Childhood Obesity

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Abstract
The prevalence of obesity in U.S. children is rising. Etiologic studies have focused on infants and school age children but little is known about obesity in early childhood. To study the development of childhood obesity and its medical correlates, the authors reviewed 175 charts of obese children seen in a nutrition clinic. The 61 study subjects (37% of charts reviewed) had growth records for ages 7 years and less and were without developmental delay syndromes. Thirty-nine (64%) of 61, were girls; ages at presentation were 1 to 14 years. Data collection included previous and presenting weights, heights, medical problems, and evidence of parental and sibling obesity. Study subjects' mean percent of ideal body weight for height (%IBWH) at presentation was 160 percent. Many study subjects had medical problems considered to be related to obesity: 30 percent had asthma, 25 percent elevated blood pressure, and 28 percent hyperlipidemia. Thirty (63%) of 48, study subjects with data on maternal weight and height, had obese mothers and 14 (31%) of 45 had obese fathers. Fourteen (50%) of 28 had one or more obese siblings. Among all study subjects, the proportion of obese (% IBWH >120%) and severely obese children (% IBWH>140%) increased between ages 1 and 7 years. For example, the proportion >140% IBWH was zero percent at 1 year and 3 years; 0.1 at 2 years; 0.2 at 4 years; 0.5 at 5 to 6 years; and 0.6 at 7 years. Of the 29 study subjects obese beyond 7 years, 0.1 were obese at 1 year; 0.2 at 2 years; 0.4 at 3 years; 0.6 at 4 years; 0.8 at 5 to 6 years; and 0.9 at 7 years. In these 61 study subjects 1.) of those who were obese by age 7, most became obese by age 4 years and severely obese by age 5 years; 2.) most children had obese family members; and 3.) obesity in early childhood was associated with nontrivial medical problems. The data imply that prevention of persistent, severe childhood obesity will require a family-oriented approach aimed at preschool children and suggest specific testable hypotheses related to early childhood obesity.