Overweight Children and Youth

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The proportion of U.S. adolescents who are obese continued to increase in 2011-12, while the proportion among younger children remained the same or decreased. More than one in five adolescents, and one in six elementary-school-aged children, were obese, as was more than one in twelve preschoolers.

Importance

Children who are overweight or obese are at increased risk for physical and socio-emotional problems. Overweight children are more likely than their peers to develop cardiovascular disease, type-2 diabetes, hepatic steatosis (a fatty liver), sleep apnea, high cholesterol, and asthma.[1] Childhood obesity has also been linked to the premature onset of puberty.[2] Being overweight may be associated with being bullied, which in turn is related to poorer mental health and decreased physical activity.[3]

The health threats posed by being overweight as a child can be long-lasting. Children and adolescents who are overweight are at risk for becoming overweight adults. Overweight adults face many problems due to their weight, such as decreased productivity, social stigma, high health care costs, and premature death.[4] In addition, overweight adults are at increased risk for type-2 diabetes, coronary heart disease, elevated blood pressure, high cholesterol levels, stroke, respiratory problems, gallbladder disease, osteoarthritis, sleep apnea, and some types of cancer.[5]

Studies suggest that excessive belly fat is of particular concern. The abdominal and visceral fat (found surrounding the internal organs) has been more closely linked with diseases than has general body fat.[6] Waist circumference may therefore be a better predictor of being unhealthily overweight than body mass index, which is a ratio of height and weight.

Given the seriousness of the health consequences associated with being overweight, and the rate of increase in the past few decades, the Surgeon General declared overweight prevalence in children and adolescents “a major public health concern."[7] Reducing child and adolescent obesity requires efforts by families, schools, communities, government and industry.[8] Parents can play an important role in preventing and reducing child and adolescent obesity by promoting healthy eating through family meals, providing healthy foods in the home, limiting television watching and other sedentary behavior, and encouraging physical activity.[9] One study of the diets of over 3,000 infants and toddlers found that very young children consume too many high-calorie foods, too much sodium, and consume too few fruits and vegetables, emphasizing the importance of addressing healthy eating habits from the beginning of a child’s life.[10]

Trends

15_fig1Children ages six to 11 were nearly three times as likely to be obese in 2011-2012 as they were in 1976-1980 (18 and seven percent, respectively), although the rate was generally constant between 2003-2006 and 2011-2012. During the same period, the share of adolescents ages 12 to 19 who were obese more than quadrupled, from five to 21 percent. Fewer data points are available for children ages two to five, but indicate rates of obesity have fluctuated between eight and 12 percent over the past decade. (Figure 1)

The percentage of overweight children follows similar trends. Children ages six to 11 were more than twice as likely to be overweight in 2011-2012 as they were in 1971-1974 (34 and 16 percent, respectively). During the same period, the share of adolescents ages 12 to 19 who were overweight nearly doubled, from 17 to 35 percent. Fewer data points are available for children ages two to five, but indicate rates of overweight have fluctuated between 21 and 27 percent over the past decade. (Appendix 2)

Differences by Gender

15_fig2Overall, boys and girls are about equally likely to be obese or overweight, and there are no significant differences among subgroups. (Figure 2)

Differences by Race/Hispanic Origin[11]

Among adolescent females ages 12 to19 in 2011-2012, Asians were substantially less likely to be obese than white, black, and Hispanic females (seven percent versus 18, 21, and 24 percent, respectively).  Among adolescent males, whites were less likely to be overweight than their peers, at 18 percent, compared with 21 and 24 percent among blacks and Hispanics, respectively. (Figure 2) Among children ages 6 to 11, black and Hispanic children were significantly more likely to be obese than their white counterparts. (Appendix 1)

State and Local Estimates

2008-2011 estimates by state for low-income preschool-aged children are available from the Centers for Disease Control and Prevention.

2013 estimates are available for high school students (grades 9 to 12) by grade, sex, and race/ethnicity and for selected states and cities from the Youth Risk Behavior Survey (YRBS): table 106.

The Data Resource Center for Child & Adolescent Health provides 2011/2012 weight status for 10- to 17-year-olds by state.

International Estimates

According to the International Obesity Taskforce, more than 155 million school-aged children worldwide are overweight.

National Goals

Through its Healthy People 2020 initiative, the federal government has set national goals to reduce the number of obese children and adolescents. There are also goals under development for preventing inappropriate weight gain at all ages.

More information available here. (goals NWS-10 and 11)

What Works to Make Progress on This Indicator

See "What Works for the Prevention and Treatment of Obesity Among Children: Lessons From Experimental Evaluations of Programs and Interventions." A Child Trends Fact Sheet.

