National Academy of Medicine

Advancing the Care of Children and Adolescents with Severe Obesity: A Reason for Clinical Subtyping

By Ihuoma Eneli, Susan J. Woolford, Sandra Hassink
April 30, 2015 | Discussion Paper

Childhood obesity, a serious and urgent public health problem, affects 17 percent of children in the United States, almost a third of whom have severe obesity defined as an age and sex-specific body mass index above the 99th percentile on the 2000 Centers for Disease Control and Prevention growth chart. The prevalence rates of children with severe obesity are increasing rapidly, with significant disparities noted: Higher rates of severe obesity are reported among lower socioeconomic status and ethnic and racial minority groups. Even more concerning is that the rate of conversion from obesity to severe obesity over a 4-year period among Pennsylvania middle and high school students is 42-44 percent. Severe obesity affects more children than autism spectrum disorders, cystic fibrosis, and cancer combined and can have devastating consequences in childhood such as early atherosclerosis, obstructive sleep apnea, hypertension, type 2 diabetes, metabolic syndrome, fatty liver disease, psychological problems, and a greater risk for obesity in adulthood and premature death.

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Disclaimer: The views expressed in this paper are those of the authors and not necessarily of the authors’ organizations, the National Academy of Medicine (NAM), or the National Academies of Sciences, Engineering, and Medicine (the National Academies). The paper is intended to help inform and stimulate discussion. It is not a report of the NAM or the National Academies. Copyright by the National Academy of Sciences. All rights reserved.