Trends in Childhood Obesity Bode Poorly for Country’s Future Health

Severe Obesity Spikes While Parents Underestimate Children’s Weight, Risks

September 10, 2009

 

Two recent studies point out alarming trends in childhood obesity – not only is the group of severely obese children getting larger, but parents don’t even see it. Between 1976 and 2004, the rate of severely obese children – those with BMIs at or above the 99th percentile – has tripled to a total of 2.7 million. A separate, smaller study shows that almost a third of parents underestimate their child’s weight.

The University of Rochester Medical Center (URMC) researchers, along with colleagues at Wake Forest University and Baylor College of Medicine, used the Centers for Disease Control and Prevention’s new definition of severe obesity and found that about 4 percent of children in the U.S. are morbidly obese. The most recent estimate of the rate of obesity among children is 17 percent of the population.

“We knew the rate of severely obese children was increasing, but we were surprised at how quickly the number is rising,” said Stephen Cook, M.D., M.P.H., assistant professor of Pediatrics at URMC’s Golisano Children’s Hospital and one of the authors of the study to be published this month in Academic Pediatrics. “These children have a higher prevalence of cardiovascular risk factors, even before they reach adulthood. We’re very concerned about the future as well as immediate health of these children.”

The study examined nationally representative data from the National Health and Nutrition Examination Surveys from 1976 to 2004 and found that the rate increased from 0.8 percent in the 1976-1980 survey to 3.8 percent in the 1999-2004 survey. Researchers also found that the greatest increases were seen among blacks, Mexican Americans and those living in poverty.

One third of the teens with severe obesity were classified as meeting the adult criteria for the metabolic syndrome, a clustering of risk factors that put them on the path toward heart disease and diabetes in adulthood, and ultimately, could lead to an early death. Nearly 4 percent, or 2.7 million children, have a BMI at or above the 99th percentile, the point at which bariatric surgery is first considered.

“Until a child reaches the point where bariatric surgery is an option, there are few treatment options for families. Insurance doesn’t typically cover the cost, and without that, most families cannot afford to pay,” Cook said. “Without coverage for non-surgical options, the treatment services lose money and have to close.”

Researchers said that their findings point to the environment (where they live, socio-economic level, etc.) as an important factor in whether a child develops obesity and something over which children have no control.

Another URMC study shows that parents often underestimate their children’s weight status and the health effects of the extra pounds. The study, to be published in Clinical Pediatrics, shows 31 percent of interviewed parents underestimated their children’s weight, including both children who are overweight and normal weight. And parents who believed their children to be underweight were more concerned about their health than parents who did not realize that their children were overweight. Considering parents, especially of young children, make most decisions about what children eat, how they spend their time and where they live, researchers are concerned parents aren’t taking the problem of childhood obesity seriously enough.

“Parents play an important role in lowering their child’s risk of obesity – they have the ability to encourage physical exercise and teach their children about a healthy diet beginning in early childhood,” said Jillian M. Tschamler, an author of the paper who was a student at the University of Rochester at the time it was written and is currently a graduate student in nursing at the University of Virginia. “Healthy habits that children learn at a young age will decrease their risk of becoming overweight in the future, and prevention is a crucial step in lowering the overall rate of obesity in children.” 

Researchers interviewed parents of 193 children between 18 months and 9 years old at the outpatient clinic at URMC’s Golisano Children’s Hospital. More than 30 percent of the children were overweight (BMI greater than 85th percentile). Almost half of the parents of children who were overweight said they thought their children’s weight was “about right,” and 24 percent of parents of normal-weight children said they thought their children were a little or very underweight. Parents were less likely to underestimate the weight of their girls.

This work was funded by the American Legion Ladies Auxiliary, the Halcyon Hill Foundation, the National Heart, Lung and Blood Institute of the National Institutes of Health, the federal Agency for Healthcare Research and Quality and the Robert Wood Johnson Foundation.

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Heather Hare
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