Related Indicators

Definition

In children, obesity is defined as having a body mass index (BMI) at or above the sex- and age-specific 95th percentile, while overweight is defined as having a BMI at or above the sex- and age-specific 85th percentile. Obesity statistics for 1971-1974, and overweight statistics for 1971-1991, are based on BMI distributions of nationally representative samples from 1963-1970. Data for other years are based on the revised CDC Growth Charts, which refer to nationally representative samples of children between 1963 and 1994. They are not intended to represent ideal development. For more information, see

Kuczmarski R. J., Ogden C. L., Guo S. S., et al. (2002). 2000 CDC growth charts for the United States: Methods and development. National Center for Health Statistics. Vital Health Stat 11(246).

BMI is expressed as weight (in pounds) divided by height squared (in inches), all multiplied by 703. For example, an adult who is six feet, two inches tall and weighs 200 pounds has a BMI of 25.7, which standard weight tables list as overweight.

Current BMI age-for-growth charts for the United States are available here.

Data Sources

Data for 2011-2012: Ogden, C. L., Carroll, M. D., Kit, B. K., & Flegal, K. M. (2014). Prevalence of childhood and adult obesity in the United States, 2011-2012. JAMA 311(8), 806-814. Available at: http://jama.jamanetwork.com/article.aspx?articleID=1832542

Data for 2009-2010: Ogden C.L., Carroll, M.D., Kit, B.K., Flegal, K.M., (2012). Prevalence of obesity and trends in body mass index among US children and adolescents, 1999-2010, JAMA 307 (5). pp 483-490. Available at: http://jama.jamanetwork.com/article.aspx?volume=307&issue=5&page=483

Data for 2007-2008: Ogden C.L., Carroll, M.D., Curtin, L.R., Lamb, M. M., Flegal, K. M. (2010). Prevalence of high body mass index in US children and adolescents, 2007-2008, JAMA 303(3). 242-249. Available at: http://jama.jamanetwork.com/article.aspx?articleid=185233.

Data for 2003-2006: Ogden, C. L., Carroll, M. D., and Flegal, K. M. (2008). High Body Mass Index for age among US children and adolescents, 2003-2006. JAMA, 299(20), 2401-2405.

Data for 1999-2002: Hedley, A. A., Ogden, C. L., Johnson, C. L., Carroll, M. D., Curtin, L. R., and Flegal, K. M. (2004) Prevalence of overweight and obesity among US children, adolescents, and adults, 1999-2002, JAMA, 291(23), 2847-2850.

Obesity Data for 1976-1994: National Center for Health Statistics. (2003). Health United States, 2003 with chartbook on trends in the health of Americans. National Center for Health Statistics. Table 69.

Overweight data for 1971-1991 and obesity data for 1971-1974: Troiano, R. P., Flegal, K. M., Kuczmarski, R. J., Campbell, S. M., Johnson, C. L. (1995) Overweight prevalence and trends for children and adolescents: The National Health and Nutrition Examination Surveys, 1963-1991. Archives of Pediatrics and Adolescent Medicine, 149(10), 1085-1091. Available at: http://archpedi.jamanetwork.com/article.aspx?articleid=517675

Raw Data Source

National Health and Nutrition Examination Survey (NHANES)

http://www.cdc.gov/nchs/nhanes.htm

 

Appendix 1 - Percentage of Children Who Are Obese, by Selected Age Groups: Selected Years, 1971-2012

