The life course of severe obesity: Does childhood overweight matter?

Objectives. A life course perspective is used to examine the epidemiology of severe obesity in adulthood, defined as a body mass index greater than or equal to 35 kg/m(2). Methods. Data from adults in the National Health and Nutrition Examination Survey 1: Epidemiologic Followup Study, including their reports of childhood overweight, were used to examine the risk of severe obesity and mortality over 20 years (N = 6,767). All multivariate models control for age, sex, race, smoking, and socioeconomic resources. Results. Childhood overweight was significantly associated with severe obesity for both women and men, although the effect was stronger for men. The prevalence of severe obesity was highest between 45 and 64 years of age than for persons under 45 or over 65, and higher for African Americans than White Americans. Childhood overweight was associated with lower mortality risk for women, but not for men. Mortality risk was higher for persons with severe obesity (relative risk 1.571, 95% confidence interval = 1.335-1.849, p <.001). Discussion. The findings demonstrate the importance of childhood overweight as a risk factor for severe obesity over the life course. Nevertheless, overweight children who did not become severely obese were not at greater risk of mortality.