Extremely severe obesity in children has surged by 253% over the past 15 years, with the steepest rise among non-Hispanic Black adolescents aged 16 to 18. A new study analyzing data from over 25,800 participants in the National Health and Nutrition Examination Survey reveals that obesity is not only increasing but becoming more severe—prompting researchers to propose new classifications beyond the current three-tier system.
Children in the newly defined class 4 and 5 obesity categories—those with a BMI 160% to over 180% of the 95th percentile—face alarming health risks. Every child in these categories showed signs of insulin resistance, compared to 81% in lower obesity classes and just 27% among children with healthy weights. These children also had significantly higher rates of diabetes, metabolic disease, and liver complications.
The burden is not just clinical. Families face mounting costs and emotional strain, while the public health system grapples with the long-term consequences. “The findings of this study… provide robust evidence supporting extremely severe obesity specifically as a public health emergency,” the authors warn, calling for early prevention, targeted education, and mobilization of resources.
Without urgent intervention, the trajectory of obesity-related illness in minority youth threatens to deepen existing health disparities and overwhelm care systems already stretched thin.
See: “Extremely severe obesity is on the rise in kids—along with a barrage of health problems” (July 17, 2025)
