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Obesity in Youth
Diabetes, hypertension and other obesity-related chronic diseases that
are prevalent among adults have now become more common in youngsters.
The percentage of children and adolescents who are overweight and obese
is now higher than ever before. Poor dietary habits and inactivity are
reported to contribute to the increase of obesity in youth.
Today's youth are considered the most inactive generation in history
caused in part by reductions in school physical education programs and
unavailable or unsafe community recreational facilities.
This fact sheet outlines many factors related to obesity in youth
that make it the major health care challenge for the 21st
century.
Overweight and Obesity Defined
 | Overweight and obesity for children and adolescents are defined
respectively in this fact sheet as being at or above the 85th and
95th percentile of Body Mass Index (BMI).
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| Some researchers refer to the 95th percentile as overweight and
other as obesity. The Centers for Disease Control and Prevention
(CDC), which provides national statistical data for weight status of
American youth, avoids using the word "obesity," and identifies
every child and adolescent above the 85th percentile as
"overweight."
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| The AOA uses the 95th percentile as criteria for obesity because
it:
 | corresponds to a BMI of 30 which is obesity in adults. The
85th percentile corresponds to a BMI of 25, adult overweight.
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| is recommended as a marker for when children and adolescents
should have an in-depth medical assessment.
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| identifies children that are very likely to have obesity
persist into adulthood.
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| is associated with elevated blood pressure and lipids in
older adolescents, and increases their risk of diseases.
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| is a criteria for more aggressive treatment.
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| is a criteria in clinical trials of childhood obesity
treatments.
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Prevalence and Trends
| Approximately 30.3 percent of children (ages 6 to 11) are
overweight and 15.3 percent are obese. For adolescents (ages 12 to
19), 30.4 percent are overweight and 15.5 percent are obese.
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| Excess weight in childhood and adolescence has been found to
predict overweight in adults. Overweight children, aged 10 to 14,
with at least one overweight or obese parent (BMI> 27.3 for
women and > 27.8 for men in one study), were reported to have
a 79 percent likelihood of overweight persisting into adulthood.
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Gender
| Overweight prevalence is higher in boys (32.7 percent) than
girls (27.8 percent). In adolescents, overweight prevalence is about
the same for females (30.2 percent) and males (30.5 percent).
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| The prevalence of obesity quadrupled over 25 years among boys
and girls, as shown in Table 1.
Increase in Obesity Prevalence (%)
Among U.S. Children (Ages 6 to 11) |
|
|
Boys |
Girls |
|
1999 to 2000 |
16 |
14.5 |
|
1988 to 1994 |
11.6 |
11 |
|
1971 to 1974 |
4.3 |
3.6 |
|
Source: CDC, National Center for Health Statistics,
National Health and Nutrition Examination Survey. Ogden et.
al. JAMA. 2002;288:1728-1732. |
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| Obesity prevalence more than doubled over 25 years among
adolescent males and females, as shown in Table 2.
Increase in Obesity Prevalence (%)
Among U.S. Adolescents (Ages 12 to 19)
|
|
|
Males |
Females |
|
1999 to 2000 |
15.5 |
15.5 |
|
1988 to 1994 |
11.3 |
9.7 |
|
1971 to 1974 |
6.1 |
6.2 |
|
Source: CDC, National Center for Health Statistics,
National Health and Nutrition Examination Survey. Ogden et.
al. JAMA. 2002;288:1728-1732. |
|
Race
| African American, Hispanic American and Native American children
and adolescents have particularly high obesity prevalence.
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| Overweight (85th percentile) and obesity (95th percentile)
prevalence for children and adolescents is presented by racial group
in Table 3. |
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Children
(Ages 6 to 11)
Prevalence (%) |
Adolescents
(Ages 12 to 19)
Prevalence (%) |
|
Race |
Overweight |
Obesity |
Overweight |
Obesity |
|
Black (Non-Hispanic) |
35.9 |
19.5 |
40.4 |
23.6 |
|
Mexican American |
39.3 |
23.7 |
43.8 |
23.4 |
|
White (Non-Hispanic) |
26.2 |
11.8 |
26.5 |
12.7 |
|
Source: CDC, National Center for Health Statistics,
National Health and Nutrition Examination Survey. Ogden et. al.
