Key research papers on childhood obesity

How the literature is organised

Two Lancet papers and a long report are among the most-cited early works. Ebbeling, Pawlak and Ludwig (2002) called childhood obesity a public health crisis with a "common sense cure". Lobstein, Baur and Uauy (2004) wrote a supplement-length report for the International Obesity TaskForce in Obesity Reviews. Ludwig, Peterson and Gortmaker (2001) had already reported a prospective association between sugar-sweetened drinks and obesity in schoolchildren.

Later work follows four lines. Epidemiology tracks prevalence, with Ng et al. (2014) providing global estimates from 1980 to 2013. Aetiology covers behaviour, such as sleep (Cappuccio et al., 2008), and genetics, such as the FTO variant (Dina et al., 2007). Consequences are documented in long cohort studies, including Franks et al. (2010) on premature death. Prevention trials are synthesised in successive Cochrane reviews (Brown et al., 2019, was the fourth version of its review).

Main debates

One debate is about explanation. Haqq et al. (2021) argue that weight stigma rests on a misunderstanding of the origins of obesity, in which behavioural, environmental, genetic and metabolic factors interact, and on the misconception that it results solely from personal choices. The listed papers span that range, from a single dietary exposure (Ludwig, Peterson and Gortmaker, 2001) to a genetic variant (Dina et al., 2007). A second is about targeting. Simmonds et al. (2016) found that obese children are likely to become obese adults but that 70% of obese adults had not been obese in childhood or adolescence, so programmes aimed only at children who are already obese may not reduce the adult burden much. A third is about how well prevention works, where the pooled effects in Brown et al. (2019) were small and differed by age group.

Where recent work is heading

Jebeile et al. (2022) give a current overview of epidemiology, causes, assessment and management. The pandemic produced studies of weight gain during lockdowns (Stavridou et al., 2021; Vážná et al., 2022, on Czech children). Reviews now cover e-health interventions (Azevedo et al., 2022), prenatal exposure to persistent organic pollutants (Stratakis et al., 2022) and adverse childhood experiences (Schroeder et al., 2021). Mendelian randomisation studies, such as Cao et al. (2022) on osteoarthritis, test whether associations with later disease are causal.