PuSH - Publication Server of Helmholtz Zentrum München

Berisha, A.* ; Kiess, W.* ; Gausche, R.* ; Beger, C.* ; Körner, A. ; Spielau, U.* ; Pfaeffle, R.* ; Stein, R. ; Kaspar, A.* ; Vogel, M.*

From childhood to adolescence: Long-term trends in severe obesity in German youth (2002-2023).

Obes. Facts, DOI: 10.1159/000546217 (2025)
Publ. Version/Full Text DOI
Open Access Gold
Creative Commons Lizenzvertrag
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 (2002-2023). 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 (OR5) 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: OR5: 0.8-1, p < 0.001) but rose significantly afterward (OR5: 1.1-1.2, p < 0.001). Children between 12 and 16 years of age showed a continuous increase, especially boys (boys(12-16): OR5: 1.3, girls(12-16): OR5: 1.1, p < 0.001). During the pandemic, SO peaked in 2021 across all groups (OR21 vs. 19: 1.3-1.7, p < 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 (OR23 vs. 19: 1.2-1.5, p < 0.001-0.002). 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.
Altmetric
Additional Metrics?
[➜Log in]
Edit extra informations Login
Publication type Article: Journal article
Document type Scientific Article
Corresponding Author
Keywords Adolescent; BMI; Childhood obesity; Children; COVID-19; Epidemiology; Extreme obesity; Obesity; Obesity management; Overweight; Pediatric obesity; Severe obesity; Weight gain; Weight loss; Weight maintenance; Weight status; Z-score; Body-mass Index; Cardiovascular Risk-factors; Extreme Obesity; United-states; Children; Prevalence; Overweight; Stabilization; Moderate; Cohort
ISSN (print) / ISBN 1662-4025
e-ISSN 1662-4033
Journal Obesity Facts
Publisher Karger
Publishing Place Allschwilerstrasse 10, Ch-4009 Basel, Switzerland
Non-patent literature Publications
Reviewing status Peer reviewed
Institute(s) Helmholtz Institute for Metabolism, Obesity and Vascular Research (HI-MAG)
Grants Facultyof Medicine, University Leipzig
Sandoz Pharmaceuticals Hexal AG
Novo Nordisk Pharma GmbH
Merck Serono GmbH
Lilly Deutschland GmbH
Ipsen Pharma GmbH
Ferring Arzneimittel GmbH
Free State of Saxony
German Diabetes Association
BioMarin Deutschland GmbH