July 20, 2000 -- Obesity is fast becoming an epidemic in the U.S., and perhaps no group is as hard hit as American children.
In children, obesity is loosely defined as a weight that is 20% or more in excess of the expected weight for a given height. Although many parents think their kids will "grow into it", obese kids who remain heavy through adolescence tend to stay that way into adulthood.
The resulting illnesses associated with obesity in adulthood -- diabetes, heart disease, high blood pressure and several cancers -- now claim an estimated half-million American lives per year, costing $100 billion in medical expenses and lost productivity.
"Obese or overweight children are at an increased risk for developing type 2 diabetes and all the consequences of diabetes like kidney failure, congestive heart failure, [high blood pressure], elevated risk of [arthritis] and shortened life span," says Denise Bruner, MD, an obesity specialist on Arlington, Va.
The bottom line is that "there are no virtues to obesity," says Harvey Hecht, MD, director of preventive cardiology and cardiac imaging at the Arizona Heart Institute in Phoenix.
"The heart is a pump," he says. "Envision an engine powering a car. The larger the car, the more stress on the engine. If you are overweight, your heart has to work harder and that puts a strain on the heart.
"Most cholesterol disorders are aggravated by increases in weight and blood pressure increases along with body mass," he says. High blood pressure and high cholesterol are risk factors for heart disease.
In addition, "obese children and adults are less likely to exercise and reap the health benefits of regular exercise," Hecht says. Regular physical activity is associated with enhanced physical and emotional health.
According to Bruner, there is an epidemic of childhood obesity in America for several reasons. "We are seeing an epidemic because children mimic their parents behavior," she says. Further complicating matters, among parents of a severely obese child, 8% will think the child is actually underweight, according to a study presented at the annual meeting of the Pediatric Academic Societies and the American Academy of Pediatrics.
"In our country, there has been a decrease in the importance of physical activity," Bruner tells WebMD. "Physical education in school is archaic -- an anomaly." Bruner is also president of the Society for Bariatric Physicians, which is a group for obesity specialists.
Additionally, children often sit in front of computers, video games, or the television instead of going outside and playing because often being indoors is safer than being outdoors. Hours spent in front of the television increase a child's risk of becoming obese, according to a study by researchers at Johns Hopkins University School of Medicine in Baltimore.
"Burn the television set and the computer and get kids to move more," says Arthur Frank, MD, the medical director of George Washington University Weight Management Program in Washington, D.C.
The availability of high-calorie fast foods also contributes to childhood obesity. The trend toward "super sizing," where for an extra few pennies you can get an extra 700 calories, certainly doesn't help either, Bruner says.
Now, results of a study published in the February issue of the Journal of the American Dietetic Association suggests that by the age of 5, children will eat more food than they actually crave when presented with larger portions.
Putting an end to the obesity epidemic is as multifaceted as the reasons behind it.
"The answer lies first of all in public education," Bruner says. "We need to mobilize communities and/or churches to generate safe after-school activities that involve exercise and to encourage schools to reinstitute physical education as a requirement."
Schools need to make a wider variety of wholesome foods available, she says. "Why not put fruit in the candy machine, instead of candy bars?" she asks.