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What Will it Take to Reverse Childhood Obesity? More Than a Single Solution

August 29, 2018

For decades, pediatricians have tried to lower childhood obesity in the United States. What practical steps would help preschoolers reduce weight, prevent illness and improve the likelihood that they enjoy longer, healthier lives? Shari Barkin wanted to find out.

Barkin, a professor at Vanderbilt University, gathered a large sample size of 610 predominantly Latino children, each between ages 3 and 5, who were paired with a parent. More than half came from low-income households in Nashville recreation centers.

Barkin rolled out weekly skills-building sessions focused on families. She then followed up with coaching phone calls, along with lessons to ensure these new skills were sustainable and the children and families were ready to use them in time for kindergarten. Retention remained at a high 90 percent during the 36-month program.

Yet by the study’s measure for success, it was a dud. Published recently in the journal JAMA Pediatrics, her study showed no significant change in the body-mass index, which hovered at 17.8 on average.

“You can’t focus on one child at a time when you look at complex problems like obesity, but you have to look at communities over time,” Barkin told the PBS NewsHour.

This study, funded by the National Institutes of Health, highlights how complicated childhood obesity continues to be, as the United States scrambles to address one of the greatest risk factors for chronic illness, including diabetes, cancer and heart disease, later in life.

How has childhood obesity changed in the United States?

In four decades, overweight and obesity rates among children and adults has tripled nationwide. Between 1999 and 2016, the number of U.S. children who were overweight or obese continued to increase, despite earlier federal data from 2011 and 2012 suggested a decline among preschool boys, researchers from Duke University said in a February study released in the journal Pediatrics. In 2016, a third of U.S. children between ages 2 and 19 were overweight — up from 29 percent in 1999 — and one out of five children were obese, the study said.

Skinner said. “If we make great efforts in one area of a child’s life, such as school lunch, it doesn’t override all the other areas of their life.”

Why is childhood obesity a public health problem today?

Obesity touches nearly every bodily organ and function, said Christopher Bolling, a pediatrician who also chairs the American Academy of Pediatrics section on obesity.

When federal data in 2012 suggested that preschoolers were showing signs of lowered childhood obesity rates, Bolling said he and fellow pediatricians were left scratching their heads. To each other, they shared that that wasn’t what they were seeing in practice. “This issue is too important to brush off”, he said, especially as “each succeeding generation has more of a problem.”

In his clinic in Crestview Hills, Kentucky, Bolling said he sees 5-year-olds who are bigger than 5-year-olds he treated a decade earlier. But he also said many of the children he treats have no access to fresh healthy fruits and vegetables or parks. Many children in Kentucky, nearby West Virginia and across rural parts of the United States, live closer to a fast-food restaurant than a grocery store. The path of least resistance is the one frequently taken, he said.

Read more on PBS.org.

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The NNED has been a multi-agency funded effort with primary funding by the Substance Abuse and Mental Health Services Administration (SAMHSA). It is managed by SAMHSA and the Achieving Behavioral Health Excellence (ABHE) Initiative.
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