Stability of relative weight category and cardiometabolic risk factors among moderately and severely obese middle school youth


  • Funding agencies: This work was completed with funding from NIDDK/NIH grant numbers U01-DK61230, U01-DK61249, U01-DK61231, and U01-DK61223, with additional support from the American Diabetes Association.

  • Disclosure: Dr. Marcus reports grants from NIDDK, during the conduct of the study; personal fees from Scientific Advisory Board for United Health Group, outside the submitted work. Dr. Foster reports grants from NIH/NIDDK, during the conduct of the study; personal fees from Con Agra Foods, Tate and Lyle, and United Health Group for Service on Scientific Advisory. These relationships were present during the study but no longer exist. Currently, Dr. Foster is a full-time employee of Weight Watchers International. Ms. El ghormli reports grants from NIDDK.



To examine the stability of severe pediatric obesity relative to moderate obesity and associated changes in cardiometabolic risk from the beginning of 6th to the end of 8th grade.


Participants in HEALTHY, a multi-site, cluster randomized school-based study designed to mitigate risk for type 2 diabetes, completed standardized assessments of height, weight, glucose, insulin, lipids, and blood pressure at the beginning of 6th grade and the end of 8th grade. Youth were classified as moderately obese (100-119% of the 95th percentile of BMI for age and gender) or severely obese (≥120% of the 95th percentile of BMI for age and gender). Generalized linear mixed models (GLMM) that controlled for relevant covariables were used to examine the relation between baseline demographic and cardiometabolic risk factors and BMI status, as well as changes in relative weight category and risk factors during middle school.


Severe obesity was more likely to endure over the course of middle school than was moderate obesity, and was associated with significantly higher levels of cardiometabolic risk.


Research with a specific focus on understanding, preventing, and treating severe obesity in children is warranted.