The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a federally funded program that provides healthy foods and nutrition education to pregnant and postpartum parents and infants and children up to 5 years of age who have low income. Approximately 20% of US children received WIC benefits in 2019.
Even though we know that severe obesity in childhood is associated with multiple future health issues, there are very little data about severe obesity in early childhood.
In an article entitled, “Trends in Severe Obesity Among Children Aged 2–4 Years in WIC: 2010–2020,” which is being early released this week in Pediatrics, Lixia Zhao, PhD, and colleagues at the CDC report on trends in severe obesity from 2010 to 2020 among 2-4-year-old children who receive WIC benefits (10.1542/peds.2023-062461).
The authors analyzed nearly 17 million measurements from nearly 8 million children. Severe obesity was defined as a BMI-for-age of at least 120% of the 95th percentile, or a BMI of at least 35 kg/m2.
The news is not great. Although the prevalence of severe obesity in 2-4-year-old children enrolled in WIC decreased from 2.1% in 2010 to 1.8% in 2016, it increased to 2.0% in 2020. When the authors looked at subgroups, they found that between 2016 and 2020:
- Prevalence of obesity increased in all racial/ethnic groups except for children who were identified as non-Hispanic White and American Indian/Alaska Native.
- The largest increases were seen in 4-year-olds and in children who were identified as Hispanic.
- 21 states had increased prevalences of severe obesity. The state with the largest increase was California.
- The only state with decreased prevalence of severe obesity was Alaska.
In an invited commentary by Drs. Sarah Armstrong and Asheley Skinner, PhD, from Duke University, they label this increased prevalence as “a canary in the coal mine for the health of future generations” (10.1542/peds.2023-063799). They note that severe obesity at this young age is almost always irreversible and that there are very few evidence-based treatment options.
Thus, prevention of early life obesity is critical. Drs. Armstrong and Skinner cite the strong association of food insecurity and obesity. Although WIC provides supplemental foods, it may not be enough to eliminate food insecurity.
As a society, we will need to think about how we can make all children and families food secure. A first step will be for all of us to read this article and commentary to better understand the problem, so that we can better advocate for our families.
