I have been reading a lot of studies lately centering on childhood obesity. The more I read, the more it becomes abundantly clear that we HAVE TO do something to address childhood obesity, and quick. Many people dismiss this issue, waiting for some medical or technological fix; in the meantime, obesity is killing our children.

The Shape of Things to Come

When I was growing up, I was one of only a handful of overweight or obese kids in my class. Since that time, the rate of childhood obesity has more than tripled. Currently, more than 9 million children and adolescents are overweight or obese – that’s 17% of kids; in many demographics, it’s much higher.^1-4 If you pay attention, this fact is blatantly obvious; there are many, many more overweight and obese kids today than there was 30 years ago. The problem is it hasn’t ‘hit home’ or cost us a lot up to this point, so most people aren’t taking notice; that, however, is about to change.

David Ludwig, MD, PhD, wrote an interesting article in The New England Journal of Medicine that looked at the childhood obesity issue as an epidemic consisting of four overlapping phases.⁵ We are just entering Phase 2, which is characterized by the emergence of serious weight-related problems. This is supported by recent statistics, including⁶:

• Type 2 diabetes in adolescence has increased by 1000% over the past 20 years.
• Fatty liver disease (unrecognized in pediatric literature before 1980) today occurs in about 33% of obese children.
• Symptoms of cardiovascular disease, including high blood pressure and high cholesterol, now occur in 70% of obese children.⁷

Other studies have shown that obese children are more likely to have: breathing problems, such as sleep apnea and asthma^8,9; joint problems and musculoskeletal discomfort^8,10; gallstones and acid reflux^8,11; as well as mental health disorders, such as depression. The data is out there, but these problems haven’t yet reached a high enough ‘point of pain’ to elicit the dramatic response needed to reverse them. This is unfortunate, as the data also shows that things are about to get a lot worse.

The Not-so-Distant Future

It may take a few years to get through this phase and onto the next one, but by then, it will be too late for our kids. The next phase of the obesity epidemic will involve life-threatening disease. If current projections are correct, by the year 2035, it is estimated that more than 100,000 of our children will have coronary heart disease attributable solely to being obese their entire lives. This will result in many of our children dying in early adulthood. In fact, it is projected that pediatric obesity will shorten life expectancy in the United States by 2 to 5 years overall; to put that in perspective, that is equal to that of all cancers combined.¹²

Large and In-Charge

The Challenge

The good news is, it doesn’t have to be this way. However, in order to change, we – that is to say each one of us – have to do our part to change the downward health spiral of childhood obesity. We know what’s coming if we stand by and do nothing; our children and our kid’s children are going to die early and have a diminished quality of life. If we can elicit some change, we can help them to live long, healthy and productive lives. To that end, this will be the first part of a four part series designed to shed some light on the consequences of childhood obesity and what we can do to change them, because change them we can!

Look for next month’s post on Childhood Obesity – Part Two of Four!

1. Prevalence of overweight among children and adolescents: United States, 2003-2004. Hyattsville, MD: National Center for Health Statistics. (Accessed November 15, 2007, at http://www.cdc.gov/nchs/products/pubs/pubd/hestats/overweight/overwght_child_03.htm.)
2. Hedley AA, Ogden CL, Johnson CL, Carroll MD, Curtin LR, Flegal KM. Prevalence of overweight and obesity among US children, adolescents, and adults, 1999-2002. JAMA 2004;291:2847-50.
3. Ogden CL, Carroll MD, Curtin LR, McDowall MA, Tabak CJ, Flegal KM. Prevalence of overweight and obesity in the United States, 1999-2004. JAMA 2006;295:1549-55.
4. Ogden CL, Flegal KM, Carroll MD, Johnson CL. Prevalence and trends in overweight among US children and adolescents, 1999-2000. JAMA 2002;288:1728-32.
5. Ludwig DS. Childhood Obesity – The Shape of Things to Come. N Engl J Med 357;23; Dec. 6, 2007:2325-2327.
6. Ebbeling CB, Pawlak DB, Ludwig DS. Childhood obesity: public health crisis, common sense cure. Lancet 2002;360:473-82.
7. Freedman DS, Mei Z, Srinivasan SR, Berenson GS, Dietz WH. Cardiovascular risk factors and excess adiposity among overweight children and adolescents: the Bagalusa Heart Study. J Pediatr. 2007;150(1):12-17.
8. Han JC, Lawlor DA, Kimm SY. Childhood obesity. Lancet. May 15 2010;375(9727):1737—1748.
9. Sutherland ER. Obesity and asthma. Immunol Allergy Clin North Am. 2008;28(3):589—602, ix.
10. Taylor ED, Theim KR, Mirch MC, et al. Orthopedic complications of overweight in children and adolescents. Pediatrics. Jun 2006;117(6):2167—2174.
11. Whitlock EP, Williams SB, Gold R, Smith PR, Shipman SA. Screening and interventions for childhood overweight: a summary of evidence for the US Preventive Services Task Force. Pediatrics. 2005;116(1):e125—144.
12. Olshansky SJ, Passaro DJ, Hershow RC, et al. A potential decline in life expectancy in the United States in the 21^st century. N Engl J Med 2005;352:1138-45.