Expert’s Insights on Childhood Obesity

According to the CDC, in the U.S., the percentage of children and adolescents affected by obesity has more than tripled since the 1970s. Data from 2015–2016 show that nearly 1 in 5 school-age children and young people aged 6 to 19 years in the U.S. has obesity.

To gain a better understanding of childhood obesity, The Kids Cook Monday team asked Dr. Sara Benjamin-Neelon, PhD, JD, RD, for her perspective and insights. Dr. Benjamin-Neelon is an adviser to The Monday Campaigns’ Meatless Monday and Kids Cook Monday initiatives. She is an associate professor in the Department of Health, Behavior and Society and director of the Lerner Center for Public Health Promotion at Johns Hopkins Bloomberg School of Public Health. Her research focuses on policy and environmental approaches to childhood obesity prevention. She is the lead author for the new study, which was published this month in Obesity, about how physical activity in infancy may help prevent obesity.

  • What is childhood obesity?  How is it defined? What does the latest research say about this issue?

Childhood obesity is defined as having a body mass index (BMI) above the 95% percentile when plotting height and weight on child growth charts.  Essentially, this metric considers how much children weigh for their given height, compared to a “normal” reference population. Body mass index is not a perfect measure though because children can be very muscular and have a high BMI percentile.

Obesity in childhood is associated with a number of unfavorable health outcomes in later childhood and even adulthood.  Children with obesity are at greater risk for developing chronic diseases like cardiovascular disease, high blood pressure, and type 2 diabetes.  Children with obesity also experience more stress and discrimination that can have long-term health implications.

Obesity rates in some groups of children – like younger children – may be leveling off in the US.  However, these signs of improvement are relatively absent for racial and ethnic minority groups, where children are disproportionately affected by obesity.

  • How can schools address childhood obesity? What about families?

The Centers for Disease Control and Prevention (CDC) put forth recommendations for schools to address childhood obesity.  Specifically, the CDC recommends a comprehensive approach that includes collaborations between schools, parents and other caregivers, community members, and health professionals.  Importantly, children with obesity should not be singled out. Instead, schools can promote health for all children.  

The goal in schools, homes, and communities is to make healthy choices the default option so health becomes the norm in all setting where children spend time – but especially in schools.  This includes addressing healthy eating – allowing sufficient time for children to eat lunch, providing healthy options for lunch, and limiting the availability of high-fat, high-sugar foods and beverages in schools.  It also involves promoting active play and decreasing sedentary time in schools so children have some opportunity to move and sleep well at night. There is evidence that physical activity during the school day and even in the classroom may actually promote learning!

After-school time is also an important opportunity to promote healthy eating and active play.  Many children spend time in these setting and programs like The Kids Cook Monday provide opportunities for children to learn cooking skills and also engage all of their senses with healthy foods.  This type of experiential learning can have lasting effects on children’s health.

  • What tips can you provide to teachers or other school professionals to help them manage this issue? What about parents? How does one talk to an obese child to encourage them to be mindful of their condition and seek ways to get to a healthier weight?

Parents and teachers can do three things to help all children achieve a healthy weight.  First, the best approach that parents and teachers can take is to model healthy behaviors.  Children do what they see and healthy, active adults are great role models for children.  

Second, children need healthy environments so school programs and policies should support the health of all children.  Children are still growing, so the best approach is to encourage healthy eating, healthy sleep (sleep is also closely tied to obesity so make sure children get adequate rest), and lots of active play.  

Third, children with obesity should not be singled out.  Calling it a “condition” or telling children to manage their weight may actually perpetuate the stigma and could ultimately be more harmful for children in the long run.  Children with obesity often experience weight-related bias, social isolation, bullying, and shame – and being a kid is hard enough!

Contributors:

Dr. Sara Benjamin-Neelon, PhD, JD, RD,  Associate Professor in the Department of Health, Behavior and Society and director of the Lerner Center for Public Health Promotion at Johns Hopkins Bloomberg School of Public Health.

Nara Sandberg, The Monday Campaigns

Cherry Dumaual, The Monday Campaigns