Any hope that the obesity epidemic among children in the United States might be slowing down or even reversing itself was shattered Monday with the publication of a new study in the journal Pediatrics.
Childhood obesity continues its stealthy, decades-long climb, the study found. In fact, 35.1 percent of U.S. children were overweight or obese in 2016 — a sharp 4.7 percent increase from just two years earlier, in 2014.
“About four years ago, there was evidence of a decline in obesity in preschoolers,” said Asheley Cockrell Skinner, the study’s lead author and an associate professor of population health sciences at Duke University, in a released statement. “It appears any decline that may have been detected by looking at different snapshots in time or different data sets has reversed course.”
“The long-term trend is clearly that obesity in children of all ages is increasing,” she added.
And that’s a serious public health issue — for communities as well as for families. As the Centers for Disease Control and Prevention (CDC) points out, children and teens who are obese are at increased risk for a variety of medical problems, including high blood pressure and high cholesterol (which are risk factors for heart disease), type 2 diabetes, asthma, sleep apnea and joint problems. In addition, they are more likely to experience depression, anxiety and low self-esteem.
Young people who are obese are also at greater risk of being obese as adults — and their obesity-related risk factors for disease are likely to be more severe.
“The obesity epidemic threatens to shorten life expectancy in the United States and bankrupt the health care system,” notes an editorial accompanying the new study.
It’s currently estimated that U.S. healthcare costs related to obesity-related medical illnesses and conditions are somewhere between $147 to $210 billion a year.
No improvements found
For their study, Skinner and her colleagues used information collected from 1999 through 2016 by the CDC’s National Health and Nutritional Examination Survey (NHANES), a database that is updated every two years. The information included body mass index (BMI) data (as well as other health information) for a nationally representative sample of more than 33,000 children aged 2 to 19.
After analyzing all that data, the researchers found that more than a third (35 percent) of America’s children were overweight in 2016, up from more than a quarter (about 29 percent) in 1999.
In addition, about one in five children were obese in 2016.
The researchers did not find improvements in the obesity rates within any subgroup of children. In fact, among 2- to 5-year-olds — the age group that previous research had suggested might be becoming less obese — almost 14 percent were mildly obese in the 2015-2016 NHANES survey — up from 9 percent in 2013-2014.
Older teenagers — those aged 16 to 19 — were the most likely of any age group to fall into an unhealthy weight category. Almost 42 percent of them were overweight or obese in 2016, and 4.5 percent had class III obesity, the most extreme weight category.
The study also found racial disparities among the data. Almost 46 percent of Hispanic children were overweight or obese in 2016, compared to 44 percent of African-American children, 30 percent of white children and 23 percent of Asian-American children.
African-American and Hispanic children were also two to four times more likely to have class III obesity than white children.
Lacking: political willpower
Needless to say, the study’s findings are both alarming and discouraging.
“Our public health approach to the [obesity] epidemic has largely failed so far,” writes Dr. David Ludwig, professor of nutrition at Harvard T.H. Chan School of Public Health and director of the New Balance Foundation Obesity Prevention Center at Boston Children’s Hospital, in the editorial published alongside the study.
“Yet,” he also points out, “the progressive weight gain from one generation to the next is not inevitable. Most children in the United States have had access to abundant food since the end of the Great Depression and were not engaged in heavy physical labor, but obesity rates remained relatively stable until [around] 1980.”
As a country, we are lacking the “intensity, consistency, and persistence” to develop and implement effective strategies, Ludwig contends.
“For example, agricultural policy should be revised to promote underconsumed ‘specialty crops,’ like vegetables, fruits, and nuts over lower-nutritional-quality commodities (eg, corn for high-fructose corn syrup),” he writes. “Federal food assistance programs like the Supplemental Nutrition Assistance Program could be restructured to place greater emphasis on nutritional quality, not just quantity. And National School Lunch Program regulations (eg., that allow sugar-sweetened reduced-fat milk but not plain whole milk) require reassessment to reflect the latest science on dietary fats and added sugars.”
But ultimately, Ludwig stresses, “the burden of obesity-related disease is inextricably linked to income inequality”:
Poverty predisposes individuals to obesity through multiple mechanisms and to chronic diseases, like diabetes, at any weight. Tax cut legislation pending in Congress, estimated to raise the budget deficit by more than $1 trillion, may increase pressure to cut the social safety net, including Medicaid and food assistance.
These are short-sighted actions that would undermine public health and paradoxically increase federal obesity-related medical costs over the long term.
The battle against childhood obesity faces many obstacles, most notably entrenched special interests and a “business as usual” mindset. But with political will and collaboration across key sectors of society, we can hopefully, soon, begin to end this worsening epidemic.