Clinical Scorecard: Additional Insights on Metabolically Healthy Obesity Among Pediatric Populations
At a Glance
Category
Detail
Condition
Metabolically Healthy Obesity (MHO)
Key Mechanisms
Cumulative type 2 diabetes incidence and psychosocial impacts of treatment
Target Population
Children aged 7 to 8.9 years
Care Setting
Pediatric obesity treatment
Key Highlights
Cumulative type 2 diabetes incidence by age 30 years was 9.1% in the MHO group.
Type 2 diabetes incidence was 36.2 per 10,000 person-years among children with MHO.
MHO prevalence was 59.6% among children aged 7 to 8.9 years.
The study lacked an untreated comparator group with MHO.
Psychosocial harms associated with weight loss interventions were not analyzed.
Guideline-Based Recommendations
Diagnosis
Identify children with obesity and assess metabolic health status.
Management
Consider the potential harms of treatment in metabolically healthy individuals.
Monitoring & Follow-up
Monitor for transitions from MHO to metabolically unhealthy obesity.
Risks
Unnecessary medicalization may lead to psychological harm and stigma.
Patient & Prescribing Data
Children with obesity, particularly those classified as MHO.
Weight loss interventions may reinforce stigma and cause disordered eating behaviors.
Clinical Best Practices
Conduct rigorous benefit-harm assessments before initiating treatment.
Incorporate psychological costs of treatment nonresponse and weight cycling in evaluations.
Related Resources & Content
Putri et al, JAMA Pediatrics, 2023 -- Additional Insights on Metabolically Healthy Obesity in Pediatric Populations
Putri et al, JAMA Pediatrics, 2023 -- Additional Insights on Metabolically Healthy Obesity Among Pediatric Patients
The Journal of Clinical Endocrinology & Metabolism, 2023 -- Metabolomics: An Emerging Approach for Addressing Prevention, Diagnosis, and Management of Obesity
Putri et al, JAMA Pediatrics, 2023 -- Long-Term Cardiometabolic Outcomes in Children With Metabolically Healthy and Unhealthy Obesity
American Academy of Pediatrics Clinical Practice Guideline
U.S. Preventive Services Task Force Recommendation
Long-Term Cardiometabolic Outcomes in Children With Metabolically Healthy and Unhealthy Obesity | Pediatrics | JAMA Pediatrics | JAMA Network
Risk factors, cutoff points, and definition of metabolically healthy/unhealthy obesity in children and adolescents: A scoping review of the literature.
Association of Childhood Obesity Phenotypes With Cardiometabolic Outcomes in Adulthood: A Systematic Review and Meta‐Analysis
