Obesity in adolescents with chronic fatigue syndrome: an observational study.
Norris, T, Hawton, K, Hamilton-Shield, J et al. · Archives of disease in childhood · 2017 · DOI
Quick Summary
This study looked at whether adolescents with ME/CFS are more likely to be overweight or obese than young people without the condition. Researchers compared teenagers attending specialist ME/CFS clinics with healthy teenagers from a large population study. They found that adolescents with severe ME/CFS (those referred to specialist services) had higher rates of obesity, particularly by age 16.
Why It Matters
Understanding the relationship between ME/CFS and obesity is important because obesity may complicate ME/CFS management, affect symptom severity, or represent a significant comorbidity requiring integrated clinical approaches. This finding highlights the need for weight-aware care in adolescent ME/CFS populations.
Observed Findings
Adolescents attending specialist CFS/ME services had obesity prevalence of 9.28% at age 13 and 16.43% at age 16.
Adolescents with CFS/ME identified in the general population (ALSPAC) had lower obesity rates: 3.72% at age 13 and 5.46% at age 16.
Non-CFS adolescents in ALSPAC had obesity rates of 4.18% at age 13 and 4.46% at age 16.
The odds ratio for obesity increased substantially from age 13 to age 16 in the specialist CFS/ME group (2.31 to 4.07).
Inferred Conclusions
Adolescents with CFS/ME severe enough to warrant specialist referral have markedly elevated obesity rates compared to population controls.
The relationship between CFS/ME severity and obesity appears to strengthen as adolescents age from 13 to 16 years.
Longitudinal research is needed to determine whether obesity precedes CFS/ME onset, develops as a consequence of the condition, or results from shared underlying mechanisms.
Remaining Questions
Does obesity contribute to ME/CFS development, does ME/CFS lead to obesity, or do both conditions share common biological pathways?
Why does the association between specialist CFS/ME attendance and obesity strengthen significantly between ages 13 and 16?
How do lifestyle factors (reduced activity, dietary changes) versus biological factors contribute to the elevated obesity prevalence?
What This Study Does Not Prove
This study cannot establish whether obesity causes ME/CFS, whether ME/CFS causes weight gain, or whether both conditions share a common mechanism—it only demonstrates they co-occur more frequently in severely affected adolescents. The study also cannot exclude confounding factors or explain why the association strengthens with age. Selection bias may be present, as adolescents referred to specialist services likely represent more severe cases.
Tags
Symptom:Fatigue
Phenotype:SeverePediatric
Method Flag:Weak Case DefinitionStrong PhenotypingSevere ME IncludedSex-Stratified