No abstract

Adolescent health and well-being are of great concern worldwide, and adolescents encounter particular challenges, vulnerabilities and constraints. The dual challenges of adolescent parenthood and obesity are of public health relevance because of the life-altering health and socioeconomic effects on both the parents and the offspring. Prevention and treatment strategies at the individual and population levels have not been successful in the long term, suggesting that adolescent pregnancy and obesity cannot be managed by more of the same. Here, we view adolescent obese pregnancy through the lens of the social contract with youth. The disruption of this contract is faced by today’s adolescents, with work, social and economic dilemmas which perpetuate socioeconomic and health inequities across generations. The lack of employment, education and social opportunities, together with obesogenic settings, increase vulnerability and exposure to lifelong health risks, affecting their offspring’s life chances too. To break such vicious circles of disadvantage and achieve sustainable solutions in real-world settings, strong efforts on the part of policymakers, healthcare providers and the community must be oriented towards guaranteeing equity and healthy nutrition and environments for today’s adolescents. The involvement of adolescents themselves in developing such programs is paramount, not only so that they feel a sense of agency but also to better meet their real life needs.

Obesity and pregnancy are a combination that may create unique interconnected challenges for the health of the next generation. Although pregnant obese adolescents are of concern worldwide, yet it is an issue that is currently unattended to. Here, we provide an overview of the implications for the mother-offspring pair’s health associated to teenage-pregnancy, with a focus on obesity and ‘what works’ to prevent the obesity-risk during pregnancy. Interrelated health-issues are highlighted, which include: increased negative consequences related to childbearing at young age; associations of maternal pre-gravid excessive-weight with maternal and fetal complications; and limited evidence addressing obese pregnancy in adolescents. Targeting adolescents appears the most effective approach to reduce the obesity-risk trajectory of the prospective parents early-in-life, thus breaking the intergenerational cycle of non-communicable diseases. Specifically-focused educational programs with clear and motivational messages about nutrition, physical activity and sexual health, are perceived as key-components of preventive campaigns with digital web-based technology and specialized health-services being the most promising platforms to deliver knowledge. Successful education has a double advantage: to establish healthy behaviors among adolescents at an early-stage of life, thereby preventing both obesity and early pregnancy. Lastly, realistic solutions require also political understanding and commitment.