The World Health Organization made this assertion in an assessment published March of 2012. Childhood obesity is certainly a growing epidemic in the United States. According to the CDC, it affects more than 30 percent of children, making it the most common chronic health concern for the young. This number has more than tripled in the US since the 1970’s, and, if current trends continue, more than half of all children in the US today will be characterized as obese as an adult.
Obesity can harm nearly every system in a developing body – heart and lungs, muscles and bones, kidneys and digestive tract, as well as the hormones that control blood sugar and puberty. It can also take a heavy social and emotional toll that is incalculable. Medical experts say youth who are overweight or obese have substantially higher odds of remaining so into adulthood, increasing their risk of disease and disability later in life.
WARNING: Those with patterns of disordered eating may be triggered by this article, and there are certainly strong opinions associated with the word obesity and anyone being characterized as “obese”.
Childhood Obesity Statistics
Globally, an estimated 43 million preschool children (under age 5) were overweight or obese in 2010, a 60 percent increase since 1990. The problem affects countries rich and poor, and by sheer numbers, places the greatest burden on the poorest. Of the world’s 43 million overweight and obese preschoolers, 35 million live in developing countries. By 2020, if the current epidemic continues unabated, 9 percent of all preschoolers will be overweight or obese – nearly 60 million children.
Here in the United States, childhood obesity has increased nearly 3-fold since 1980, and today, the country has some of the highest obesity rates in the world. One out of six children is obese, and one out of three is overweight or obese. Though the overall U.S. child obesity rate has held steady since 2008, some groups have continued to see increases, and some groups have higher rates of obesity than others. For children and adolescents aged 2-19 years:
- The prevalence of obesity was 18.5% and affected about 13.7 million children and adolescents.
- Obesity prevalence was 13.9% among 2- to 5-year-olds, 18.4% among 6- to 11-year-olds, and 20.6% among 12- to 19-year-olds. Childhood obesity is also more common among certain populations.
- Hispanics (25.8%) and non-Hispanic blacks (22.0%) had higher obesity prevalence than non-Hispanic whites (14.1%).
- Non-Hispanic Asians (11.0%) had lower obesity prevalence than non-Hispanic blacks and Hispanics.
- The prevalence of obesity decreased with increasing level of education of the household head among children and adolescents aged 2-19 years.
- Obesity prevalence was 18.9% among children and adolescents aged 2-19 years in the lowest income group, 19.9% among those in the middle income group, and 10.9% among those in the highest income group.
- Obesity prevalence was lower in the highest income group among non-Hispanic Asian and Hispanic boys.
- Obesity prevalence was lower in the highest income group among non-Hispanic white, non-Hispanic Asian, and Hispanic girls. Obesity prevalence did not differ by income among non-Hispanic black girls.
How Childhood Obesity is Measured
A child is described as “affected by obesity” if their body mass index-for-age (or BMI-for-age) percentile is greater than 95 percent. A child is described as “overweight” if their BMI-for-age percentile is greater than 85 percent and less than 95 percent.
Measuring Weight Status
Obesity in children is determined by using BMI-for-age percentiles. BMI-for-age percentiles have emerged as the favored method to measure weight status in children. This method calculates your child’s weight category based on age and BMI, which is a calculation of weight and height. However, it should be kept in mind that this method, among other methods, should be used as a tool, and only a physician can best determine and diagnose weight status in your child.
Measuring Growth in Children
You may have heard your pediatrician refer to your child’s weight in terms of a percentile. To measure growth in your child based on their weight, doctors most commonly use weight-for-age percentiles. Weight-for-age percentiles are used to measure your child’s weight based strictly on age. It does not take into account the height of a child. This is not a method to determine obesity (or overweight) in children, but simply an indicator of growth as compared to children of the same age.
For example, if your child is in the 95th percentile, this means that their weight is greater than 95 percent of children of the same age.
About Body Mass Index (BMI)
BMI is the most common method to measure adult obesity. However, BMI is now becoming a popular tool, which is combined with BMI-for-age percentiles, used to measure obesity in children. BMI is a number calculated by dividing a person’s weight in kilograms by his or her height in meters squared.
It should be noted, again, BMI is one simple measure that may or may not correlate with true health. Other measures, such as actual metabolic scores and grip strength may be better indicators of overall health.
Risks Associated with Childhood Obesity
Children who are considered affected by obesity are 70 percent more likely to continue being affected by obesity into adulthood. In addition, they are at greater risk for serious medical issues such as:
- Heart disease
- High cholesterol
- High blood pressure
- Sleep Apnea
Aside from the clinical perspective, children who are affected by obesity face social discrimination, leading to low self-esteem and depression.
Causes of Childhood Obesity
Although the causes of childhood obesity are widespread, certain factors are targeted as major contributors to this epidemic. Causes include:
- Lack of physical activity
- Heredity and Family
- Dietary Patterns
- Socioeconomic status
Today’s environment plays a major role in shaping the habits and perceptions of children and adolescents. The prevalence of television commercials promoting unhealthy foods and eating habits is a large contributor. In addition, children are surrounded by environmental influences that demote the importance of physical activity.
