Clinical and Biological Characteristics of Early Versus Late Onset Obesity in Subjects Seeking Weight Management

Background: A growing body of research suggests that obesity may be related to mood and eating disorders in adults and possibly children, and that obesity with childhood onset may represent a subtype of obesity requiring specific diagnostic and treatment interventions.Objective: This study was designed to examine whether childhood onset obesity differed significantly from adult onset obesity in lifetime prevalence of mood and eating disorders, and metabolic abnormalities.Methods: Data were collected prospectively for 450 consecutive patients who presented for weight loss treatment. A subgroup of participants with clearly defined childhood-onset obesity (N=44) were compared with a group with adult-onset obesity (N= 69) on a number of a priori defined clinical and biological features.Results: High lifetime prevalence rates of mood (77.8% vs. 9.2% in the general population) and eating (81.4% vs. 4% in the general population) disorders were observed in the patients seeking weight loss as a group. Patients with childhood onset obesity had a significantly higher lifetime prevalence of eating disorders (93.2%) than patients with adult-onset obesity (73.9%, p=0.01). Bulimia nervosa (BN) was more common among patients with childhood onset obesity (15.9%) than among patients with adult onset obesity (2.9%, p =0.01). 71.4% of the patients with childhood onset obesity and lifetime history of BN and 50% of the patients with adult onset obesity and lifetime history of BN were diagnosed with binge eating disorder at presentation to our clinic. The two groups did not differ in any other of the examined variables.