SUN-686 High Differential Burden of Obesity Among US Asian and Pacific Islander Children in Contemporary Pediatric Practice (2021-2023)

Abstract Disclosure: B.K. Seto: None. J.A. Darbinian: None. L.C. Greenspan: None. E.L. Garcia: None. G.H. Lee: None. J.C. Lo: None. BACKGROUND: Pediatric obesity rates have risen after the COVID-19 pandemic, but data for disaggregated Asian and Pacific Islander (API) populations remain scarce. Among adults, obesity affects Asians differently and lower obesity-equivalent body mass index (BMI) thresholds have been recognized. Young Asian adults have higher rates of diabetes and other weight-related comorbidities, despite lower obesity burden. This study examines demographic differences in obesity in a large API population receiving pediatric care during 2021-2023. METHODS: Using data from a large US health plan, BMI percentiles were derived from height and weight at a well child visit in 2021-2023 for non-Hispanic White (NHW, N=167,127) and API (125,218) children aged 5-17y. The API subset included Chinese (N=16,041), Filipino (16,969), South Asian (17,173), Native Hawaiian/Pacific Islander (NHPI, 4825), and all other/unspecified API ethnicity (Other/NOS, 70,210). BMI was classified as overweight (85th to <95th) and obesity (≥95th percentile). Sex-specific findings were examined by age group (5-8y, 9-12y, 13-17y) and demographic differences compared using chi-squared tests. Prevalence ratios (PR) for API vs NHW were examined in each age-sex strata. RESULTS: Among 292,345 NHW and API children (51.3% male; 31.0% age 5-8y, 29.0% age 9-12y, 40.1% age 13-17y), 14.3% were overweight and 13.1% obese. Obesity varied widely by API vs NHW (13.6%): higher for NHPI (29.6%) and Filipino (17.6%), lower for Chinese (6.3%), South Asian (10.6%) and Other/NOS (11.7%). Overweight or obesity (BMI ≥85th percentile) followed a similar pattern but was much higher: NHW 28.3%, NHPI 46.9%, Filipino 33.4%, Chinese 17.2%, South Asian 24.5% and Other/NOS 25.1%. Males had more obesity vs females (15.2% vs 10.8%, p<.001), especially Chinese and Filipino. There was a non-linear trend in obesity by age, higher for age 9-12y (15.5%) than 5-8y (11.1%) and 13-17y (12.8%). By age strata, Chinese females (PRs 0.30-0.40) and males (PRs 0.48-0.65) had the lowest obesity prevalence vs NHW (p<0.01), whereas NHPI females (PRs 2.06-2.08) and males (PRs 2.13-2.52) had the highest. Filipino males (PRs 1.34-1.67) had more obesity vs NHW, but Filipina females were similar except age 9-12y (PR 1.15). South Asian females (PRs 0.60-0.70) and males (PRs 0.68-0.81) had lower obesity prevalence vs NHW age 9-12y and 13-17y. However, when examining overweight or obesity prevalence (BMI ≥85th percentile), ethnic differences vs NHW were attenuated. CONCLUSION: Disparities in pediatric weight status start at a young age, with greater obesity among high-risk API ethnic groups (NHPI, Filipino), males, and during middle childhood. However, some ethnic differences were attenuated when examining BMI ≥85th percentile rather than only obesity. This may be especially important for Asian populations, who are known to have increased metabolic risk at lower weight thresholds. Presentation: Sunday, July 13, 2025