Young Children with Severe Obesity: Who Are They and What Might We Do Differently
to Help Them
LewisFirst, MD, MA, Editor in Chief, Pediatrics
While we have recently released an article noting worsening of trends in children and adolescents with obesity from 1999 to
2016, there are subgroups of younger children for whom we have limited understanding.
One such group that calls for a better understanding of this problem are children
ages 2 to 5 years with severe obesity (BMI ≥ 120% of the 95th percentile). That is why Tester et al. (10.1542/peds.2017-3228) evaluated children from 1999-2014 as captured in National Health and Nutrition Examination
Survey (NHANES). The authors compared children with severe obesity in this age group
with normal weight children in terms of sociodemographic information, as well as birth
histories, screen time, and measures of healthy eating.
Sadly, the results reflect that toddlers and preschoolers with obesity and severe
obesity are more likely to be part of a racial/ethnic minority and to experience more
worrisome social determinants of health than children who are not obese. There is
lots to consume in terms of the findings in this study which will make you ask why
this high prevalence of obesity is happening in children so young. To help address
this, we again refer you to a commentary by Dr. David Ludwig (10.1542/peds.2017-4078), endocrinologist and director of an obesity prevention center at Boston Children’s
Hospital who has some great suggestions as to what each of us can do to help stop
the increasing prevalence of children experiencing obesity even at the young ages
of 2-5 years.