Obesity in children and adults has been declared an epidemic in the United States and other countries as well. It is not going away in the near future, despite studies in our journal and others of small-scale interventions with promising short-term and occasionally long-term results in stabilization or even reduction in the rate of weight gain in children and teenagers (https://www.ncbi.nlm.nih.gov/pubmed/27272581). Skinner et al. (10.1542/peds.2017-3459) examined the prevalence in this country of obesity in children from those who are overweight (BMI >85%-95%ile) to those experiencing severe obesity (BMI >= 140% above the 95%ile) from 1999 to 2016. The authors analyzed weights and heights recorded for physical exams and then submitted as data for sequential versions of the National Health and Nutrition Examination Survey (NHANES). Sadly, from children to adolescents, the trend news is not good. There is no evidence of a decline in the prevalence of obesity at any age and even upward trends for some subgroups of children divided by age, race, and ethnicity, with the details to be learned by reading this important article.
Why the worsening obesity trends despite the public attention this health problem has gotten in the media and in attempts to understand the etiology and best management of this problem? We asked Dr. David Ludwig, endocrinologist at Boston Children’s Hospital who specializes in understanding the multifactorial mechanisms underlying obesity in children, to share his thoughts in an accompanying commentary (10.1542/peds.2017-4078). He paints a concerning picture that despite our efforts to date to understand the pathophysiology underlying this disorder and the many interventions we attempt to manage it, we are not succeeding. Dr. Ludwig notes the role of media in promoting unhealthy foods, and the need for more federal influence to better emphasize food quality and not just food quantity. Dr. Ludwig also calls for better promotion of more nutritious foods in school breakfasts and lunches that focus on reduction of unhealthy fats and added sugars, while emphasizing the important role poverty in this country and other countries plays in the obesity epidemic.
There is plenty of food for thought to digest in both the study and commentary so give them both your attention, and then reflect on what you can do in your practice, your community, and even at a national level to advocate for more to be done to overcome the problem of obesity in children and in turn in adults.