1971-19741 1976-19802 1988-1994 1999-2002 2003-2006 2007-2008 2009-2010 2011-2012
Ages 2-53 - - - 10.3 12.4 10.4 12.1 9.5
Male - - - 9.9 12.8 10.0 14.4 9.5
Race/Hispanic origin4
White, non-Hispanic - - - 8.6 11.1 6.6 11.9 6.3
Black, non-Hispanic - - - 8.8 13.3 11.1 20.5 9.0
Asian, non-Hispanic - - - - - - - 1.9
Hispanic - - - - - - 17.8 18.0
Mexican-American - - - 13.1 18.8 19.3 19.1 -
Female5 - - - 10.7 12.1 10.7 9.6 7.2
Race/Hispanic origin4
White, non-Hispanic - - - 9.1 10.2 12.0 6.0 0.6
Black, non-Hispanic - - - 9.6 16.6 11.7 17.0 13.9
Asian, non-Hispanic - - - - - - - 4.7
Hispanic - - - - - - 14.6 15.2
Mexican American - - - 12.2 14.5 7.5 11.9 -
Ages 6-113 5.5 6.5 11.3 15.8 17.0 19.6 18.0 17.7
Male 6.5 6.6 11.6 16.9 11.7 21.2 20.1 16.4
Race/Hispanic origin4
White, non-Hispanic 6.7 6.1 10.7 14.0 15.5 20.5 16.8 8.8
Black, non-Hispanic 5.6 6.8 12.3 17.0 18.6 17.7 29.5 25.9
Asian, non-Hispanic - - - - - - - 13.2
Hispanic - - - - - - 23.9 28.6
Mexican-American - 13.3 17.5 26.5 27.5 27.1 21.8 -
Female5 4.3 6.4 11.0 14.7 15.8 18.0 15.7 19.1
Race/Hispanic origin4
White, non-Hispanic 4.5 5.2 *9.8 13.1 14.4 17.4 10.7 17.9
Black, non-Hispanic 3.5 11.2 17.0 22.8 24.0 21.1 27.8 21.7
Asian, non-Hispanic - - - - - - - 3.7
Hispanic - - - - - - 21.0 23.4
Mexican American - 9.8 15.3 17.1 19.7 22.3 22.4 -
Ages 12-193 5.9 5.0 10.5 16.1 17.6 18.1 18.4 20.5
Male 5.3 4.8 11.3 16.7 18.2 19.3 19.6 20.3
Race/Hispanic origin4
White, non-Hispanic 5.5 3.8 11.6 14.6 17.3 16.7 17.5 18.3
Black, non-Hispanic 4.3 6.1 10.7 18.7 18.5 19.8 22.6 21.4
Asian, non-Hispanic - - - - - - - 14.8
Hispanic - - - - - - 26.5 23.9
Mexican-American - 7.7 14.1 24.7 22.1 26.8 28.9 -
Female5 7.2 5.3 9.7 15.4 16.8 16.8 17.1 20.7
Race/Hispanic origin4
White, non-Hispanic 6.6 4.6 8.9 12.7 14.5 14.5 14.7 20.9
Black, non-Hispanic 11.2 10.7 16.3 23.6 27.7 29.2 24.8 22.7
Asian, non-Hispanic - - - - - - - 7.3
Hispanic - - - - - - 19.8 21.3
Mexican-American - 8.8 *13.4 19.9 19.9 17.4 18.6 -
"-" Indicates data not available.

Note: Obese is defined as Body Mass Index (BMI) at or above the sex- and age-specific 95th percentile, based on the revised CDC Growth Charts, which use nationally representative samples of children between 1963 and 1994. For more information, see Kuczmarski R. J., Ogden C. L., Guo S. S., et al. (2002). 2000 CDC growth charts for the United States: Methods and development. National Center for Health Statistics. Vital Health Stat 11(246). Available at http://www.cdc.gov/nchs/data/series/sr_11/sr11_246.pdf.

1In 1971-1974, data are for 6-17 year-olds only.

2Data for Mexicans are for 1982–84.

3Totals include data for racial/ethnic groups not shown separately.

4 Mexican-Americans may be of any race.

5Excludes pregnant women.

Sources: Data for 1971-1974: Troiano, R. P., Flegal, K. M., Kuczmarski, R. J., Campbell, S. M., Johnson, C. L. (1995) Overweight prevalence and trends for children and adolescents: The national health and nutrition examination surveys, 1963-1991. Archives of Pediatrics and Adolescent Medicine, 149(10), 1085-1091. Available at: http://archpedi.jamanetwork.com/article.aspx?articleid=517675. Data for 1976-1994: National Center for Health Statistics. (2003). Health United States, 2003 with Chartbook on Trends in the Health of Americans. National Center for Health Statistics.. Table 69. Available at: http://www.cdc.gov/nchs/data/hus/tables/2003/03hus069.pdf.   Data for 1999-2002 from Hedley, A., Ogden, C., Johnson, C., Carroll, M., Curtin, L. and Flegal, K. Prevalence of overweight and obesity among us children, adolescents, and adults, 1999-2002, JAMA, 291(23): 2847-2850. Data for 2003-2006: Ogden, C., Carroll, M., and Flegal, K. High Body Mass Index for age among us children and adolescents, 2003-2006. JAMA, 299(20):, 2401-2405. Data for 2007-2008: Ogden C. L., Carroll, M. D., Curtin, L. R., Lamb, M. M., and Flegal, K. M. (2010). Prevalence of High Body Mass Index in US children and adolescents, 2007-2008, JAMA, 303(3), 242-249. Available at: http://jama.jamanetwork.com/article.aspx?articleid=185233. Data for 2009-2010: Ogden C. L., Carroll, M. ., Kit, B. K., and Flegal, K.M (2012). Prevalence of obesity and trends in Body Mass Index among US children and adolescents, 1999-2010, JAMA, 307(5), 483-490. Available at: http://jama.jamanetwork.com/article.aspx?volume=307&issue=5&page=483. Data for 2011-2012: Ogden, C. L., Carroll, M. D., Kit, B. K., & Flegal, K. M. (2014). Prevalence of childhood and adult obesity in the United States, 2011-2012. JAMA 311(8), 806-814. Available at: http://jama.jamanetwork.com/article.aspx?articleID=1832542

