1 Faculty of Land and Food Systems, Food, Nutrition and Health, The University of British Columbia, Vancouver, BC, Canada.
2 BC Children's Hospital Research Institute, Healthy Starts, BC Children's Hospital, Vancouver, BC, Canada.
3 Department of Pediatrics, Faculty of Medicine & Dentistry, College of Health Sciences, University of Alberta, Edmonton, AB, Canada.
4 Department of Mathematics and Statistics, Concordia University, Montreal, QC, Canada.
5 School of Human Nutrition, McGill University, Montreal, QC, Canada.
6 Department of Pediatrics, McMaster University, Hamilton, ON, Canada.

Few studies have characterized metabolically healthy (MHO) and unhealthy obesity (MUO) in pediatric populations over time. The objective of this study was to determine the prevalence of MHO in children and adolescents enrolled in a weight management program and examine changes in cardiometabolic indicators over 1 year.Methods: Participants from the CANadian Pediatric Weight management Registry were stratified by age (6-11-year-olds; 12-17-year-olds) and sex to determine MHO/MUO status at baseline and 1-year follow-up.Results: In this sample (n = 387), the baseline and 1-year follow-up prevalence of MHO were 35% and 34%, respectively. Obesity status remained stable in 72% of participants. Of the 387 participants, n = 55 transitioned from MHO to MUO, while n = 53 transitioned from MUO to MHO by 1 year. Patterns of change in MHO were generally similar across sexes and age groups.Conclusion: In this study, MHO was present in approximately one-third of children and adolescents, with one-quarter changing MHO to MUO or MUO to MHO status from baseline to 1-year follow-up.