COVID-19 Pandemic Tied to Increased Obesity Prevalence Among Adolescents

By Lisa Rapaport

January 10, 2022

(Reuters Health) - Childhood obesity prevalence rose at a faster than expected pace in Massachusetts during the COVID-19 pandemic, a recent study suggests.

Researchers examined electronic health records for 46,151 youth aged 2 to 17 years in 2018 who had body mass index (BMI) recorded during three time periods: a control period from July 1 to December 31, 2018; a pre-pandemic period from July 1 to December 31, 2019; and a pandemic period from July 1 to December 31, 2020. They assessed obesity prevalence based on BMI at the 95th percentile or higher using standardized growth charts.

Overall, obesity prevalence increased more during 2019 to 2020 than should be expected based on the increase seen in the earlier periods. Obesity prevalence climbed from 15.1% in 2018 to 15.7% in 2019 and 17.3% in 2020, the analysis found; the difference in trends was 1.1%.

The more pronounced increases in childhood obesity during the pandemic are likely multifactorial, said lead study author Dr. Allison Wu, an attending physician in the Division of Gastroenterology, Hepatology and Nutrition at Boston Children's Hospital in Massachusetts.

For example, school and afterschool programs were disrupted, leaving most children at home with more sedentary activity and screen time, Dr. Wu said by email.

"Stressors surrounding the pandemic, including caregiver financial and job strains, food insecurity, and social isolation, may have also contributed to changes in diet such as through increased intake of calorically dense and ultra-processed foods," Dr. Wu added. "And contributions to weight gain via the emotional and psychological toll of the pandemic on children cannot be overstated."

While many clinicians were noticing trends in weight gain at the individual patient level, the findings at the population level were striking, particularly the disparities in Black and Hispanic youth, and boys ages 6 to 11 years old, Dr. Wu said.

Across all ages in the study, difference in trends for obesity prevalence from 2019 to 2020 was 1.1% greater than expected overall, according to the report in JAMA Pediatrics. It was 2.0% greater for Asian youth, 4.8% greater for Black youth, 3.5 percent greater for Hispanic youth, and 0.5% lower than expected for white youth.

Among boys ages 6 to 11 years old, the difference in trends for obesity prevalence from 2019 to 2020 was 2.8% overall, 6.3% for Black boys, and 7.1% for Hispanic boys.

One limitation of the study is that it only included data on youth who received in-person care during the pandemic at three Massachusetts practice groups, meaning results might not be generalizable to other populations.

Even so, the results underscore a need for resources to prevent and treat obesity in children, such as registered dieticians, social workers, community resources, and multidisciplinary care teams, Dr. Wu said.

"Care teams also can recognize and attempt to address situations where there may be social needs such as housing instability or food insecurity impacting overall child health," Dr. Wu added. "Clinicians, researchers, community members, and policymakers can together advocate for changes to the food and neighborhood environment, to better support childhood obesity prevention and management."

SOURCE: JAMA Pediatrics, online December 13, 2021.