Childhood obesity has been increasing rapidly over the past few decades, rising fourfold between 1990 and 2022, according to a study published in JAMA Network Open.
The study analyzed data from nearly 26,000 children who took part in the National Health and Nutrition Examination Survey (NHANES) from 2008 to 2023. It found a shocking 253 percent increase in extremely severe obesity over that period. While all categories of obesity increased, the rise was most noticeable among teens aged 16 to 18 and among non-Hispanic Black children.
Obesity in children is measured using Body Mass Index (BMI), which compares a child's weight to others of the same age and sex. A child is considered obese if their BMI is higher than 95 percent of their peers. Currently, childhood obesity is divided into three categories - Class 1 includes children at or above the 95th percentile, Class 2 ranges from 120 percent to 140 percent of the 95th percentile, and Class 3, or severe obesity, is 140 percent or higher.
The latest study from researchers at the University of California San Diego proposes adding two more levels of severity - Class 4 (160 percent to 180 percent of the 95th percentile) and Class 5 (above 180 percent). These new categories would help identify children with extremely severe obesity, who may face even greater health risks than those in current categories.
The researchers noted that health issues linked to obesity also increased with each class. Children in higher obesity classes were more likely to have conditions such as type 2 diabetes, prediabetes, metabolic syndrome (which raises the risk of heart disease and stroke), and liver disease.
"[They're] developing adult-type complications—fatty liver scarring, type 2 diabetes, metabolic syndrome—years before graduation. These conditions track into adulthood and shorten life expectancy," lead author Phillipp Hartmann, an assistant adjunct professor of pediatrics at UCSD, told Gizmodo. "Treating them strains families, clinics, and the health care system."
The study also found that insulin resistance, a condition that often leads to these diseases, was present in 100 percent of children in Classes 4 and 5, 81 percent in Classes 1 to 3, and only 27 percent of children with a healthy BMI. Overall, the findings show that the more severe a child's obesity, the higher their risk of serious and long-term health problems.
"The findings of this study with over 25,800 participants provide robust evidence supporting extremely severe obesity specifically as a public health emergency. The association with metabolic and cardiovascular complications necessitates urgent public health action, such as early prevention, targeted education, and the mobilization of resources," the authors wrote.
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