In the past 30 years, obesity has more than doubled in children and quadrupled in adolescents, according to the Centers for Disease Control and Prevention (CDC).

In 2012, nearly 18 percent of children and 21 percent of adolescents in the United States were obese. In 1980, 7 percent of children and 5 percent of adolescents were obese.

Reversing the trend is no easy task. Public health initiatives must address multiple and complicated factors of childhood obesity, including health disparities that are beyond the control of children and their families. Many of these factors, once they take hold in a child’s life, are difficult to overcome.

The Complexity of Childhood Obesity

Causes

Obesity is defined as having excess body fat. Overweight is having excess body weight for a particular height from fat, muscle, bone, water or a combination of these factors.

“The main causes of excess weight in youth are similar to those in adults, including individual causes such as behavior and genetics,” the CDC explains. “Behaviors can include dietary patterns, physical activity, inactivity, medication use, and other exposures. Additional contributing factors in our society include the food and physical activity environment, education and skills, and food marketing and promotion.”

Although causes of obesity such as poor food choices and a sedentary lifestyle may be controlled by a child, other causes are external. The Journal of the American College of Nutrition says that children tend to prefer to eat foods readily available in the home. Parents’ preferences, beliefs and attitudes about food shape children’s preferences. The Future of Children maintains that 25 to 40 percent of body mass index is heritable, or able to be passed from a parent or grandparent to a child through the genes.

Social determinants of health — such as unemployment, racism and inadequate access to social, health and other services — interact with and reinforce each other.

Social factors contributing to childhood obesity extend well beyond a child’s control. The Wellesley Institute points out that people facing poverty or other forms of social inequality and exclusion have poorer health. Social determinants of health — such as unemployment, racism and inadequate access to social, health and other services — interact with and reinforce each other.

People who are disadvantaged are more likely to lack access to services and supports enabling good health. For instance, obesity rates are lower in neighborhoods with access to shops that sell nutritious foods. Yet, poorer communities tend to have more fast-food restaurants and fewer grocery stores where fresh foods can be purchased. “One of the greatest challenges in addressing health inequities is that children are particularly negatively impacted,” writes Wellesley Institute policy analyst Steve Barnes. Children in poorer families and poorer neighborhoods are more likely to have poorer health and negative health outcome continue throughout their lives.

Consequences

Children who are obese have a greater risk of high blood pressure and high cholesterol, which can lead to heart disease. According to the CDC, one study determined that 70 percent of obese children had at least one risk factor for heart disease, and 39 percent had two or more risk factors. Childhood obesity also raises the risk of other health conditions.

Impaired glucose tolerance, insulin resistance, and Type 2 diabetes

Breathing problems and asthma

Joint problems and musculoskeletal discomfort

Fatty liver disease, gallstones, and heartburn

Psychological effects of childhood obesity include depression, behavioral problems, issues in school, low self-esteem and low self-reported quality of life. There is a greater risk of impaired social, physical and emotional functioning.

Children and adolescents who are obese are more likely to be obese as adults, consequently raising the risk for adult health problems like heart disease, Type 2 diabetes, osteoarthritis and several types of cancer. “Overweight and obesity now ranks as the fifth leading global risk for mortality,” according to the World Health Organization. “In addition, 44% of the diabetes burden, 23% of the ischaemic heart disease burden and between 7% and 41% of certain cancer burdens are attributable to overweight and obesity.”

Public Health Initiatives

Prevention Is Paramount

The National Prevention Strategy focuses on increasing the number of Americans who are healthy at every stage of life. It seeks to build healthy communities, expand preventive services, empower people to make healthy choices and eliminate health disparities. The seven priority areas are:

Tobacco-free living Preventing drug abuse and excessive alcohol use Healthy eating Active living Injury and violence-free living Reproductive and sexual health Mental and emotional well-being

Community Efforts

Several community efforts and initiatives target healthy eating and active living across settings such as early childhood care, hospitals, schools, and foodservice. From water access and nutritional standards in schools to walking routes and breastfeeding in the workplace, these efforts support positive steps toward reversing the obesity epidemic.

Early Care and Education

Because more than one in five American children ages 2 to 5 are already overweight or obese, the CDC has established several early care and education initiatives to prevent and control obesity in childcare centers, daycare, Head Start programs, and preschool and prekindergarten programs. The initiatives include various learning collaboratives, nutrition, and physical activity standards, research and partnerships.

Let’s Move! Initiatives

The Let’s Move! initiatives implement programs that help parents, schools, healthcare professionals, faith-based and community-based organizations, private sector companies and elected officials from all levels of government help in the fight against childhood obesity. Several programs encourage healthy food choices and physical activity.

Nutrition Policies

Various nutrition policies help schools institute healthy standards that can impact childhood obesity through laws, mandates, regulations, resolutions, and guidelines.

Promoting Healthy Eating and Active Living

Public health initiatives are raising awareness and presenting solutions not only for preventing childhood obesity but for promoting the importance of making healthy eating and active living choices. In homes, schools, hospitals and other environments, children and adults can take strides toward a more active and healthier life.

At Rivier University, the online B.S. Public Health and the online Master of Public Health allow students to develop the skills and knowledge to address public health crises such as childhood obesity. Both programs are offered in a convenient and flexible online format and can be completed alongside students’ work and personal schedules.