Predicting Infant Risk for Childhood Obesity

Written by Susan Spinasanta

Pediatric obesity is a major health problem in the United States in approximately 17%, or 12.7 million children and adolescents aged 2 through 19 years.1 Early childhood obesity often persists into adulthood and increases lifelong risks for serious health issues such as high blood pressure, heart disease, and metabolic disease.2 A means to predict an infant’s risk of becoming obese in childhood was the topic presented by Allison R. Smego, MD. Dr. Smego is a clinical fellow at Cincinnati Children’s Hospital.

“Pediatricians do not have much to guide identifying at-risk children prior to the age of two. There is little known about how growth patterns differ between children who develop severe obesity and those who stay lean,” stated Dr. Smego. The objectives of the study were two-fold:

  1. Determine when children with severe obesity gain weight more rapidly compared with children who stay lean.
  2. Determine a weight-related marker to help identify children who are at-risk of becoming severely obese before they develop obesity

Electronic health records were utilized to identify four study populations. “The children were selected based on a BMI [body mass index] between the ages of two and six or early childhood. We had two severely obese groups with a BMI ≥ the 99th percentile [n=480], and two lean groups with a BMI between the 5th and 75th percentile [n=783]. We collected height and weight data on these patients from the electronic medical record,” Dr. Smego explained.

Weight evaluation over time determined BMI divergence between the two groups starting around 4 to 6 months of age—the obese groups were separated from the lean children. Dr. Smego stated the study provided the following results: “At 6, 12, or 18 months of age, a BMI greater than or equal to the World Health Organization [WHO] BMI growth charts led to a greater than a 50% chance of being overweight or obese by age 6 years. And having a BMI exceeding the 85th percentile during infancy led to a 3- to 9-fold increased risk of developing severe obesity by age 6.”



Smego AR. Predicting Future Severe Obesity: BMI of Severely Obese Children Diverges from Normal-Weight Children During Infancy. OR07-5: Body mass index can predict infant’s risk of becoming an obese child. The Endocrine Society’s 98th Annual Meeting & Expo, Boston Convention and Exhibition Center, Boston, MA. April 1, 2016.


  1. Childhood Obesity Facts. Prevalence of Childhood Obesity in the United States, 2011-2012. Centers for Disease Control and Prevention. June 19, 2015.  Accessed April 20, 2016.
  1. Kelly AS, Barlow SE, Rao G, Inge TH, et al. American Heart Association Atherosclerosis, Hypertension, and Obesity in the Young Committee of the Council on Cardiovascular Disease in the Young, Council on Nutrition, Physical Activity and Metabolism, and Council on Clinical Cardiology. Severe Obesity in Children and Adolescents: Identification, Associated Health Risks, and Treatment Approaches. A Scientific Statement From the American Heart Association. Circulation. 2013;128:1689-1712.