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National prevalence, severity of childhood obesity rising
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The prevalence of childhood obesity in the United States increased across all age groups between 1999 and 2014, despite public health efforts to combat the growing epidemic, according to study findings published in Obesity.
“Despite widespread efforts to reduce obesity children, there is no evidence of improvement on a national level,” Asheley Skinner, PhD, of the Duke Clinical Research Institute, told Endocrine Today. “The successes others have found in local levels should not be confused with an ongoing need to address this problem across the population.”
Asheley Skinner
Skinner and colleagues analyzed data from children participating in the National Health and Nutrition Examination Survey between 1999 and 2014. Overweight was defined as greater than the 85th percentile for age- and sex-specific BMI; class I obesity was defined as greater than the 95th percentile, class II obesity as greater than 120% of the 95th percentile or BMI greater than 35 kg/m², and class III obesity as greater than 140% of the 95th percentile or BMI greater than 40 kg/m².
Researchers reported the prevalence of obesity by 2-year NHANES cycle and reported P values from adjusted Wald tests comparing the 2011-2012 cycle with the 2013-2014 cycle, as well as the linear trend from 1999 to 2014. ORs for differences by each 2-year cycle were estimated using multivariable logistic regression models.
In 2013-2014, 17.4% of children met criteria for class I obesity, including 6.3% for class II obesity and 2.4% for class III obesity, none statistically different than the period between 2011-2012. Researchers noted that an increase in all classes of obesity continued from 1999 through 2014.
“Our study suggests that more than 4.5 million children and adolescents in the U.S. have severe obesity,” Skinner told Endocrine Today. “We need to expand interventions that have shown success on local levels, and also look for completely new treatment approaches.”
In commentary accompanying the study, William H. Dietz, MD, PhD, director of the Sumner M. Redstone Global Center for Prevention and Wellness at George Washington University, noted that the findings differ from data published in an issue brief by the National Center for Health Statistics that concluded the prevalence of obesity in children did not change significantly between 2003-2004 and 2011-2012, and that the prevalence in children aged 2 to 5 years decreased from 13.9% to 8.4% during the same period.
“Although the two studies appear contradictory, neither analysis is incorrect — it all depends on whether you start with the 1999-2000 or 2003-2004 data,” Dietz wrote. “This observation suggests that 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.”
“Future research will need to determine if the successes seen at local levels can be scaled up to improve weight in all U.S. children,” Skinner said. “Additional research will also be needed to evaluate the effectiveness of big-picture strategies that combine multiple kinds of policies and interventions.” – by Regina Schaffer
Disclosure: Dietz reports serving on the Weight Watchers scientific advisory board and as a board member of Partnership for a Healthier America. Skinner and the other researchers report no relevant financial disclosures.
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