There are 12.5 million overweight children in the United States. They comprise 17 percent of children and adolescents ages two to 19 in the country according to the National Health and Nutrition Examination Survey. In the United States, two-thirds of adults are overweight and obese.
Many health disparities exist with this condition. From 1980 to 2008, the prevalence of overweight and obesity in the United States more than doubled in adults and more than tripled in children. Overweight and obesity are more common among non-Hispanic black teenagers than it is among Hispanic teenagers or non-Hispanic white teenagers. Seventy percent of American Indian/Alaska Native adults are overweight or obese.
Overweight and obesity result from excessive calorie or energy intake and insufficient expenditure of that energy through physical activity. There are also hereditary influences and environmental issues which contribute to the problem. For example, meals which children and adolescents consume at school and child care centers influence their dietary patterns from early childhood. Employer cafeterias also have an impact on the quality of food that adults consume each day.
The presence of bicycle paths, neighborhood parks, and sidewalks may determine how physically active residents will be during childhood, adolescence, and adulthood. Children also learn dietary patterns from their parents. Moreover, certain medical conditions and treatments for those illnesses will predispose an individual to overweight or obesity. For example, certain drugs to treat mental disorders will cause these patients to gain weight.
Body Mass Index
To determine if an individual is overweight or obese, physicians may use several indicators such as the body mass index, which is the ratio of the weight to the square of the person’s height. For children and adolescents, pediatricians use this formula in conjunction with growth charts which serve to define overweight and obesity according to the percentile for children of the same age and gender.
The body mass index enables physicians to determine whether a patient is underweight, healthy weight, overweight, or obese. The American Academy of Pediatrics recommends this approach for children ages two through 19, and physicians who care for adult patients use the body mass index without the need for growth charts.
Several behaviors will predispose children and adolescents to overweight and obesity. Large portion sizes for food and beverages, meals away from home, frequent snacks of high energy dense foods, and beverages which contain a great deal of sugar will increase the possibility that a child or adolescent will become overweight. The mass media advertises many of these food products as well.
Consequences of Obesity
The consequences of overweight and obesity are many, and they tend to be especially serious in children and adolescents who become overweight or obese. These patients are at risk for coronary heart disease, stroke, diabetes mellitus, high cholesterol, and high blood pressure. They may also develop liver and gallbladder disease, arthritis, cancer, and sleep apnea. Overweight women may experience reproductive problems such as irregular menstrual periods and infertility or the inability to become pregnant.
Children and adolescents who suffer from overweight and obesity also encounter psychological issues such as lack of self-esteem, and this may lead to decline in school performance or impairment in social interactions. These young people become targets of social discrimination.
Adults who are overweight or obese may not be as productive at work as individuals who maintain a healthy weight, and their attendance at work will likely suffer. In general, overweight and obese people do not live as long as others whose weights are normal.
Management of Overweight and Obesity
To manage this public health problem, the United States Surgeon General, the American Academy of Pediatrics, the Centers for Disease Control, and other organizations have made recommendations for parents, children, and communities. Families should eat breakfast every day, and family meals together are important. Employers and schools can serve healthy foods in their cafeterias. Children whose mothers breastfeed them are less likely to encounter weight problems as they grow older than are children who consume alternative sources of nutrition.
Children, adolescents, and adults should consume more water, fruits and vegetables, whole grains, and lean proteins. They should also take low-fat or non-fat dairy products. With those changes, young people will have to drink fewer sodas and juices which contain added sugars. Parents should limit their children’s television time to two hours daily. They also need an hour of daily physical exercise, and schools can require physical education classes for elementary and secondary schools.
The combination of regular health screening and health behavior change, therefore, is the first step necessary to address the worldwide problem of overweight and obesity which increases health care costs and causes significant disease and premature death.
Michael Koger - Dr. Koger obtained his medical education at Meharry Medical College and specialized in Internal Medicine.
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