May 27, 2008 -- For the first time in 20 years, America's child obesity rate hasn't gotten worse.
But it's not any better, according to the latest figures from the CDC.
- 31.9% of kids are overweight
- 16.3% of kids are obese
- 11.3% of kids are in the "heaviest of the heavy" category
"The numbers are still too high, but there is cause for cautious optimism. It may be leveling off after steady increases," CDC epidemiologist Cynthia L. Ogden, PhD, tells WebMD.
The numbers come from in-home surveys in which trained researchers interviewed parents and examined a nationally representative sample of 8,165 children and adolescents. The findings are not based on parent reports, which tend to be highly inaccurate, so the CDC data is considered a true snapshot of American children's health.
From 1980 to 1989 and from 1990 to 1999, similar surveys revealed ballooning child and teen obesity. Surveys from 1999 to 2004 showed the weight trend continued to balloon. But data from 2003 to 2004 and from 2005 to 2006 showed no change from previous years.
"This is different from what we had been seeing in the 20 years before," Ogden says.
Just because the news isn't worse doesn't make it good. About a third of America's kids are in the 85th percentile in terms of their body mass index or BMI, a measure of weight that takes height into account.
These percentiles are based on growth charts that compare today's kids to the kids of the 1960s and 1970s. This means that 32% of today's kids are as heavy as the heaviest 15% of kids in the '60s and '70s -- and that 11.3% of today's kids are as heavy as the heaviest 3% of kids in the not-so-distant past.
And something else hasn't changed. There are still huge racial and ethnic differences in weight. For example:
- Non-Hispanic black girls are 2.4 times more likely than non-Hispanic white girls to be in the "heaviest of heavy" category and two times more likely to be obese.
- Mexican-American girls are 69% more likely than non-Hispanic white girls to be in the "heaviest of heavy" category.
- Mexican-American boys are 88% more likely than non-Hispanic white boys to be in the "heaviest of heavy" category and 68% more likely to be in the obese category.
Child Obesity: Good News to Come?
Ogden's statistics suggest that the obesity epidemic is leveling off. Do these numbers reflect what's going on in the real world?
Yes, says family therapist Beth Passehl, MS, director of the Fit Kids and TIPPs for Kids programs at Children's Hospital of Atlanta. Passehl's community programs help the families of overweight and obese children to become more active and to eat more nutritious meals.
Passehl was not surprised when previous CDC figures showed the child obesity epidemic getting worse; she already was seeing obese children flooding into her programs.
"It looked worse than we knew -- and, as it turned out, it was," she tells WebMD.
And now she's not surprised that the CDC numbers suggest the epidemic has stopped accelerating. There are signs, she says, that government efforts -- such as programs to make school meals more nutritious and to get kids to be more active -- are starting to work.
"It is a bit like turning the Titanic, but there have been changes that matter," Passehl says.
She recently started a new child obesity program in one community, and noticed that people have begun to ask the right questions.
"When we start a program in a community we always ask the parent, 'What are the three things you most want?' In past they said, 'I want my child to lose weight, I want to lose weight, I don't know how to cook,'" she says. "Now I get more specific answers: 'I would like to cut down the number of sodas we drink, I would like the family to be more physically active.' To me, these are indicators that health messages are getting across."
The key, Passehl says, is not to get into a struggle with children. She says parents just don't know where to start, so they typically begin by trying to withhold food from their overweight or obese child.
"When you do this, you actually create a struggle and a challenge over who is going to win, the parent or the child. So any health messaging is never going to happen because the kids are too busy doing what they are not supposed to do," she says.
Instead, Passehl says, the entire family has to get on board -- and to begin with small changes. If everyone in the family is drinking sugary soft drinks all day long, it will just be an exercise in frustration to try to stop drinking soda. But slightly cutting back on sodas might be an achievable goal. And once family members achieve one success, their sense of accomplishment lets them build up to other successes.
The main focus of Passehl's program is to divide responsibilities for weight loss between the parents and the children. For example, it is the parent's job to put healthy food on the table -- and not to provide snacks all day long. It is the child's job to come to the table and to choose from the food that is there -- without running to the refrigerator to gobble unhealthy food.
One trick Passehl uses is to teach the children about nutrition, and then have them teach their parents.
"This is where you want your kids to be. You want them to take better charge of their health," she says. "So when kids educate their parents, the kids have the opportunity to embrace the message themselves. I don't want them to make changes because I told them to. I want them to make changes based on their own ability to decide."
Have America's children made enough of these decisions to turn the tide of the child obesity epidemic? We may know in a year or so. Ogden's team already is crunching the next set of numbers.
The CDC report appears in the May 28 issue of The Journal of the American Medical Association.