Childhood obesity – how do we tackle this worsening health issue?

Most people now live in countries where being overweight or obese is a bigger problem than being underweight. More than one billion people worldwide are estimated to be living with obesity – and 159 million of them are children or adolescents.

The growth in childhood obesity rates is concerning. Back in 1975, fewer than 1 in every 100 children was obese – now the rate is almost 10 per 100 young people, according to figures from the World Obesity Federation. And when you look at the combined prevalence of both obesity and being overweight among children and adolescents, a fifth are affected, compared to just 4% in 1975.

Unhealthy weight in childhood is linked to multiple adverse physical and mental health outcomes, and is likely to have lifelong implications. And unless action is taken, it is likely that obesity and being overweight will become increasingly common. As such, it is recognized as one of the most important public health problems we currently face.

The spread of unhealthy weight is not even around the world and due to a complex interplay of factors affects some groups more than others.

In the US for example, around a fifth of children and adolescents overall are obese. However, when you break it down by age, 12.7% of two to five year-olds are obese compared to 22.2% of 12-19 year-olds.

Obesity in the US is also more prevalent among Hispanic children (26.2%) and non-Hispanic Black children (24.8%). By contrast, prevalence among non-Hispanic white children and non-Hispanic Asian children is 16.6% and 9% respectively.

Household income levels are also a strong predictor of obesity levels – obesity is more common among poorer households. For example, national data for England shows that the prevalence of 10- and 11-year-old children living with severe obesity was over four times as high for children living in the most deprived areas (9.4%) compared with those living in the least deprived areas (2.1%).

Data also shows that during the pandemic, weight problems among children multiplied, and has still not fallen back to previous levels. With most overweight children going on to become overweight adults, this risks having a significant economic and social impact for countries.

On the surface, problems with weight may seem simple – the body stores excess energy from food as fat. The reality is obesity is a complex chronic disease which can be caused by many interlinked factors.

Many people, particularly in affluent countries, live in ‘obesogenic’ environments which encourage low levels of activity, sedentary behaviour, and the consumption of lots of fatty, oily, starchy and sugary foods.

Genetic disorders or medications may cause or predispose some individuals to unhealthy weight. Psychological factors can influence weight. And social deprivation also has a significant role to play.

Childhood obesity can lead to a number of physical and mental health problems and may have long-term implications.

Among these are metabolic disorders like diabetes, cardiovascular problems like high blood pressure or cholesterol, and respiratory problems like asthma. Extra weight can also lead to joint and muscular skeletal problems which affect mobility and the ability to do physical activities.

And being obese also increases the chance of certain cancers like endometrial, breast and colon. Research by scientists in Sweden suggests that obesity in childhood also increases the chance of early-onset multiple sclerosis.

The World Health Organization estimates that at least 2.6 million people die each year as a result of being overweight or obese. Some research suggests that children with persistent severe obesity could have half the average life expectancy.

There is also a significant stigma associated with weight, and people with obesity may be subject to negative comments. Bias means people may link obesity with laziness, low intelligence, or poor hygiene.

Fear of this stigma can make people less likely to seek help for treatment or prevention. It is also correlated with disordered eating such as binge or restrictive eating or eating anxiety.

Stigma or fear of obesity may also lead to stress, depression and drive people to isolate themselves socially, reducing attendance at school and making it harder to find and keep work.

Given the complex causes of childhood obesity, tackling the issue needs to focus on more than just encouraging people to eat less and do more exercise. Families, schools, communities and policymakers need to work together to create a multifaceted response.

Promoting healthy lifestyle choices from an early age is key and one strand of this is helping improve education and access to information. This can include school and community programmes as well as public health campaigns.

The World Economic Forum’s New Frontiers of Nutrition initiative is aiming to highlight the role of nutrition in good mental and physical wellbeing. It recognizes that although many people want to live healthier lives, conflicting information and lack of access to nutritious food can prevent this.

Harmful food marketing is also a key area policymakers are attempting to tackle, including restricting marketing food and drinks to children, taxes on sugary drinks, a requirement to provide clear nutrition information on packs and limiting portion size.

Research suggests that digital health interventions like text messaging programmes and digital therapeutics have also been shown to have promising effects in supporting weight management and promoting healthy behaviours in children and adolescents.