Childhood obesity: A glimmer of hope, but a long way to go

New estimates on the numbers of overweight and obese children indicate that the epidemic may have stabilized, but significant work still is needed.

Posted June 23, 2008.

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Last month, a new round of Centers for Disease Control and Prevention figures on childhood obesity were published in the Journal of the American Medical Association, offering what was viewed as good news. The data showed that, after years of increasing at almost exponential rates, childhood overweight and obesity prevalence may have plateaued.

In the official science-speak of the CDC researchers, the incidence of high BMI for age among children and adolescents showed no significant changes between 1999-2000 and 2005-06 and no significant trends between 1999-2006.

This information was heralded as a positive sign -- the first indication of stabilization since the rates began to soar in the early 1980s. But most agree it is only a glimmer of hope. After all, the number of American youngsters considered overweight or obese remains critically high -- an estimated 32% nationally -- and for nearly 2½ decades, the heaviest kids have gotten heavier.

The CDC data quantify what to many people is obvious. Look around a grade school or shopping mall -- about a third of the kids will be hefty. This reality has emerged as one of public health's greatest concerns. Even the most positive spin on the latest estimates don't alter the fact that, at the current level, tens of millions of youngsters are on a fast track to serious health problems.

According to the CDC, overweight children and adolescents are more likely during their youth to have risk factors associated with cardiovascular disease than are their slimmer peers. For instance, while type 2 diabetes is a common result of adult obesity, only recently has it begun to emerge in young patients.

In addition, studies show that overweight kids often turn into obese adults -- triggering an even greater wave of populationwide health complications.

Thus, the recent findings in JAMA mark what can be considered only a first, small step in the right direction. Substantial declines in childhood obesity are necessary if the condition's public health toll is to be reduced. Achieving such a goal will continue to require broad plans of attack that involve schools, families, communities, various levels of government and physicians.

In this regard, American Medical Association policy supports devising a school health advocacy agenda that includes funding for meaningful school health programs, physical education and physical activity. The AMA has urged the development and implementation of evidence-based nutrition standards for all food served in K-12 schools. It has collaborated with medical and public health groups, government agencies and other entities to educate the public about this epidemic, as well as the benefits of exercise, physical fitness and healthful diets for children.

The AMA also has worked to inform physicians in the trenches and arm them with the tools and understanding necessary to make a difference. Last year, for instance, the AMA, along with the CDC, the Health Resources and Services Administration and other medical and health professional societies, convened an expert committee that offered specific recommendations on assessing, preventing and treating childhood obesity.

For now, though, it is clear that much still needs to be done if the trend is to be reversed, not just stabilized. Some observers maintain that, because childhood obesity rates did not increase, the end of the epidemic may be in sight and public health interventions may have begun to pay off. But others note that it really is too soon to tell.

Although interpretation of these issues varies, no doubt surrounds one bottom-line number: Almost a third of U.S. children and adolescents remain either overweight, obese or morbidly obese. Their futures are at risk and, despite a glimmer of good news, the bigger picture of an overweight generation is a call for continued action.

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