Prevalence of Preclinical and Clinical Obesity Among US Children and Adolescents Aged 5 to 18 Years: NHANES 2017-2023.
Chaudhary P, Yang S, Waldrop S, Katzmarzyk PT, Staiano AE
One in five US youth aged 5-18 have obesity using the new Lancet Diabetes & Endocrinology Commission framework, with 12.5% having clinical obesity that includes physiological dysfunction. Cross-sectional analysis of NHANES 2017-2023 data from 5,513 youth, comparing traditional BMI percentile classification with the new framework that incorporates waist-to-height ratio and clinical impairments. This provides the first US population-level data applying the new obesity framework that shifts focus from BMI alone to physiological dysfunction, potentially expanding the pediatric population eligible for medical intervention. The analysis reveals limitations in routinely collected clinical data for implementing the new classification system in practice.
Strategic Signal
The new Lancet framework's emphasis on physiological dysfunction rather than BMI alone could expand the pediatric obesity treatment population by identifying children with clinical obesity at lower BMI thresholds. This would benefit companies developing pediatric obesity therapies, as payers and clinicians increasingly adopt frameworks that prioritize metabolic health over weight metrics. However, the study highlights data collection challenges that could slow adoption in clinical practice, potentially limiting near-term market expansion until healthcare systems adapt their assessment protocols.