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Study: BMI rates nearly doubled for children, adolescents during pandemic

September 16, 2021
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Editor’s note: For the latest news on COVID-19, visit http://bit.ly/AAPNewsCOVID19.

Body mass index (BMI) rates among children rose sharply during the pandemic, according to a study published today in the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report.

The longitudinal cohort study of 432,302 children ages 2-19 years old is the largest and first geographically diverse analysis of the pandemic’s impact on BMI.

Data were obtained from IQVIA’s Ambulatory Electronic Medical Records database of de-identified information from 800 health systems and hospitals. It included data on patients whose BMI had been recorded at least twice during outpatient visits before the pandemic (including once between March 1, 2019, and Feb. 29, 2020) and at least once between June 1 and Nov. 30, 2020.

In all BMI categories except underweight, children experienced “significant increases in their rate of BMI change during the pandemic,” according to the report. In addition, children who had overweight or obesity prior to the pandemic had higher rates of BMI increase and greater weight gain during the pandemic than those with healthy weight.

“During March–November 2020, persons with moderate or severe obesity gained on average 1.0 and 1.2 pounds per month, respectively,” the authors wrote. “Weight gain at this rate over 6 months is estimated to result in 6.1 and 7.6 pounds, respectively, compared with 2.7 pounds in a person with healthy weight.”

Other findings included:

  • Overall, the average rate of BMI increase was 0.05 kg/m2 per month before the pandemic and 0.1 kg/m2 per month during the pandemic.
  • Children ages 3-5 and 6-11 years experienced an increasing rate of change with each increasing BMI category.
  • The rate of BMI change was highest for children ages 6-11 (0.09 kg/m2/month), 2.50 times the pre-pandemic rate of BMI change.
  • An estimated 19.3% of youths in the cohort had obesity in August 2019 compared with 22.4% a year later.

“The increase in BMI is not unexpected and an important indicator of the need for pediatricians to help families and children navigate the obesogenic environment exacerbated by the COVID pandemic,” said Sandra G. Hassink, M.D., M.S. FAAP, medical director, AAP Institute for Healthy Childhood Weight. “It is also vitally important for pediatricians to ensure that children and adolescents with obesity continue to have access to treatment.”

The study authors noted that public health professionals will play a key role in screening for BMI, food security and social determinants of health, and connecting families to resources for food assistance and evidence-based pediatric weight management programs.

“These findings underscore the importance of obesity prevention and management efforts during and following the COVID-19 pandemic, as well as during future public health emergencies, including increased access to efforts that promote healthy behaviors,” they wrote.

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