Today, it is estimated that approximately 40 to 50 percent of every dollar that is spent on food is spent on food outside the home in restaurants, cafeterias, sporting events, etc. In addition, as portion sizes have increased, when people eat out they tend to eat a larger quantity of food (calories) than when they eat at home.
Beverages such as soda and juice boxes also greatly contribute to the childhood obesity epidemic. It is not uncommon for a 32-ounce soda to be marketed toward children, which contains approximately 400 calories. The consumption of soda by children has increased throughout the last 20 years by 300 percent. Scientific studies have documented a 60 percent increase risk of obesity for every regular soda consumed per day. Box drinks, juice, fruit drinks and sports drinks present another significant problem. These beverages contain a significant number of calories and it is estimated that 20 percent of children who are currently overweight are overweight due to excessive caloric intake from beverages.
Recent studies indicate weight gain trajectories in early childhood are related to the composition of oral bacteria of two-year-old children, suggesting this understudied aspect of a child’s microbiota – the collection of microorganisms, including beneficial bacteria, residing in the mouth – could serve as an early indicator for childhood obesity. A study describing the results appears September 19 in the journal Scientific Reports. 
Lack of Physical Activity
Children in today’s society show a decrease in overall physical activity. The growing use of computers, increased time watching television and decreased physical education in schools, all contribute to children and adolescents living a more sedentary lifestyle.
Another major factor contributing to the childhood obesity epidemic is the increased sedentary lifestyle of children. School-aged children spend most of their day in school where their only activity comes during recess or physical education classes. In the past, physical education was required on a daily basis. Currently, only 8 percent of elementary schools and less than 7 percent of middle schools and high schools have daily physical education requirements in the U.S.
Heredity and Family
Science shows that genetics play a role in obesity. It has been proven that children with parents affected by obesity are more likely to be affected as well. Estimates say that heredity contributes between 5 to 25 percent of the risk for obesity.
However, genes alone do not always dictate whether a child is affected by excess weight or obesity. Learned behaviors from parents are a major contributor. Parents, especially of those whose children are at risk for obesity at a young age, should promote healthy food and lifestyle choices early in their development.
Over the past few decades, dietary patterns have changed significantly. The average amount of calories consumed per day by has dramatically increased. Furthermore, the increase in caloric intake has also decreased the nutrients needed for a healthy diet.
Food portions also play an important role in the unhealthy diet patterns that have evolved. The prevalence of “super size” options and “all you can eat” buffets create a trend in overeating. Combined with a lack of physical activity, children are consuming more and burning off less.
Children and adolescents that come from lower-income homes are at greater risk of being affected by obesity. This is a result of several factors that influence behaviors and activities.
Lower-income children cannot always afford to partake in extracurricular activities, resulting in a decrease in physical activity. In addition, families who struggle to pay bills and make a living often opt for convenience foods, which are higher in calories, fat and sugar.
Educational levels also contribute to the socioeconomic issue associated with obesity. Parents with little to no education have not been exposed to information about proper nutrition and healthy food choices. This makes it difficult to instill those important values in their children.
What to do about Treating Childhood Obesity
Treating obesity in children and adolescents differs from treatment in adults. Involving the family in a child’s weight management program is a key element to treatment. As a support system, family is integral in ensuring all health goals, not just weight, are met.
It is important to talk with your physician about options for treating childhood obesity. The various treatments of obesity in children and adolescents include:
- Diet therapy
- Physical activity
- Behavior Modification
When treating a child or adolescent affected by obesity, it is often recommended they have a consultation with a nutritionist that specializes in children’s needs. Nutritionists can best help children understand healthy eating habits and how to implement them in their long-term diet.
In some cases, nutritionists do not always recommend restricting caloric intake for children. Education on how to read food labels, cut back on portions, understand the food pyramid and eat smaller bites at a smaller pace is generally the information given to change a child’s eating habits.
The goal should be to enjoy a balanced and nutritious diet and have an appropriate level of physical activity to promote overall health and well-being.
Another form of treatment of obesity in children is increasing physical activity. Physical activity is an important long-term ingredient for children, as studies indicate that inactivity in childhood has been linked to a sedentary adult lifestyle.
Increasing physical activity can decrease, or at least slow the increase, in fatty tissues in children affected by obesity. The US Surgeon General recommends that children get at least 60 minutes of physical activity each day. Individualized programs are available and possible for those children or adolescents that are not able to meet minimum expectations.
Lifestyles and behaviors are established at an early age. It is important for parents and children to remain educated and focused on making long-term healthy lifestyle choices.
There are several ways that children and adolescents can modify their behavior for healthier outcomes, such as: changing eating habits, increasing physical activity, becoming educated about the body and how to nourish it appropriately, engaging in a support group or extracurricular activity and setting realistic weight management goals.
While surgery has been performed on adolescents in extreme cases to treat obesity, it is only considered for those with severe medical conditions that can only be improved through such intervention.
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