The latest data show that obesity affects approximately 14.7 million children and adolescents, or nearly 20% of the US population aged 2-19.
As physicians and healthcare professionals, we know that pediatric obesity is complex, with contributing factors like genetics, environment, and behavior. But we are also acutely aware that if we don’t proactively treat patients with childhood obesity, they could be at risk for serious conditions later in life.
It’s crucial for us to understand the nuances of pediatric obesity, including who may be most at risk for contracting the disease and how we can help our patients—and their families—get the care they need when it is most clinically effective.
Evaluation & Treatment of Childhood Obesity
Clinicians should screen for obesity-related health conditions at visits using the CDC BMI-for-age Growth Charts. In addition, a thorough medical and family history and physical exam should be conducted to help identify children who have or are at risk for developing obesity and obesity-related diseases.
Childhood overweight and obesity is assessed by determining BMI percentile relative to peers of the same age and gender.
- A child or adolescent with a BMI that falls in the 5th to less than the 85th percentile would be considered normal weight.
- A child or adolescent in the 85th percentile to less than the 95th percentile would be considered overweight.
- A child or adolescent with BMI percentile greater than the 95th percentile would be defined as having obesity.
To treat children with obesity, clinicians should formulate a plan that is individualized based on the burden of disease, the child’s age and pubertal status, as well as the family’s readiness and access to resources to effect change. Every treatment plan should be family-centric to ensure the child feels supported on their journey.
Childhood Obesity Prevalence Disparities
The data clearly show racial and ethnic disparities in childhood obesity rates. The highest rates are among Hispanic and non-Hispanic Black children, while lower rates are noted among non-Hispanic White children. The lowest rates are among non-Hispanic Asian children.
Healthcare professionals can address childhood obesity in minority populations by becoming more familiar with cultural and social norms, including perceptions of weight in the patient’s community. Culturally sensitive and non-stigmatizing language should always be used, with an emphasis on health as opposed to weight. Remember to help patients navigate the environments in which they live to help them achieve more positive outcomes.
Studies have also shown that socioeconomic status is inversely related to pediatric obesity. Among children and adolescents, the prevalence of obesity decreases as the head of household’s level of education increases and is lowest among children in households headed by college graduates. Often in obesity care, we see families who have limited resources disproportionately affected by obesity.
Multi-Faceted Approach to Prevention
While childhood obesity is a complex interaction of epigenetics, environment, culture, social norms, and economic, health, and legislative policies, there are things we can do as a medical community to prevent the disease. This includes a multi-faceted approach that focuses on the following:
In-utero environments can affect the likelihood of childhood obesity and may be the first line of defense against childhood obesity. Advise patients to receive proper prenatal care and eat healthily during pregnancy.
School meal programs have shown to improve the quality of dietary intake. Studies found that children who ate school lunches scored higher on their Healthy Eating Index.
Healthy Meals For All: No-cost meal programs offered to all children in schools provide nutritious food options and eliminate the stigma associated with free or reduced-cost school meals. This waiver was offered during the COVID-19 pandemic, and some argue that this should be ongoing.
Summer meal programs ensure children eat healthily even when school is not in session. These may require logistical considerations for families who are not able to leave work or do not have transportation.
The Supplemental Nutrition Assistance Program (SNAP) provides benefits to supplement the food budget of needy families so they can purchase healthy food and move toward self-sufficiency.
Legislation is helping increase funding for programs like SNAP and impact how and where food is grown, distributed, priced, sold, and advertised.
Education for Patients & Parents
Parents are responsible for nutrition in the early years, and that’s why it’s essential to educate them about obesity-related conditions and the life-long health risks those conditions pose. It is vital that parents become models of healthy nutrition and function as the family’s agents of change when necessary. A number of studies have shown that parents who maintain a healthy weight are less likely to have children who are affected by obesity. Parents who have healthy eating patterns are more likely to offer more nutritious foods early on—and this can impact a child’s food preferences later in their life.
When families foster healthy eating patterns (eg, share meals together) and support each other, the results can change the course of the disease of obesity and set children up for wellness later in life. By staying up to date on advances in obesity medicine, supporting public health education and food initiatives, and collaborating with parents (and families), we can help our patients overcome pediatric obesity and achieve their health goals.
Join the Obesity Medicine Association today to stay in the know about preventing, treating, and reversing the disease of obesity.