- Posted March 27, 2026
Healthy Lab Results May Mask Future Risks for Kids with Obesity
For parents of a child with obesity, a normal lab report from the pediatrician may suggest that their weight isn’t yet a problem.
But even if the child’s blood pressure is steady and their sugar levels are fine, those encouraging results — called metabolically healthy obesity or MHO — might be a deceptive snapshot of a much riskier future.
Researchers at the Karolinska Institute in Sweden followed more than 7,200 children aged 7 to 17 who were in treatment for obesity. They were followed until age 30.
Over that period, researchers compared those with metabolically healthy test results to those with early warning signs, and to a control group of more than 35,000 from the general population.
The study published March 23 in JAMA Pediatrics found that even kids with MHO — meaning they had normal blood pressure, liver values and blood fats — were at a disadvantage compared to their peers over the long term.
By age 30, 9% of the MHO group had developed type 2 diabetes. Though better than the 17% seen in the early-warning group, it was staggering compared to the general population, where only 0.5% developed the disease.
Similar differences were seen in those with high blood pressure and abnormal cholesterol levels.
“There has been a debate about whether children with normal blood and liver values and normal blood pressure might not need treatment for their obesity,” study co-author Claude Marcus, a professor at the institute, said in a news release. "Our study shows that this assumption is incorrect."
The research highlighted that a child’s body might be able to compensate for extra weight in the short term, but the underlying strain eventually catches up.
“Even children with obesity who show no signs of cardiometabolic impact have a clearly increased risk of future diseases,” said co-author Emilia Hagman, an associate professor.
The good news is that the study also showed that treatment works.
A subset of children in the study received help with nutrition and exercise habits for at least one year.
Those who saw a measurable improvement in their body mass index (BMI), an estimate of body fat based on height and weight, during childhood significantly lowered their risk of getting type 2 diabetes, high blood pressure and high cholesterol as adults.
This benefit was seen in every child, whether their initial blood work was good or bad.
“Our results suggest that all children with obesity need treatment, even if they appear completely healthy upon examination,” Marcus said.
More information
The National Institute of Child Health and Human Development provides resources on understanding and managing childhood obesity.
SOURCES: Karolinska Institute, news release, March 23, 2026; JAMA Pediatrics, March 23, 2026
