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More Kids Under Age 4 Have Severe Obesity: Study

Lisa O'Mary

Severe obesity among preschool-age children from low-income families is on the rise in the U.S., according to a new analysis of federal data.

An estimated 2% of children ages 2 to 4 years old had severe obesity in 2020, up from 1.8% in 2016, according to the report that appeared Monday in Pediatrics, a journal published by the American Academy of Pediatrics. 

The increase is "small but significant," a group of experts not involved in the research wrote in a companion commentary published alongside the research.

The new data put an end to hopes that childhood obesity was on the retreat following a small decrease in rates from 2010 to 2016. Instead, the researchers noted that the new childhood obesity figures reflect those of the general population. About 20% of children and teens in the U.S. are obese, and about 42% of adults in the U.S. are obese, according to the CDC.

This latest study looked for severe obesity, which was defined as being well above the 95th percentile for the combined height-weight measure known as body mass index. The figures are important because rates of severe obesity among young children can foreshadow health problems that may occur on a scale to warrant concerns among public health officials, policymakers, and health care professionals.

Compared to children who have moderate obesity, children with severe obesity "are at a greater risk of various health complications, including cardiovascular disease, metabolic syndrome, type 2 diabetes, fatty liver disease, and premature death," the study authors wrote.

The largest increases from 2016 to 2020 in severe obesity were observed among 4-year-olds and among Hispanic children. When looking at state-level data, Alaska was the only state to report a decline in severe obesity among young children from 2016 to 2020.

The new estimates were drawn from data on children enrolled in the federal Special Supplemental Nutrition Program for Women, Infants, and Children, also known as WIC.

"WIC is a federal assistance program that provides healthy foods, nutrition education, health care referrals, and other services to millions of low-income pregnant and postpartum women, as well as infants and children up to age 5, who are at nutritional risk," the researchers summarized.

The new figures indicate 16.6 million children ages 2 to 4 years old have severe obesity. Having severe obesity at these early ages is "nearly irreversible," the authors of the commentary article noted, adding that little research exists that indicates how to effectively treat obesity before age 6.

"The study underscores the need for ongoing monitoring... post-pandemic of children's health status," a news release from the American Academy of Pediatrics stated. "It also further supports the need for children and families from households with lower incomes across the nation to have access to early clinical detection, such as healthcare screenings and referrals to effective family-based interventions to support healthy growth."

Sources:

Pediatrics: "Trends in Severe Obesity Among Children Aged 2 to 4 Years in WIC: 2010 to 2020," "Severe Obesity in Toddlers: A Canary in the Coal Mine for the Health of Future Generations."

CDC: "Prevalence of Childhood Obesity in the United States," "Adult Obesity Facts," "BMI Percentile Calculator for Child and Teen."

American Academy of Pediatrics: "New Study Shows Recent Upward Swing in Severe Obesity Among Children in WIC."

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