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The goal of this continuing education offering is to examine childhood obesity over the past 20 years. After reading this article, you will be able to:

1. Define childhood obesity.
2. Identify four causes that contribute to childhood obesity.
3. Identify one pharmacological and three behavioral management approaches for childhood obesity.

Childhood obesity has become an epidemic in the U.S. and other developed countries, and its prevalence continues to increase with each passing year.

It has become a major public health issue because of the obesity-related physical and psychological comorbidities associated with it. These comorbidities or health risks include cardiovascular disease, bone and joint problems, type 2 diabetes, depression, sleep apnea and asthma.^1,2

Healthy People 2010 lists obesity as one of the leading health indicators that will be used to measure the health of the U.S. population within the next 10 years.³

Definition & BMI Screening

Obesity is an abnormal increase of excess of body fat. This is correlated as a body mass index (BMI) of greater than or equal to the 95th percentile for age and gender. BMI is age- and gender-specific, and calculated using weight in kilograms divided by height in meters squared (BMI = weight in kg/height in m²).

Although not a diagnostic tool, BMI is the standard screening tool used to measure obesity as it directly correlates with adiposity.

The American Academy of Pediatrics (AAP) and the Institute of Medicine (IOM) recommend this screening be done on an annual basis as an approach to prevent and manage childhood obesity.⁴ The AAP and the IOM recommend this screening beginning at age 2 and continuing through age 19.^5,6

After the child's BMI is calculated, the value is plotted on the standardized BMI sex- and age-specific chart to determine the respective child's percentile rating.² See Table below for Children's BMI Classification.

Epidemiology

The obesity epidemic affects both boys and girls of all ages, ethnicities and socioeconomic backgrounds. According to the CDC, the prevalence of obesity among children ages 6-11 has doubled in the past 20 years, while the rate among adolescents ages 12-19 years has more than tripled.

The National Health and Nutrition Examination Survey (NHANES) for 2003-04 reported 17 percent of children and adolescents between 2 and 19 years of age are overweight.

The percentage of overweight children increased from 7.2 percent to 13.9 percent for the 2-5 age group and from 11 percent to 19 percent for the 6-11 age group between 1988-1994 and 2003-04.

For adolescents ages 12-19, proportions of those who are overweight increased from 11 percent to 17 percent during the same period.^1,7,8