Childhood Obesity

  • Medical Author:
    John Mersch, MD, FAAP

    Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.

  • Medical Editor: David Perlstein, MD, MBA, FAAP
    David Perlstein, MD, MBA, FAAP

    David Perlstein, MD, MBA, FAAP

    Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.

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How prevalent is childhood obesity?

The national statistics regarding childhood obesity prevalence (total number of cases in the pediatric population) have risen remarkably. In the 1970s and 1980s, approximately 5% of children were obese. By 2000, over 13% were obese, and 2010 statistics indicate pediatric obesity to be leveling off at approximately 18% of the population. (In contrast, approximately 35% of adults are obese.) While the frequency of obesity appears to be leveling off, the amount of excess weight has continued to rise (for example, BMI value has risen higher per individual).

The Midwest and South have the highest frequency of obesity (31%), with Arkansas, Mississippi, and West Virginia having the highest frequency (36%) and Colorado having the lowest (21%). Of the remaining states, 26 have an obese population of over 25%; 18 states have over 30% of their population being obese. In 2000, no states had more than 30% of their population considered obese. As of 2014, no state had less than 20% of its adult population classified as obese.

The Centers for Disease Control and Prevention's web site (http://www.cdc.gov) has an excellent demonstration of the rise in obesity over the last 30 years by using an interactive map of the United States (http://www.cdc.gov/obesity/data/trends.html#State).

An area of concern is that the statistics gathered in many studies are self-reported by the individual and may therefore be overly optimistic (for example, purposely underestimating weight and overestimating height).

What causes childhood obesity?

Most obesity is caused by excessive daily caloric intake relative to daily caloric expenditure. Excessive intake of calories is most commonly associated with poor food-quality choices (for example, fast-food high in fat and sugar calories) but may also result from over-ingestion of "healthy foods." The simple biological fact is that all excessive calories (regardless whether triple cheese meat lovers pizza vs. fat free yogurt with berries) will be stored by the body and only as fat. Attempts at only reducing caloric intake without increasing caloric utilization (read: 60 minutes daily vigorous exercise) will only help temporarily. If calorie restriction is the sole approach toward losing weight, the body's metabolism adopts a conservation mode and learns how to get by on fewer calories. Adding physical activity to the calorie-burning equation encourages breakdown of excessive carbohydrate and fat stores, allowing for more functional and long-term health.

Body weight (not necessarily excessive body fatness) is a reflection of genes, metabolism, behaviors, culture, and socioeconomic status. These relatively infrequent causes of obesity will be detailed below.

Medically Reviewed by a Doctor on 1/29/2016
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