In the United States, the percentage of children and adolescents affected by obesity has more than tripled since the 1970s.1 In 2017–2018, an estimated 19.3% of US children and adolescents aged 2 to19 years have obesity, but this rate varied by race and ethnicity. It was 25.6% for Hispanic children, 24.2% for Black children, 16.1% for White children, and 8.7% for Asian children.2 Many factors contribute to childhood obesity, including3-8:
- Metabolism—how your body changes food and oxygen into energy it can use.
- Eating and physical activity behaviors.
- Community and neighborhood design and safety.
- Short sleep duration.
- Negative childhood events.
Genetic factors cannot be changed. However, people and places can play a role in helping children achieve and maintain a healthy weight. Changes in the environments where young people spend their time—like homes, schools, and community settings—can make it easier for youths to access nutritious foods and be physically active. Schools can adopt policies and practices that help young people eat more fruits and vegetables, eat fewer foods and beverages that are high in added sugars or solid fats, and increase daily minutes of physical activity.4,9-14 These kinds of school-based and after-school programs and policies can be cost-effective and even cost-saving.12-14
For more information about childhood obesity, visit Child & Teen Healthy Weight and Obesity.
A comprehensive approach is most effective at addressing childhood obesity in schools, especially for elementary and middle school students.1,2 Scientists know less about what school-based obesity prevention approaches are effective for teenagers.1,2 A comprehensive approach means directing attention to nutrition and physical activity in schools and involving school nurses, parents, caregivers, and other community members (e.g., pediatricians, after-school program providers) in the process. This approach aims to support the health and well-being of all students. It does not single out students according to their weight status or body size. Overweight and obesity are sensitive issues for students and families and must be addressed with compassion, understanding, and care.15 To avoid embarrassing or shaming students, schools should not emphasize physical appearances or reinforce negative stereotypes about obesity.3
School nurses play an important role to prevent and reduce student overweight and obesity prevalence. School nurses can address the complex physical, social, and health education needs of children and adolescents who are overweight or who have obesity.15, 16 School nurses have the knowledge and skills to create a culture of health and wellness in school, promote and implement school-based policies and strategies for healthy eating and physical activity, coordinate care with families and health care professionals, and lead the school community to influence policy changes that reinforce healthy eating, physical education, and physical activity before, during, and after school.
- Fryar CD, Carroll MD, Ogden CL. Prevalence of overweight, obesity, and severe obesity among children and adolescents aged 2-19 years: United States, 1963-1965 through 2015-2016. Health E-Stats. September 2018. https://www.cdc.gov/nchs/data/hestat/obesity_child_15_16/obesity_child_15_16.htm.
- Hales CM, Carroll MD, Fryar CD, Ogden CL. Prevalence of obesity among adults and youth: United States, 2015–2016. NCHS Data Brief. 2017;288:1–8.
- Swinburn BA, Sacks G, Hall KD, et al. The global obesity pandemic: shaped by global drivers and local environments. Lancet. 2011;378(9793):804–814.
- Institute of Medicine. Accelerating Progress in Obesity Prevention: Solving the Weight of the Nation. Washington, DC: National Academies Press; 2012.
- Han JC, Lawlor DA, Kimm SY. Childhood obesity. Lancet. 2010;375(9727):1737–1748.
- Eisenburg LK, can Wijk KJE, Liefbroer AC, Smidt N. Accumulation of adverse childhood events and overweight in children: a systematic review and meta-analysis. Obesity. 2017;25(5):820–832.
- Danese A, Tan M. Childhood maltreatment and obesity: systematic review and meta-analysis. Mol Psychiatry. 2014;19:544–54.
- Fatima Y, Doi SAR, Mamun AA. Longitudinal impact of sleep on overweight and obesity in children and adolescents: a systematic review and bias-adjusted meta-analysis. Obes Rev. 2015;15(2):137–149.
- US Department of Health and Human Services. The Surgeon General’s Vision for a Healthy and Fit Nation. Rockville, MD: US Dept of Health and Human Services; 2010.
- Micha R, Karageorgou D, Bakogianni I, et al. Effectiveness of school food environment policies on children’s dietary behaviors: A systematic review and meta-analysis. PLoS ONE 2018;13(3):e0194555.
- The Community Guide. Interventions to Increase Healthy Eating and Physical Activity in Schools. 2019. Retrieved from https://www.thecommunityguide.org/content/interventions-increase-healthy-eating-and-physical-activity-schoolsexternal icon.
- Lobstein T, Jackson-Leach R, Moddie Ml, et al. Child and adolescent obesity: part of a bigger picture. Obesity. 2015;85(9986):2510–2520.
- Gortmarker SL, Want CY, Long MW et al. Three interventions that reduce childhood obesity are projected to save more than they cost to implement. Health Affairs. 2015;11(34):1932–1939.
- Cradock AL, Barrett JL, Kenney EL. Using cost-effectiveness analysis to prioritize policy and programmatic approaches to physical activity promotion and obesity prevention in childhood. Prev Med. 2017;95(S):S17–27.
- National Association of School Nurses. Overweight and obesity in children and adolescents in schools -The role of the school nurse (Position Statement). Silver Spring, MD: Author. 2018. Retrieved from https://www.nasn.org/advocacy/professional-practice-documents/position-statements/ps-overweightexternal icon. Accessed November 9, 2021.
- Schroeder K, Travers J, Smaldone A. Are school nurses an overlooked resource in reducing childhood obesity? A systematic review and meta-analysis. J Sch Health. 2016;86(5):309–321. doi: 10.1111/josh.12386