Have you ever wondered how or why someone is considered obese?


Pediatricians and public health experts predict a potential drastic increase in childhood obesity this year, as months of pandemic feeding, closed schools, stalled sports and public space constraints extend indefinitely.

About one in seven children have met the criteria for childhood obesity since 2016, when the Federal National Child Health Survey changed its methodology, a report by the Robert Wood Johnson Foundation said Wednesday.

While the percentage of children considered obese has declined slightly over the last 10 years, it is expected to jump in 2020.

“So far, we have progressed slowly and steadily,” said Diane Whitmore Schanzenbach, an economist and professor at Northwestern University. “We will probably have destroyed much of the progress we have made over the last decade in childhood obesity.”

The trend, already seen in pediatric clinics is particularly worrying, as the Centers for Disease Control and Prevention this week expanded its definition of those at increased risk of severe illness and death from COVID-19 to include people with a body mass index between 25 and 30. Previously, only those with a BMI of 30 and higher were included. This could mean that 72% of all Americans are at higher risk of serious illness based on their weight alone.

Obesity is a major risk factor for almost all chronic diseases that make COVID-19 more dangerous, including diabetes and hypertension. heart disease and cancer. And childhood obesity is a leading predictor of obesity later in life.

BMI factors in weight and height to measure body fat. However, it can overestimate body fat in people with muscle build and underestimate it in those who have lost muscle, according to the National Institutes of Health.

Children “gain insignificant amounts of weight,” said Dr. Lisa Denike, who is chair of pediatrics for Northwest Permanente in Portland, Oregon. “We’ve seen kids gain 10 to 20 pounds in a year who may have had a BMI as a precursor in the 50th or 75th percentile and are now in the 95th percentile. That’s a significant intersection of percentiles in obesity.”

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Denike said an 11-year-old patient in his recent physical illness was found to have gained 40 kilograms. The rate of type 2 diabetes in children is rising, and although the boy is gone now, Denike said: “I suspect he will do it in the coming years, as his parents already have it.”

“He is at home in an environment that struggles with parents with the same problems, instead of studying in a health class and being active outside,” she said. “Children are a reflection of what their parents are doing.”

Racial, socio-economic differences

Differences in childhood obesity levels have existed for decades and now reflect the disproportionate way in which COVID-19 affects people of color and low-income, said Jamie Bussell, senior program officer at the Robert Wood Johnson Foundation.

“In both cases, these results reflect decades of disinvestment in specific communities and specific groups of people, often driven by systemic racism and discrimination, which are still so prevalent in our society,” he said.

Young people in households who make less than the federal poverty line are more than twice as likely to be obese as those with the highest income levels, the RWJF report said. The pandemic and the ongoing economic recession have exacerbated many of the factors leading to obesity, including poverty and health inequalities, Bussel said.

“We know that families are switching to lower quality foods when faced with food insecurity – that is, foods with more calories and less variety,” said Shanzenbach.

Childhood obesity ranges from 11% in high-income families to about 20% in low- to middle-income families, Dakones said. This contributes to higher levels of obesity in blacks and Hispanic populations, which include more people on lower incomes. In California, for example, she notes that the number of people classified as insecure has increased from one in nine to one in six.

A July report from researchers at Northwestern University found that more than 41% of black households with children faced food insecurity between April 23 and June 23, compared with just under 40% of Hispanic households and just over 23% of whites. Since then, the percentages have fallen for black and Hispanic families, but have remained unchanged for white families.

“Although not as bad as it was at the peak of the pandemic, food insecurity levels are still appalling,” Schanzenbach said.

Poor fitness, eating disorders are on the rise

Those who study food insecurity, mental health and fitness say trends that are already heading in the wrong direction are particularly worrying now.

Jim Bowe is the founder and president of PHIT America, which circulated a petition starting in August to demand a 30-minute break at least three times a week for all students. He noted that almost half of primary schools have no physical education and “children are more sedentary than ever.” The United States ranks 47th out of 50 countries in the world in children’s fitness.

University of Virginia School of Medicine researcher Dr. Zhen Yang has studied the role of exercise in limiting the effects of COVID-19 and agrees that more needs to be done to increase childhood activity.

“If we want to protect our children from the deadly COVID-19, we need to increase their physical activity and make them healthier,” said Ian. “Too many children already have pre-existing conditions such as obesity.”

Young adults who have experienced stigma and poor weight treatment are more prone to “increased vulnerability to distress” and poor eating habits during a pandemic, researchers at the University of Connecticut concluded in a study in the Annals of Behavioral Medicine. People who had a weight stigma before the pandemic were almost three times more likely to overeat during the pandemic than those who were not. The findings are true for men and women.

Denike said the “mental health crisis” that existed before the pandemic had intensified and contributed to the increase in the number of patients with eating disorders.

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Young people at risk for eating disorders are “looking for control areas during times of stress,” Denike said. They have a “limited menu of options” as children, she said, so limiting or overeating is convenient.

Because many more people suffer during social isolation, there is a greater risk for people who “tended to use food for less good things,” said Dr. Imelda Dakones, CEO of Northwest Permanente. “It makes children, like adults, do healthier things.”

The National Eating Disorders Association said it had seen a nearly 80 percent increase in monthly calls and online chats during the pandemic compared to the same months last year.

Social isolation hasn’t changed much for Tierney Sadler, a home-based marketing writer in Alexandria, Virginia, who said she was “painfully obese” and about 100 pounds overweight. But she can easily identify with children who are struggling today because child weight problems have been a constant focus of the family and a source of stress, which only makes her eat more, she said.

“It would never be good enough, and I couldn’t shake it off,” said Sadler, 57, who was on a diet in kindergarten. “Fat kids have a lot of company today, but in the ’60s, if you were one fat kid, that really made you a number.”

However, parents can help, protect children from household stress.

“Food is one of the ways we take comfort,” Sadler said. “There are a lot of things that children learn from their parents who may be unemployed and terrified of the whole COVID thing. Their pores are so wide they can suck up all that negative energy.”

Reach Jane O’Donnell on social media @JayneODonnell or email

Follow Adriana Rodriguez on Twitter: @AdriannaUSAT. Adriana Rodriguez

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