JAMA. 2002;288:1728-1732. |
| Among female youth, the highest overweight and obesity
prevalence is found in black (non-Hispanic) girls (ages 6 to 11),
37.6 percent and 22.2 percent respectively, and black (non-Hispanic)
adolescent females (ages 12 to 19), 45.5 percent and 26.6 percent
respectively.
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| Among male youth, the highest overweight and obesity prevalence
is found in Mexican American boys (ages 6 to 11), 43 percent and
27.3 percent respectively, and Mexican American adolescent males
(ages 12 to 19), 44.2 percent and 27.5 percent respectively.
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| Overweight prevalence for Native American children and
adolescents (ages 5 to 17) was reported in a 1999 study as 39
percent for males and 38 percent for females in the Aberdeen area
Indian Health Service.
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| Asian American adolescents (ages 13 to 18) were reported to have
an overweight prevalence of 20.6 percent in the 1996 National
Longitudinal Study of Adolescent Health.
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| Asian-American and Hispanic-American adolescents born in the
U.S. to immigrant parents are more than twice as likely to be
overweight as foreign born adolescents who move to the U.S. |
Health Effects
Many adverse health effects associated with overweight are observed
in children and adolescents. Overweight during childhood and
particularly adolescence is related to increased morbidity and mortality
in later life.
| Prevalence of overweight is reported to be significantly
higher in children and adolescents with moderate to severe
asthma compared to a peer group.
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Diabetes (Type 2)
| Type 2 diabetes in children and adolescents has increased
dramatically in a short period. The parallel increase of obesity
in children and adolescents is reported to be the most
significant factor for the rise in diabetes.
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| Type 2 diabetes accounted for 2 to 4 percent of all
childhood diabetes before 1992, but skyrocketed to 16 percent by
1994.
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| Obese children and adolescents are reported to be 12.6 times
more likely than non-obese to have high fasting blood insulin
levels, a risk factor for type 2 diabetes.
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| Type 2 diabetes is predominant among African American and
Hispanic youngsters, with a particularly high rate among those
of Mexican descent.
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Hypertension
| Persistently elevated blood pressure levels have been found
to occur about 9 times more frequently among obese children and
adolescents (ages 5 to 18) than in non-obese.
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| Obese children and adolescents are reported to be 2.4 times
more likely to have high diastolic blood pressure and 4.5 times
more likely to have high systolic blood pressure than their
non-obese peers. |
Orthopedic Complications
| Among growing youth, bone and cartilage in the process of
development are not strong enough to bear excess weight. As a
result, a variety of orthopedic complications occur in children
and adolescents with obesity. In young children, excess weight
can lead to bowing and overgrowth of leg bones.
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| Increased weight on the growth plate of the hip can cause
pain and limit range of motion. Between 30 to 50 percent of
children with this condition are overweight. |
Psychosocial Effects & Stigma
| Overweight children are often taller than the
non-overweight.
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| White girls, who develop a negative body image, are at a
greater risk for the subsequent development of eating disorders.
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| Adolescent females who are overweight have reported
experiences with stigmatization such as direct and intentional
weight-related teasing, jokes and derogatory name calling, as
well as less intentional, potentially hurtful comments by peers,
family members, employers and strangers.
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| Overweight children and adolescents report negative
assumptions made about them by others, including being inactive
or lazy, being strong and tougher than others, not having
feelings, and being unclean. |
Sleep Apnea
| Sleep apnea, the absence of breathing during sleep, occurs
in about 7 percent of children with obesity. Deficits in logical
thinking are common in children with obesity and sleep apnea.
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Note: Information for this fact sheet comes from
various sources, some of which use different terminology for the 85th
and 95th percentile of BMI. For consistency, the AOA refers to any use
of the 85th percentile of BMI as overweight and the 95th percentile as
obesity in children and adolescents. In general, childhood is defined as
6 to 11 years of age, and adolescence as 12 to 19 years of age.
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