People who were severely obese as teens are four times more likely to have swollen legs with skin ulcers later in life and three times more likely to have severe walking limitations and abnormal kidney function, according to a national, multicenter study led by investigators at Cincinnati Children’s Hospital Medical Center and the University of Pittsburgh.

Those who were severely obese as teens were also significantly more likely to have polycystic ovary syndrome, asthma, diabetes and obstructive sleep apnea than those who were normal weight as teens.

The study, published online Nov. 18 in Pediatrics, examined 1,502 severely obese adults ranging in age from 19 to 76 who were about to undergo bariatric surgery. Participants were asked to report their height and weight at age 18 and were then evaluated for medical conditions related to obesity.

The investigators found that 42 percent of the adults scheduled for surgery reported age 18 weights in the normal range, and 29 percent reported weights in the obese range, including 13 percent in the severely obese range. By the time surgery was performed, 96 percent of the adults had developed at least one obesity-related medical condition.

“Most people understand that the longer you carry extra weight, the higher your chances of developing heart disease or diabetes,” says lead author Thomas Inge, MD, PhD, Director of the Center for Bariatric Research and Innovation at Cincinnati Children’s.  “But now it seems that an even larger number of conditions should be added to the list of health problems that some obese teenagers will likely face down the road.”

Co-author David Flum, MD, MPH, University of Washington, says, “These findings underscore the importance of interventions in children to prevent the progression to obesity in teenage years and young adulthood.”

As the numbers of severely obese children grow, Inge says it is important for pediatricians to inform families about the short-term and longer-term health issues linked to weight gain.