The Epidemiology of Overweight in Children: Relevance for Clinical Care

Childhood obesity is a well-recognized problem in the United States^1-3 and in some other countries (eg, in Latin America).⁴ It can cause other medical problems in childhood and adolescence,^{5 6} tends to persist,^{7 8} and long-standing obesity brings health risks in adults.⁹ Thus, current childhood obesity promises to contribute lower adult quality of life and higher medical costs in the future. To guide both prevention and treatment, a thorough understanding of its patterns, causes, and treatment options is needed.

The article by Mei et al¹⁰ in this issue ofPediatrics electronic pages adds to our understanding of patterns of ponderosity in low-income children, based on a study of children receiving WIC services between 1983 and 1995. The investigators focus on overweight, defined as weight for height ≥85th percentile (the term “obesity” is not used). During the time studied, the percentage of overweight children increased from 18.6% to 21.6% for children 0 to 5 years. The trend was most marked for boys, Hispanic children, the oldest preschoolers (age 4 to 5), and those in cities.¹⁰ These findings are consistent with recent publications on children 2 to 11 years old^{2 3}; the finding that percentage of overweight children among those 0 to 1 year of age has been increasing is new.

This report makes it clear that despite growing evidence that early childhood overweight has increased dramatically in recent years,^{1-3 10} the rise continues. This suggests that awareness of the problem and its correlates may not be guiding clinicians toward effective intervention. Mei et al conclude their report with a call for new research to address many unanswered questions. We agree that further research is needed (as discussed further below), but those who work with children and families need …

Address correspondence to: Katherine Kaufer Christoffel, MD, MPH, Children's Memorial Hospital, #46, 2300 Children's Plaza, Chicago, IL 60614.