"version":"4.4.0"},"reference-count":56,"publisher":"S. Karger AG","issue":"5","license":[{"start":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T00:00:00Z","timestamp":1746144000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T00:00:00Z","timestamp":1746144000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Obes Facts"],"abstract":"<jats:p>&lt;p&gt;Introduction: Research on severe obesity (SO) is scarce and often contradictory. As higher weight status persists into adulthood, we aimed to analyze long-term trends in the prevalence of SO in children and adolescents in Germany using a large real-world data set. Furthermore, we analyzed subgroup differences and assessed how the COVID-19 pandemic affected weight status. Methods: We analyzed data from the CrescNet auxological network, including 1,495,401 clinical visits by 4- to 16-year-old children (2002\u20132023). Weight trends were examined with a focus on SO using logistic regression, stratified by sex and age. Effects are reported as odds ratio per 5 years (OR&lt;sub&gt;5&lt;\/sub&gt;) pre-pandemic and as OR for consecutive years during the pandemic. Quantile regression assessed trends of the 50th, 90th, 97th, and 99th percentiles of excess weight. Results: Pre-pandemic, SO remained stable or declined in children under 12 until 2010: OR&lt;sub&gt;5&lt;\/sub&gt;: 0.8\u20131, p &lt; 0.001) but rose significantly afterward (OR&lt;sub&gt;5&lt;\/sub&gt;: 1.1\u20131.2, p &lt; 0.001). Children between 12 and 16 years of age showed a continuous increase, especially boys (boys&lt;sub&gt;12\u201316&lt;\/sub&gt;: OR&lt;sub&gt;5&lt;\/sub&gt;: 1.3, girls&lt;sub&gt;12\u201316&lt;\/sub&gt;: OR&lt;sub&gt;5&lt;\/sub&gt;: 1.1, p &lt; 0.001). During the pandemic, SO peaked in 2021 across all groups (OR&lt;sub&gt;21 vs. 19&lt;\/sub&gt;: 1.3\u20131.7, p &lt; 0.001). By 2023, younger children had returned to pre-pandemic levels, while older children, particularly 8- to 16-year-old girls, remained at higher weights (OR&lt;sub&gt;23 vs. 19&lt;\/sub&gt;: 1.2\u20131.5, p &lt; 0.001\u20130.002). Weight gain was most prominent in SO groups but could also be seen in pre-pandemic and pandemic overweight and obesity subgroups, generally decreasing toward the end of the pandemic. Conclusion: SO has increased over the last 2 decades, with the COVID-19 pandemic accelerating this trend, particularly in adolescents. While younger children recovered by 2023, excess weight in older children, especially girls, continues to escalate. &lt;\/p&gt;<\/jats:p>","DOI":"10.1159\/000546217","type":"journal-article","created":{"date-parts":[[2025,5,3]],"date-time":"2025-05-03T12:01:50Z","timestamp":1746273710000},"page":"503-513","source":"Crossref","is-referenced-by-count":6,"title":["From Childhood to Adolescence: Long-Term Trends in Severe Obesity in German Youth (2002\u20132023)"],"prefix":"10.1159","volume":"18","author":[{"given":"Albana","family":"Berisha","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wieland","family":"Kiess","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth","family":"Gausche","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1166-0368","authenticated-orcid":false,"given":"Christoph","family":"Beger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6001-0356","authenticated-orcid":false,"given":"Antje","family":"K\u00f6rner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrike","family":"Spielau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6754-3681","authenticated-orcid":false,"given":"Roland","family":"Pf\u00e4ffle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0896-9943","authenticated-orcid":false,"given":"Robert","family":"Stein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anika","family":"Kaspar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2051-1249","authenticated-orcid":false,"given":"Mandy","family":"Vogel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2025,5,2]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.3109\/17477166.2010.526305"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980017002257"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1803527"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.2105\/ajph.77.5.588"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2013.01.020"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1186\/s12887-019-1711-4"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1159\/000504540"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1186\/1687-9856-2014-3"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.acap.2009.04.005"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2017-3459"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0154879"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1089\/chi.2019.0171"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1111\/ped.15472"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.6361"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-13-789"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1007\/s00103-019-03015-8"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1055\/a-0810-1231"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1038\/s41366-021-00968-2"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.3390\/nu13103668"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2022-056552"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7037a3"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.3238\/arztebl.2011.0123"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.3205\/17gmds133"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1007\/s001120170107"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1542\/Peds.2022-058302"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1038\/ijo.2014.170"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2014-307036"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2010.01.025"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1159\/000500436"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1515\/jpem-2016-0456"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1089\/chi.2014.0151"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.1159\/000521913"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyz231"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2023.1260269"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.1002\/oby.23643"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.6065\/apem.2244116.058"},{"key":"ref37","doi-asserted-by":"publisher","DOI":"10.1002\/jcv2.12027"},{"key":"ref38","doi-asserted-by":"publisher","DOI":"10.1016\/j.econlet.2022.110458"},{"key":"ref39","doi-asserted-by":"publisher","DOI":"10.1111\/cob.12579"},{"key":"ref40","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2021.626432"},{"key":"ref41","doi-asserted-by":"publishe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