Childhood Overweight

Children (Pediatric) Obesity
The obesity epidemic is not just impacting the quality of life among adults in our nation, but among children too. Approximately 25 to 30 percent of adult obesity cases begin with childhood (pediatric) obesity⁷⁴. A history of being overweight in childhood that persists into adulthood is associated with more severe complications of obesity later in life⁷⁵. According to U.S. Centers for Disease Control and Prevention (CDC) data, today about 15 percent of children and adolescents can be labeled as having childhood (pediatric) obesity in the U.S.⁷⁶ The steadily increasing incidence of childhood (pediatric) obesity raises concern about the health of these youth as they approach adulthood.

Some research suggests that the increased incidence of obesity in children and adolescents stems from a number of factors, including lack of physical activity, sedentary behavior, heredity, socioeconomic status, eating habits, environmental factors and underlying genetic⁷⁷, hormonal(hypothyroidism, thyroid disease) and metabolic syndromes or conditions. Over the past 20 years, the proportion of overweight children ages six through 11 has more than doubled and the rate for adolescents ages 12 through 19 has tripled⁷⁸. The following chart illustrates the increased prevalence of the childhood (pediatric) obesity epidemic over approximately four decades. Most notable is the four percent increase in prevalence from 1988 to 2002.

How is Childhood (Pediatric) Obesity Measured?
The CDC offers four weight classifications for children:

1. The first category, “underweight,” represents a weight under the fifth percentile for the child’s age.
2. The second class is “healthy,” which represents a weight between the fifth and 85th percentile.
3. The third class, the “at risk” level, characterizes a child that weighs between the 85th and 95th percentile for his or her age, which corresponds to a body mass index or BMI of 25 (also considered overweight for adults).
4. Finally, a child is classified as “overweight” if their weight ranks above the 95th percentile for his or her age. This class represents the most severe level of childhood (pediatric) obesity and corresponds to a BMI of at least 30 – the same indicator used to classify adult obesity.
   

The term BMI, used to classify obesity in adults, is referred to as BMI-for-age for evaluating childhood (pediatric) obesity and is both gender and age specific⁷⁹. The BMI-for-age classifications are based on growth charts developed by the CDC and contain a series of curved lines representing different percentiles for healthy weight, overweight, and childhood (pediatric) obesity⁸⁰. The following table indicates how overweight is classified for children and adolescents based on BMI-for-age.

What Health Complications are Associated With Childhood (Pediatric) Obesity?⁸¹
As with obesity in adults, childhood (pediatric) obesity increases the risk of developing a number of health conditions and diseases, including those listed below. Please note that the glossary in Section VI provides definitions of these terms.

• Insulin resistance
• Type 2 diabetes
• Hypertension
• High LDL cholesterol and triglyceride levels; low HDL cholesterol
• Early onset of puberty
• Polycystic ovary syndrome (PCOS)
• Cholecystitis
• Orthopedic problems
• Fatty liver disease
• Symptoms of depression
• Eating disorders
• Sleep apnea
• Stroke
• Cardiovascular disease
• Possible increased risk of cancer

Addressing the Issue of Childhood (Pediatric) Obesity
Currently, a number of state and local governments are attempting to combat the current weight trends in children and adolescents through legislative means, particularly within the school setting. Members of some state legislatures are drafting and adopting legislation that increases and reinforces physical education requirements, while underscoring the importance of nutrition and health curricula. In a number of local communities, consumer groups and lawmakers are working to curb the sale of snack foods and carbonated beverages on school campuses in an effort to address the behavioral component of obesity. Educating youth about overweight at an early age, before they reach adulthood, will ultimately aid in the fight against childhood (pediatric) obesity.