27 Apr 2016 --- New research published in Obesity, the scientific journal of The Obesity Society, suggests there is no evidence of a decrease in the prevalence of childhood obesity in the US. In fact, rates of children with severe obesity are on the rise in minority groups.
"Our study suggests that more than 4.5 million children and adolescents in the US have severe obesity,” says lead researcher Asheley Skinner, PhD, of the Duke Clinical Research Institute. “We need to expand interventions that have shown success on local levels, and also look for completely new treatment approaches. Addressing obesity in children is going to require a true population health approach, combining efforts at individual, healthcare, community and policy levels."
Studies have shown that children with severe obesity are at an increased risk for the rapid development of other dangerous comorbidities including heart disease, Type 2 Diabetes and even cancer when compared to children with more mild forms of obesity, thus emphasizing the urgent need to develop an efficient, cost-effective strategy for the treatment and prevention of childhood obesity.
To conduct the study, Dr. Skinner and colleagues examined data from the National Health and Nutrition Examination Survey (NHANES), a survey designed to assess health and nutritional status of individuals in the United States. The researchers examined data from 1999 through 2014 and found that 33.4 percent of children met criteria for overweight (BMI > 85th percentile), 17.4 percent for class I obesity (BMI > 95th percentile), 6.2 percent for class II obesity (BMI > 120% of the 95th percentile or BMI > 35), and 2.4 percent for class III obesity (BMI > 140% of the 95th percentile or BMI > 40).
Additionally, the data demonstrated an increase in severe obesity among children and adolescents. In 2013 to 2014, nearly 10% of adolescents met criteria for class II obesity, and nearly 5% also met criteria for class III obesity. Substantial racial/ethnic differences were also found, with black and Hispanic children having the highest prevalence of severe obesity.
In a commentary accompanying the study in Obesity, William Dietz, MD, PhD, Director and Chair of the Sumner M. Redstone Global Center for Prevention and Wellness at Milken Institute School of Public Health at the George Washington University, discusses the findings.
"The authors' observation that severe obesity has increased is of great concern, especially because children with severe obesity become adults with severe obesity," said Dr. Dietz. "My analyses suggest that every primary care provider is likely to have approximately 50 patients with severe obesity in his or her practice. That is an overwhelming number for primary care providers, most of whom are poorly prepared to treat obesity."
"Right now our options for the treatment of childhood obesity include multidisciplinary medical programs that often do not offer specific approaches for children with the most severe obesity unless the programs include bariatric surgery," says Elsie Taveras, MD, MPH, a spokesperson for The Obesity Society. "We need more effective, cost-efficient and standardized approaches and services to manage children with the most severe obesity. This research emphasizes the urgency with which we must develop and validate a reimbursable standard of care for severe obesity in children and adolescents."
Of the assessment of prevalence of childhood obesity based on the NHANES data, Dr. Dietz adds, "It all depends on how you look at it." While Skinner et al. anchored their analysis in 1999-2000 NHANES data and found no declines in prevalence, he notes Ogden et al. observed significant declines in two- to five-year-olds when anchoring the analysis in 2003-2004 data. "Neither analysis is incorrect," he writes.
Dietz also suggests, "reliance on NHANES data alone does not provide conclusive information on the state of the epidemic and indicates that we need to broaden our inquiry."
