title: BMI > or = 50 kg/m2 is associated with a younger age of onset of overweight and a high prevalence of adverse metabolic profiles.
abstract: OBJECTIVE
  To study the demographic and clinical parameters of three different categories of obesity, with particular focus on a cohort of individuals with BMI > or = 50 kg/m2, the fastest growing category of obesity.
  
  
  METHODS
  Over 700 obese individuals were studied (186 with BMI = 30-39 kg/m2, 316 with BMI = 40-49 kg/m2 and 290 with BMI > or = 50 kg/m2).
  
  
  RESULTS
  Median BMI was 51 kg/m2 for patients who reported onset of overweight before 15 years of age, 47 kg/m2 for patients who reported onset between 15 and 30 years, and 42 kg/m2 for patients who became overweight after 30 years of age. The BMI > or = 50 kg/m2 group was notably younger than the group with BMI = 30-39 kg/m2 (44 (SD 11) years v. 50 (SD 15) years; P < 0.0001). Eighteen per cent of obese patients studied were considered metabolically healthy according to standard cut-off points for blood pressure, fasting glucose and lipid profiles. However, the proportion of metabolically healthy individuals was significantly higher in the BMI = 30-39 kg/m2 group than in the BMI = 40-49 kg/m2 and BMI > or = 50 kg/m2 groups (31% v. 17% and 12% respectively; P < 0.05 and P < 0.005). When compared with people of similar age in the general population, individuals with BMI > or = 50 kg/m2 had lower rates of marriage (51% v. 72%) and a higher prevalence of unemployment (14% v. 5%).
  
  
  CONCLUSIONS
  The current study suggests that the increasing prevalence of childhood obesity worldwide will lead to many more individuals achieving a higher BMI at a younger age. Furthermore, an earlier onset of overweight does not appear to prevent the adverse metabolic health outcomes associated with extreme obesity.
authors.affiliation: Obesity Research Group, St Columcille's Hospital and St Vincent's University Hospital, Elm Park, Dublin 4, Republic of Ireland. jeanoco@gmail.com
authors.forename: Jean
authors.initials: J
authors.lastname: O'Connell
authors.forename: Phillip
authors.initials: P
authors.lastname: Kieran
authors.forename: Kathleen
authors.initials: K
authors.lastname: Gorman
authors.forename: Tomas
authors.initials: T
authors.lastname: Ahern
authors.forename: Tom J
authors.initials: TJ
authors.lastname: Cawood
authors.forename: Donal
authors.initials: D
authors.lastname: O'Shea
mesh_terms: D000367:Age Factors; D017668:Age of Onset; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D004032:Diet; D004651:Employment; D005260:Female; D006801:Humans; D008019:Life Style; D008055:Lipids / Q000097:blood; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology / Q000378:metabolism; D009767:Obesity, Morbid / Q000453:epidemiology / Q000378:metabolism; D050177:Overweight / Q000453:epidemiology* / Q000378:metabolism*; D015995:Prevalence
chemical_list: D001786:Blood Glucose; D008055:Lipids