The Epidemic
Childhood Obesity (O-bE'-si-tE) (noun):
Body mass index (BMI, weight in kilograms divided by height in meters squared) is most commonly used in the U.S. to define who is obese. The Centers for Disease Control and Prevention use the term "overweight" for children at or above the 95th percentile of BMI for their age based on sex-specific growth charts1 and the term "at risk for overweight" for those in the 85th-95th percentile range. While the word "overweight" potentially carries less risk of stigma, increasingly, experts are using the term "obese" for children at or above the 95th percentile to be consistent with adult usage and to avoid confusion over terminology.2
The proportion of overweight and obese children in the United States is growing at an alarming rate. The percentage of children and adolescents in the U.S. who are overweight has roughly tripled since the 1970s to an estimated 16%.3
Prevalence of Overweight* Among Children and Teenagers,
by Age Group and Selected Period -- United States, 1963-20024
* Children with body mass index (BMI) values at or above the 95th percentile of CDC sex-specific BMI growth charts for 2000 are categorized as overweight.
Who Is At Risk?
In the U.S., increasingly sedentary lifestyles and calorie-rich diets are putting nearly all children at risk for becoming overweight. Minority children, particularly Hispanic children and African-American girls, are particularly at risk,5 but obesity is increasing for children across all income levels and ethnicities.
Health Consequences
During childhood, obese children are at increased risk for diabetes, high cholesterol, high blood pressure, sleep disorders, respiratory problems such as asthma, and joint problems.2, 6 Estimates suggest that one in three U.S. children born in the year 2000 will become diabetic if the current childhood obesity trend continues.7 Also, obese children risk becoming obese adults, with associated morbidity and mortality risks. About a third of obese preschool children and half of obese school-aged children remain obese as adults.8 The likelihood that childhood obesity will persist into adulthood increases the older and heavier the child is, and is more likely if one or more parents are overweight.9
Psychosocial Consequences
The social and emotional aspects of being overweight can be as serious as the health problems. Obese children tend to be stigmatized, bullied, and discriminated against, which can lead to low self-esteem, negative body image, and even depression.2, 10 These psychosocial consequences can be devastating and can persist into adulthood.
Economic Costs Associated with Childhood Obesity
Hospitalizations among children and adolescents (6-17 years of age) for diseases associated with obesity increased sharply between 1979 and 1999. Hospital costs (based on 2001 constant U.S. dollars) more than tripled, from $35 million to $127 million.11
For more information and resources, go to Tools for You and More Info for this course on the Cornell NutritionWorks website at www.nutritionworks.cornell.edu.
1 Centers for Disease Control and Prevention. Growth Charts. Available at: http://www.cdc.gov/growthcharts/. Accessed December 5, 2005.
2 Institute of Medicine. Koplan JP, Liverman CT, Kraak VA, eds. Preventing Child Obesity: Health in the Balance. Washington, DC: National Academies Press; 2005. Available at: http://www.nap.edu/openbook/0309091969/html/. Accessed December 5, 2005.
3 Hedley A, Ogden C, Johnson C, Carroll M, Curtin L, Flegal K. Prevalence of overweight and obesity among US children, adolescents, and adults, 1999-2002. JAMA. 2004;291(23):2847-2850.
4 Centers for Disease Control and Prevention. Prevalence of overweight among children and teenagers, by age group and selected period- United States, 1963-2002. Morb Mortal Wkly Rep. 2004;54(08):203.
5 Crawford PB, Story M, Wang MC, Ritchie LD, Sabry ZI. Ethnic issues in the epidemiology of childhood obesity. Pediatr Clin North Am. 2001;48:855-878.
6 Ritchie L, Ivey S, Masch M, Woodward-Lopez G, Ikeda J, Crawford P. Pediatric Overweight: A Review of the Literature. Center for Weight and Health, College of Natural Resources, University of California at Berkeley; 2001. Available at: http://www.cnr.berkeley.edu/cwh/PDFs/Full_COPI_secure.pdf. Accessed December 5, 2005.
7 Narayan KM, Boyle JP, Thompson TJ, Sorensen SW, Williamson DF. Lifetime risk for diabetes mellitus in the United States. JAMA. 2003;290(14):1884-1890.
8 Serdula MK, Ivery D, Coates RJ, Freedman DS, Williamson DF, Byers T. Do obese children become obese adults? A review of the literature. Prev Med. 1993;22:167-177.
9 Whitaker RC, Wright JA, Pepe MS, Seidel KD, Dietz W. Predicting obesity in young adulthood from childhood and parental obesity. New Engl J Med. 1997;337(13):869-873.
10 Gortmaker SL, Must A, Perrin JM, Sobol AM, Dietz W. Social and emotional consequences of overweight in adolescence and young adulthood. New Engl J Med. 1993;329(14):1008-1012.
11 Wang G, Dietz W. Economic burden of obesity in youths aged 6 to 17 years: 1979-1999. Pediatrics. 2002;109(5):e81-89.
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