Severe Obesity On the Rise in U.S. Kids

In February of this year, the Journal of the American Medical Association (JAMA) published the results of a study that looked at whether the obesity rate in U.S. children was increasing, decreasing or holding steady. They found encouraging news that the obesity in preschoolers was on the decline and the percentage of obesity in older children was not increasing. That seemed to be very good news indeed.

However, a new study using the same data as the previous study-only extending the years investigated-has more sobering results. Extreme obesity among U.S. kids is on the rise.

"We found that the number of extremely obese kids seems to be increasing," said lead researcher Asheley Cockrell Skinner, an assistant professor of pediatrics at the University of North Carolina. "This is particularly true for school-age girls and teenage boys."

For the new report, published online in the journal JAMA Pediatrics, Skinner and a colleague used the same National Health and Nutrition Examination Survey data as the CDC researchers, but extended their research from 1999 to 2012.

"When extending the data out to 14 years, we see there isn't really a decline. We need to be cautious about reports that say obesity is declining and assume things are better." Skinner noted.

Categories of obesity are based on a child's height and weight in relation to their peers. A 10-year-old boy who is 4 feet, 6 inches tall and weighs 95 pounds is considered obese, according to Dr. David Katz, director of the Yale University Prevention Research Center. At 130 pounds, that boy would be severely obese.

"This paper will come as a sobering reality check for any who believed the recent headlines about childhood obesity rates plummeting," he said.

Severe obesity in children is rising, he said, adding that this is a critical piece of information.

"Severe obesity is much more likely to induce serious chronic disease and steal years from life," Katz said. "It calls out for clinical interventions, up to and including weight-loss surgery."

For the new study, Skinner's team examined data on nearly 26,700 children ages 2 to 19 years old. For the years 2011-12, they found 32 percent of America's children were overweight and 17 percent were obese. Among obese kids, 8 percent were severely obese, the researchers said.

When specific categories of obesity were examined, more bad news emerged. Among girls, the researchers found obesity rates jumped from 14.5 percent in 1999-2000 to 17.4 percent by 2011-12. And severe obesity among girls climbed from 0.9 percent in 1999-2000 to 2.3 percent by 2011-12.

In boys, obesity rose from 14.6 percent in 1999-2000 to 17.2 percent by 2011-12, while severe obesity grew from 1 percent to 2 percent.

A second study published in JAMA Pediatrics, analyzed the additional costs associated with childhood obesity. The report suggested that, over the course of a lifetime, higher medical costs with severely obese children increased about $19,000 per person. A child in the normal weight range, who becomes overweight or obese in adulthood, could expect an extra increase of about $12,900 per person for medical costs.

"To put these findings in perspective, multiplying the lifetime medical cost estimate of $19,000 times the number of obese 10-year-olds today generates a total direct medical cost of obesity of roughly $14 billion for this age alone," wrote Eric Andrew Finklestein, PhD, from the Duke Global Health Institute at Duke University, and colleagues.

Authors who conducted the study on the rise of severe obesity in kids noted that more research is needed to determine which public health programs, if any, are helpful in preventing obesity.

Obesity in children is linked to a number of medical conditions such as high cholesterol, high blood pressure, early heart disease, diabetes, bone problems and skin conditions such as heat rash, fungal infections and acne. According to the CDC, obese children tend to become obese adults and are more risk for heart disease, type 2 diabetes, stroke, several types of cancer and osteoporosis.

Weight is a touchy subject in our culture. Nobody likes the word obese. But medically speaking, it's a reality that too many of our children are overweight, obese and severely obese. Parents are the key in helping their children get their weight under control. It doesn't mean that every child has to be skinny or even what is considered normal weight for his or her height and age. But they should be close to a healthy weight.  Children without a medical condition ought to be able to run, skip, walk and play without being exhausted or gasping for air after a few minutes. 

If you are unsure whether your child is at a normal weight, underweight, overweight or possibly obese, talk to your family doctor or pediatrician. Calculating the body-mass-index (BMI) for children is different than for adults. Your child's doctor should be able to help you determine your child's BMI and recommend a nutritional diet and exercise plan for your child and family.


Salynn Boyles,

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