Obesity in Children

by

Elizabeth Waters, Andrea M. de Silva-Sanigorski, Tahna Pettman, Miranda Bruckner, Lisa Gibbs

• LAST REVIEWED: 26 August 2013
• LAST MODIFIED: 26 August 2013
• DOI: 10.1093/obo/9780199756797-0066

Introduction

Childhood obesity is a significant public health issue internationally. Growing recognition of the problem paralleled escalating rates of childhood obesity and evidence establishing the links with a number of serious metabolic, physical, social, and psychological consequences. These consequences include increased risk of developing cardiovascular dysfunction, type 2 diabetes, pulmonary, hepatic, renal, and musculoskeletal complications, reduced health-related quality of life, stigmatization, teasing, and unhealthy behaviors. Internationally, childhood obesity rates continue to rise in some countries (e.g., Mexico, India, China, Canada), although in some countries there is emerging evidence of slowing of the rate of increase or a plateauing in some age groups. Obesity prevalence is also inextricably linked to the degree of relative social inequality, with higher rates of obesity observed in more socially disadvantaged groups in most developed countries and the reverse in developing and transitional countries. The evidence is strong however, that once obesity is established, it is both difficult to reverse and tracks into adulthood, providing a strong case for primary prevention efforts. The available knowledge base on which to develop a platform of obesity prevention action and base decisions about appropriate public health interventions to reduce the risk of obesity is strengthening: however, uncertainty remains about the most effective, equitable, sustainable, and cost-effective ways to prevent childhood obesity.

Introductory Works

The literature on obesity is now extensive. A large number of research papers, reviews, and reports are available to introduce the casual reader and the broader field to the magnitude of childhood obesity internationally. Fewer publications have synthesized the available evidence to provide recommendations for future research, policy, and practice. Useful examples such as those collated in this section identify childhood obesity prevalence internationally, discuss the difficulties with defining childhood obesity, and synthesize the evidence in the context of public health obesity guidelines. Lobstein, et al. 2004 provides a comprehensive overview of childhood obesity as a public health crisis, providing an excellent background on the risk and protective factors related to childhood obesity development, examining behavioral, environmental, social factors. Bray and Bouchard 2004 provides a thorough discussion of the etiology and pathophysiology of obesity and a range of associated conditions. Swinburn, et al. 1999 presents a very useful theoretical framework for understanding the broader environmental determinants of obesity, with specific application to selecting interventions. Flynn, et al. 2006 reports on an extensive review of literature and practice and identifies gaps in knowledge and practice around population-level and “upstream” interventions to prevent obesity. The Foresight Report (Foresight—Tackling Obesities: Future Choices) highlights the urgency of tackling obesity as a major public health issue and the complexity of the various contributions to obesity and obesity increases. Swinburn, et al. 2011 provides a contemporary view and integrated discussion of global drivers of obesity in local environments, with clear recommendations for action. French, et al. 2012 provides a comprehensive literature review of some of the psychological consequences of childhood obesity, namely self-esteem.

• Bray, George A., and C. Bouchard, eds. 2004. Handbook of obesity: Etiology and pathophysiology. New York: Marcel Dekker.

  In one comprehensive, easy-to-access volume, the Handbook of Childhood and Adolescent Obesity provides a historical framework of the problem in terms of its developmental origins, etiological factors, detailed pathophysiology of obesity, and related physical and metabolic disorders.

• Flynn, M. A., D. A. McNeil, B. Maloff, et al. 2006. Reducing obesity and related chronic disease risk in children and youth: A synthesis of evidence with “best practice” recommendations. Obesity Reviews 7 Suppl 1 (February): 7–66.

  DOI: 10.1111/j.1467-789X.2006.00242.x

  This systematic review was undertaken by an international panel of experts on obesity to inform recommendations about developing and implementing best practice recommendations to promote healthy weight in children and youth for the prevention of chronic diseases associated with obesity.

• Foresight—Tackling Obesities: Future Choices.

  The 2007 report highlighted the importance of tackling the growing obesity trend in a coherent and comprehensive manner.

• French, S. A., M. Story, and C. L. Perry. 2012. Self-esteem and obesity in children and adolescents: A literature review. Obesity Research 3.5: 479–490.

  DOI: 10.1002/j.1550-8528.1995.tb00179.x

  Examines the relationship between self-esteem and obesity in children and adolescents, presenting implications for prevention and treatment and acknowledging methodological limitations in the current evidence.

• Lobstein, T., L. Baur, and R. Uauy. 2004. IASO international obesity taskforce: Obesity in children and young people: A crisis in public health. Obesity Reviews 5:4–104.

  DOI: 10.1111/j.1467-789X.2004.00133.x

  Provides a broad background to the topic, as well as recommendations for tackling the childhood obesity epidemic. The authors provide an overview of the evidence on the causes, consequences, treatment, and prevention for childhood obesity.

• Swinburn, B. A., G. Egger, and F. Raza. 1999. Dissecting obesogenic environments: The development and application of a framework for identifying and prioritizing environmental interventions for obesity. Preventive Medicine 29.6: 563–570.

  DOI: 10.1006/pmed.1999.0585

  Explores the new term “obesogenic environments” and describes a framework to better understand the set of circumstances that encourage people to consume more calories than they burn. The ANGELO (analysis grid for environments linked to obesity) framework is a conceptual model for understanding the obesogenicity of environments and a practical tool for prioritizing environmental elements for research and intervention.

• Swinburn, B. A., G. Sacks, K. D. Hall, et al. 2011. The global obesity pandemic: Shaped by global drivers and local environments. The Lancet 378.9793: 804–814.

  DOI: 10.1016/S0140-6736(11)60813-1

  Provides a contemporary discussion about how current global food system drivers interact with local environmental factors to perpetuate trends in obesity prevalence worldwide and create variations within and between populations. Global data are described and recommendations for government leadership, regulation, and investment in programs, monitoring, and research are given.