17.4.1: Obesity and Overweight

Learning Objectives

1. Define overweight and obesity in children using the Body Mass Index (BMI) percentiles.
2. Identify current trends and contributing factors to the rise in childhood obesity.
3. Discuss the physical, cognitive, and emotional consequences associated with excess weight in children.
4. Evaluate the importance of caregiver awareness and support in promoting healthy habits and eating behaviors.

Being Overweight and Obesity in Children

Childhood overweight and obesity remain significant public health concerns. The current measurement for determining excess weight is the Body Mass Index (BMI) which expresses the relationship of height to weight. The Centers for Disease Control and Prevention (CDC) define overweight in children as a Body Mass Index (BMI) at or above the 85th percentile and below the 95th percentile for children of the same age and sex; obesity is defined as a BMI at or above the 95th percentile (CDC, 2022).

Recent data indicate that approximately 19.7% of U.S. children and adolescents aged 2–19 years are obese (CDC, 2022). This is defined as being at least 20 percent over their ideal weight. The percentage of obesity in school-aged children has increased substantially since the 1960s and has doubled since the 1980s. This is true in part because of the introduction of a steady diet of television and other sedentary activities. In addition, we have come to emphasize high-fat, fast foods as a culture. Pizza, hamburgers, chicken nuggets, and “lunchables” with soda have replaced more nutritious foods as staples. The decreased participation in school physical education and youth sports is just one of many factors that have led to an increase in children being overweight or obese.

Figure \(\PageIndex{1}\): There are certain health risks associated with being overweight. Image by Gaulsstin is licensed under CC BY 2.0.

Being Overweight Can Be a Lifelong Struggle

A growing concern is the lack of recognition from parents that children are overweight or obese. Katz (2015) referred to this as “oblivobesity”. Studies have found that a substantial proportion of parents underestimate their child's weight status, with factors such as lower socioeconomic status and higher parental BMI contributing to this misperception (Lundahl et al., 2014). Similarly, many overweight children do not recognize their weight status accurately, which can hinder motivation for behavior change (Sarafrazi et al., 2014).

Results of Childhood Obesity

Excess weight in children is associated with impairments in executive functions, including working memory, attention, and cognitive flexibility (Liang et al., 2014). Neuroimaging studies have linked higher BMI with reduced cortical thickness in the prefrontal cortex, a region critical for executive functioning (Laurent et al., 2020). Additionally, diets high in saturated fats and sugars may compromise the integrity of the blood-brain barrier, particularly in the hippocampus, which can affect memory and learning processes (Davidson et al., 2013).

Children with obesity also often face social challenges, including bullying and social exclusion, which can lead to low self-esteem and depression (Puhl & Latner, 2007). Furthermore, obesity in childhood increases the risk of orthopedic problems, type 2 diabetes, and cardiovascular diseases later in life (Daniels et al., 2005).

Dieting is not really the answer. If you diet, your basal metabolic rate tends to decrease, thereby making the body burn even fewer calories to maintain its weight. Increased activity is much more effective in lowering weight and improving the child’s health and psychological well-being. Exercise reduces stress, and being an overweight child, subjected to the ridicule of others, can certainly be stressful. Parents should take caution against emphasizing diet alone to avoid the development of any obsession about dieting that can lead to eating disorders in teens. Again, helping children to make healthy food choices and increasing physical activity will help prevent childhood obesity.²⁵

References, Contributors and Attributions

25. Lifespan Development: A Psychological Perspective by Martha Lally and Suzanne Valentine-French is licensed under CC BY-NC-SA 3.0 (modified by Dawn Rymond); Lifespan Development - Module 6: Middle Childhood by Lumen Learning references Psyc 200 Lifespan Psychology by Laura Overstreet, licensed under CC BY 4.0 (modified by Dawn Rymond)

Centers for Disease Control and Prevention. (2022). Prevalence of childhood obesity in the United States. Retrieved from https://www.cdc.gov/obesity/data/childhood.html​:contentReference[oaicite:19]{index=19}

Daniels, S. R., Arnett, D. K., Eckel, R. H., Gidding, S. S., Hayman, L. L., Kumanyika, S., ... & Williams, C. L. (2005). Overweight in children and adolescents: Pathophysiology, consequences, prevention, and treatment. Circulation, 111(15), 1999-2012. https://doi.org/10.1161/01.CIR.0000161369.71722.10​

Davidson, T. L., Hargrave, S. L., Swithers, S. E., Sample, C. H., Fu, X., Kinzig, K. P., & Zheng, W. (2013). Inter-relationships among diet, obesity and hippocampal-dependent cognitive function. Neuroscience, 253, 110-122. https://doi.org/10.1016/j.neuroscience.2013.08.053​

Faith, M. S., Van Horn, L., Appel, L. J., Burke, L. E., Carson, J. A. S., Franch, H. A., ... & Wylie-Rosett, J. (2012). Evaluating parents and adult caregivers as "agents of change" for treating obese children: Evidence for parent behavior change strategies and research gaps: A scientific statement from the American Heart Association. Circulation, 125(9), 1186-1207. https://doi.org/10.1161/CIR.0b013e31824607ee​

Laurent, J. S., Watts, R., Adise, S., Allgaier, N., Chaarani, B., Garavan, H., & Potter, A. (2020). Associations among body mass index, cortical thickness, and executive function in children. JAMA Pediatrics, 174(2), 170-177. https://doi.org/10.1001/jamapediatrics.2019.4708​JAMA Network

Liang, J., Matheson, B. E., Kaye, W. H., & Boutelle, K. N. (2014). Neurocognitive correlates of obesity and obesity-related behaviors in children and adolescents. International Journal of Obesity, 38(4), 494-506. https://doi.org/10.1038/ijo.2013.142​eatingdisorders.ucsd.edu

Lundahl, A., Kidwell, K. M., & Nelson, T. D. (2014). Parental underestimates of child weight: A meta-analysis. Pediatrics, 133(3), e689-e703. https://doi.org/10.1542/peds.2013-2690​

Puhl, R. M., & Latner, J. D. (2007). Stigma, obesity, and the health of the nation's children. Psychological Bulletin, 133(4), 557-580. https://doi.org/10.1037/0033-2909.133.4.557​

Riggs, N. R., Spruijt-Metz, D., Chou, C. P., & Pentz, M. A. (2012). Executive cognitive function and food intake in children. Journal of Nutrition Education and Behavior, 44(5), 431-435. https://doi.org/10.1016/j.jneb.2010.11.003​

Sarafrazi, N., Hughes, J. P., & Borrud, L. (2014). Weight perception among U.S. children and adolescents. Retrieved from: https://www.cdc.gov/mmwr/preview/mmw...l/mm6334a5.htm