 

Appendix 2 - Percentage of Children Who Are Overweight, by Selected Age Groups: Selected Years, 1971-2012

1971-19741 1976-1980 1988-1991 1999-2002 2003-2006 2007-2008 2009-2010 2011-2012
Ages 2-53 - - - 22.6 24.4 21.2 26.7 22.8
Male - - - 23.0 25.5 21.0 29.7 21.8
Race/Hispanic origin4
White, non-Hispanic - - - 21.7 25.4 15.6 26.0 21.8
Black, non-Hispanic - - - 20.9 23.2 28.1 30.5 22.2
Asian, non-Hispanic - - - - - - - 8.3
Hispanic - - - - - - 34.1 31.4
Mexican-American - - - 27.6 32.4 32.4 34.0 -
Female5 - - - 22.3 23.3 21.4 23.4 21.7
Race/Hispanic origin4
White, non-Hispanic - - - 20.0 20.9 19.5 21.3 19.9
Black, non-Hispanic - - - 25.6 26.4 23.9 27.0 21.6
Asian, non-Hispanic - - - - - - - 9.7
Hispanic - - - - - - 32.1 28.1
Mexican American - - - 25.0 27.3 22.5 32.7 -
Ages 6-113 16.0 17.9 22.5 31.2 33.3 35.5 32.6 34.2
Male 18.2 19.9 22.3 32.5 33.9 35.9 33.1 33.2
Race/Hispanic origin4
White, non-Hispanic 19.5 20.8 22.3 29.3 31.7 17.7 29.7 26.5
Black, non-Hispanic 12.3 15.1 27.2 29.7 33.8 36.4 40.9 39.3
Asian, non-Hispanic - - - - - - - 24.5
Hispanic - - - - - - 39.7 48.7
Mexican-American - - 33.3 43.9 47.1 44.0 38.5 -
Female5 13.9 15.8 22.7 29.9 32.6 35.2 32.1 35.2
Race/Hispanic origin4
White, non-Hispanic 13.4 15.4 22.0 27.7 31.5 34.3 25.2 32.7
Black, non-Hispanic 16.8 18.4 30.7 37.9 40.1 38.9 44.2 36.9
Asian, non-Hispanic - - - - - - - 14.9
Hispanic - - - - - - 39.6 43.6
Mexican American - - 22.7 33.8 38.1 39.3 39.5 -
Ages 12-193 17.3 15.9 21.4 30.9 34.1 34.2 33.6 34.5
Male 14.9 16.3 21.7 31.2 34.9 35.0 34.6 35.1
Race/Hispanic origin4
White, non-Hispanic 15.3 16.6 22.6 29.2 34.5 32.6 32.2 31.5
Black, non-Hispanic 12.3 14.5 23.3 32.1 32.1 33.0 34.7 37.3
Asian, non-Hispanic - - - - - - - 33.6
Hispanic - - - - - - 42.9 39.6
Mexican-American - - 26.7 41.9 40.5 46.1 46.0 -
Female5 19.7 15.5 21.2 30.5 33.3 33.3 32.6 33.8
Race/Hispanic origin4
White, non-Hispanic 19.7 15.2 20.3 26.5 31.7 29.9 27.6 31.0
Black, non-Hispanic 20.8 18.2 29.9 41.9 44.5 46.3 45.1 42.5
Asian, non-Hispanic - - - - - - - 15.0
Hispanic - - - - - - 41.9 36.5
Mexican-American - - 23.4 39.3 37.1 42.1 40.5  -
"-" Indicates data not available.

Note: Overweight is defined as having a Body Mass Index (BMI) at or above the sex- and age-specific 85th percentile. For data 1971-1991, BMI distributions based on nationally representative samples taken between 1963-1970. For later data, this is based on the revised CDC Growth Charts, which are based on nationally representative samples of children between 1963 and 1994. For more information, see Kuczmarski R. J., Ogden C. L., Guo S. S., et al. (2002). 2000 CDC growth charts for the United States: Methods and development. National Center for Health Statistics. Vital Health Stat 11(246). Available at http://www.cdc.gov/nchs/data/series/sr_11/sr11_246.pdf.   

