AAP Voices Blog

I'll never forget the afternoon I asked one of my patients, a 17-year-old high school student, what he was going to do after graduation. He had good grades and a great personality. He'd also been struggling with obesity since he was a toddler and now was being treated for hypertension. In answer to my question, he burst into tears.

"I always wanted to be a state trooper," he said, "but I'm afraid I won't pass the physical."

At that moment, I realized that we were not only fighting for his good health. We were struggling for his future.

In a new Pediatrics study, "Prevalence of Obesity and Severe Obesity in US Children 1999-2016​," the authors deliver a grim message that despite nearly 3 decades of awareness and prevention efforts, the childhood obesity epidemic continues to grow on a national scale.

A hoped-for stabilization in obesity rates among 2-5 year-old children suggested by earlier research has vanished. The new, more nuanced study found rates of overweight and obesity have increased in all age groups among children ages 2-19, in fact, and the increase in severe obesity and obesity in Black and Hispanic children is accelerating at an alarming rate.

In total, 1 out of every 5 children in the United States have obesity. The rates increase with age, and more than 40 percent of teens struggle with obesity by the time they reach 16-19 years of age. Slowly but relentlessly, the obesity epidemic has become a major threat to every child's ability to achieve their full potential as a healthy, productive adult.

Children, adolescents and young adults now have obesity related conditions that were once rarely seen before adulthood--type 2 diabetes, liver disease, hypertension, sleep apnea, and more--that are compromising their current and future health.

Obesity is not just a problem affecting individual patients, families or communities. Our collective future is in jeopardy. Beyond the human toll, the obesity epidemic threatens to bankrupt the nation and weaken our workforce. Without a healthy police force, emergency responders, teachers, and parents, for example, how can we support our community infrastructure? ​

"1 in 5 U.S. children have obesity. In #AAPVoices post, @SandyHassinkMD calls for comprehensive changes to children’s environments to ensure our nation’s future success."

​Each of us has a stake in stopping this insidious epidemic. It's going to take a society-wide shift to counteract environmental forces fueling excessive weight gain in children. But the obesity epidemic didn't happen overnight, and neither will these comprehensive changes. In the meantime, as pediatricians and citizens, we need to help families do what they can to keep kids healthy and fit. This includes:

1. Support and encourage breast feeding, responsive feeding, and other early feeding practices linked to healthy weight later in childhood. Build parenting skills and increase access to healthy foods for infants with referrals to local, state and federal resources. Help keep critical initiatives like the Women, Infant and Children (WIC) and the Supplemental Nutrition Assistance Programs alive and healthy, and encourage enrollment.
2. Make healthy schools the norm, with daily physical education, healthy meals, no junk food, and health education that includes health literacy and healthy skills like cooking and meal planning. This costs money, but so does specialty medical care, emergency department visits and missed school or work.
3. Help ensure communities have plenty of safe spaces for physical activities and access to healthy food. Incorporate population health measures into local government planning and accountability.
4. Engage the business community to promote healthy behaviors in their employees and make health a priority for product development.
5. Fix our food supply so that healthy food is incentivized and plentiful.
6. Improve payment for obesity treatment and preventive care.
7. Hold each other and policy makers accountable for doing what it takes to have a healthy population.

​"It will take all of us us – physicians, legislators, business leaders, parents, teachers, and people in every community – working together to fix the unhealthy environments that led to this epidemic among our children. Let’s redouble our efforts to ensure no child is denied a future because we let obesity grow.”

With obesity-related illness such as cardiovascular disease and diabetes accounting for several of the top causes of death in the United States, some public health experts now suggest obesity is far and away the top killer. It's a killer that threatens to steal lives, and dreams.

It will take all of us--physicians, legislators, business leaders, parents, teachers, and people in every community—working together to fix the unhealthy environments that led to this epidemic among our children. Let's redouble our efforts to ensure no child is denied a future.

*The views expressed in this article are those of the author, and not necessarily those of the American Academy of Pediatrics.