Epidemic Childhood Obesity: Not Yet the End of the Beginning

After 35 years of unremittingly bad news about childhood obesity, a plateau in overall prevalence and a statistically significant decline among 2- to 5-year-olds had been suggested in national data from earlier this decade.1–3 News reports in 2014 celebrated “the first clear evidence that America’s youngest children have turned a corner in the obesity epidemic.”4 Perhaps Michelle Obama’s Let’s Move campaign, the Robert Wood Johnson Foundation’s $500 million prevention initiative, and growing public awareness had finally begun to pay off. Unfortunately, this optimistic picture was not to be, according to an article in this issue of Pediatrics . Using nationally representative data from 1999 to 2016, Skinner et al5 examined changes in body weight status (ranging from overweight to class III obesity [BMI ≥140% over the 95th percentile]) among children ages 2 to 19 years. The study revealed that obesity prevalence did not decrease for any age group and continued upward among many subgroups. Of particular concern, previously documented racial and ethnic disparities, especially at the most extreme weight categories, showed no sign of abating. For instance, class III obesity is … Address correspondence to David S. Ludwig, MD, PhD, Endocrinology, Boston Children’s Hospital, 300 Longwood Ave, Boston, MA 02115. E-mail: david.ludwig{at}childrens.harvard.edu