1In 1971-1991, data are for 6- to 17-year-olds only.

3Totals include data for racial/ethnic groups not shown separately.

4 Mexican-Americans may be of any race. When no data is available for Mexican-Americans, Hispanics are included in other racial categories.

5Excludes pregnant women.

Sources: Data for 1971-1991: Troiano, R. P., Flegal, K. M., Kuczmarski, R. J., Campbell, S. M., Johnson, C. L. (1995) Overweight prevalence and trends for children and adolescents: The National Health and Nutrition Examination Surveys, 1963-1991. Archives of Pediatrics and Adolescent Medicine, 149(10), 1085-1091. Available at: http://archpedi.jamanetwork.com/article.aspx?articleid=517675 Data for 1999-2002 from Hedley, A., Ogden, C., Johnson, C., Carroll, M., Curtin, L., and Flegal, K. Prevalence of overweight and obesity among us children, adolescents, and adults, 1999-2002, JAMA, 291 (23): 2847-2850. Data for 2003-2006: Ogden, C, Carroll, M., and Flegal, K. High Body Mass Index for age among us children and adolescents, 2003-2006. JAMA, 299 (20): 2401-2405. Data for 2007-2008: Ogden C. L., Carroll, M. D., Curtin, L. R., Lamb, M. M., Flegal, K. M. (2010). Prevalence of high Body Mass Index in US children and adolescents, 2007-2008, JAMA 303(3), 242-249. Available at: http://jama.jamanetwork.com/article.aspx?articleid=185233. Data for 2009-2010: Ogden C. L., Carroll, M. D., Kit, B. K., Flegal, K. M. (2012). Prevalence of obesity and trends in Body Mass Index among US children and adolescents, 1999-2010, JAMA 307(5), 483-490. Available at: http://jama.jamanetwork.com/article.aspx?volume=307&issue=5&page=483. Data for 2011-2012: Data for 2011-2012: Ogden, C. L., Carroll, M. D., Kit, B. K., & Flegal, K. M. (2014). Prevalence of childhood and adult obesity in the United States, 2011-2012. JAMA 311(8), 806-814. Available at: http://jama.jamanetwork.com/article.aspx?articleID=1832542

 

Endnotes


[1]Center for Disease Control and Prevention. (2007). Overweight and obesity: Childhood overweight, Department of Health and Human Services. Available at:http://www.cdc.gov/nccdphp/dnpa/obesity/index.htm.

[2]Gidding, S., Leibel, R., Daniels, S., Rosenbaum, M., van Horn, L., Marx, G. (1996).Understanding obesity in youth. American Heart Association Medical/Scientific Statement. Available at:http://circ.ahajournals.org/cgi/content/full/94/12/3383

[3]Birdwell, A. F. (April 19, 2006). Bullying keeps overweight kids off the field. University of Florida News. Available at:http://news.ufl.edu/2006/04/19/bullies/

[4]U.S. Department of Health and Human Services. (2001). The Surgeon General's call to action to prevent and decrease overweight and obesity. Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, Office of the Surgeon General; Available from: U.S. GPO, Washington.http://www.surgeongeneral.gov/topics/obesity/calltoaction/CalltoAction.pdf

[5]Center for Disease Control and Prevention. (2007). Op. cit.

[6]Li, C., Ford, E. S., Mokdad, A. H., and Cook, S. (2006). Recent trends in waist circumference and waist-height ratio among U.S. children and adolescents. Pediatrics, 118, e1390-e1398.

[7]U.S. Department of Health and Human Services, (2001). Op. cit.

[8]Institute of Medicine. (2006). Progress in preventing childhood obesity: How do we measure up? Washington, DC: Institute of Medicine of the National Academies. Summary available atwww.iom.edu/?id=37008

[9]Hellmich, N. (April 27, 2008). Childhood obesity rates high but 'leveling off,' USA Today.Available athttp://www.usatoday.com/news/health/weightloss/2008-05-27-obesity-children_N.htm

[10]Mathematica Policy Reserch. (March 16, 2006). Problems start early in the diets of infants and toddlers: New analyses from Mathematica's groundbreaking feeding infants and toddlers study may help in fight against childhood obesity. Press Release. Princeton, NJ.http://www.mathematica-mpr.com/Press%20Releases/fits06JADA.asp.

[11]Hispanics may be any race. Estimates for whites, blacks, and Asians in this report do not include Hispanics.

 

Suggested Citation:

Child Trends Databank. (2014). Overweight children and youth. Available at: http://www.childtrends.org/?indicators=overweight-children-and-youth

 

Last updated: August 2014