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Pediatrics

Do adolescents with extreme obesity differ according to previous treatment seeking behavior? The Youth with Extreme obesity Study (YES) cohort

International Journal of Obesity volume 43, pages 103–115 (2019)Cite this article

Subjects

Abstract

Objectives

Adolescent extreme obesity is associated with somatic and psychiatric comorbidity, low quality of life, and social dysfunction. Nevertheless, few adolescents seek obesity treatment, thus many may elope appropriate care. We examine whether previous treatment seeking relates to disease burden, and whether previously non-treatment seeking adolescents accept diagnostic and therapeutic offers. This information is important to inform intervention strategies.

Methods

The Youth with Extreme obesity Study (YES) is a prospective, multicenter cohort study. We developed a novel recruitment strategy to span medical and vocational ascertainment settings and directly compare previously treatment seeking and non-treatment seeking youth. Participants aged 14–24 years; BMI ≥ 30 kg/m2 were enrolled at four medical- and one job centers. We present comorbidity and psycho-social baseline data by sex, obesity WHO grade I-III, and treatment-seeking status, defined as self-reported previous participation in a weight-loss program.

Results

Of 431 participants, 47% were male; mean age 16.6 (standard deviation 2.3) years, BMI 39.2 (7.5) kg/m2. Somatic comorbidity increased with obesity grade, p < 0.05: hypertension (42, 55, 64%), dyslipidemia (28, 24, 37%,), dysglycemia (9, 19, 20%,), elevated transaminases (15, 26, 30%). Quality of life (EQ5 D) decreased (74, 71, 70). Rates of psychiatric disorders were stable: depression 11%, attention deficit disorder 6%, substance use disorder 2%, self-injurious behavior 5%, suicide attempt 3%. Only 63% (56, 64, 69%) reported previous treatment seeking. Acceptance of the diagnostic (89%) or therapeutic (28%) program, medical or psychosocial situation did not differ by treatment seeking status. Acceptance of the therapeutic program was generally low, but high at the job center (92%).

Conclusion

Irrespective of previous treatment seeking, adolescent extreme obesity was associated with high comorbidity and psychosocial burden. Acceptance of the diagnostic program overall and the therapeutic program at the job center were high. This underscores the need of innovative, accessible programs beyond the currently offered care.

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Acknowledgements

The study was funded by the German Ministry of Education and Research (BMBF) as part of the Competence Network Obesity (FKZ 01GI1120A).

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Authors and Affiliations

  1. Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics and Adolescent Medicine, University Medical Center Ulm, Ulm, Germany

    Belinda S. Lennerz, Anja Moss, Julia von Schnurbein, Stefanie Brandt & Martin Wabitsch

  2. Division of Pediatric Endocrinology, Department of Medicine, Boston Children’s Hospital, Boston, MA, USA

    Belinda S. Lennerz

  3. Ambulatory Obesity Center, Charité University Hospital Berlin, Berlin, Germany

    Annika Bickenbach & Susanna Wiegand

  4. Institute for Epidemiology and Medical Biometry, ZIBMT, Ulm University, Ulm, Germany

    Esther Bollow & Reinhard W. Holl

  5. Center for Clinical Trials Essen (ZKSE), University Hospital Essen, University of Duisburg-Essen, Essen, Germany

    Diana Luetke-Brintrup & Claudia Ose

  6. Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Duisburg, Germany

    Yvonne Mühlig, Miriam Remy & Johannes Hebebrand

  7. Hospital for Children and Adolescents, Department of Women and Child Health, University of Leipzig, Leipzig, Germany

    Madlen Neef & Wieland Kiess

  8. Institute of Health Economics and Health Care Management, Helmholtz Center Munich – German Research Center for Environmental Health, Munch, Germany

    Renee Stark, Christina Teuner & Rolf Holle

  9. Vestische Childrens Hospital Datteln, University Witten/Herdecke, Witten, Germany

    Barbara Wolters & Thomas Reinehr

  10. Institute of Medical Statistics, Computer and Data Sciences, Jena University Hospital, Jena, Germany

    André Scherag

Authors
  1. Belinda S. Lennerz
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  2. Anja Moss
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Correspondence to Martin Wabitsch.

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Lennerz, B.S., Moss, A., von Schnurbein, J. et al. Do adolescents with extreme obesity differ according to previous treatment seeking behavior? The Youth with Extreme obesity Study (YES) cohort. Int J Obes 43, 103–115 (2019). https://doi.org/10.1038/s41366-018-0237-4

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