Childhood obesity epidemic in the USA aggravated by the Covid-19 pandemic

In a year of so much tragedy and suffering, it would be easy to drop a few extra pounds on a child or think of weight gain as a problem to be solved as soon as the pandemic subsides. But the weight gain we see in children is not trivial and cannot be expected.

The specifications that lead to weight gain vary. Sometimes it is Dad, who recently took over the kitchen and may be feeding the children too much; other times it is grandma, who has spoiled them now that they are at home; for yet others, favorite sports are no longer an option or they have completely left the house.

Through the many stories we hear in our practices, one fact remains: the pandemic created the perfect conditions for children to gain weight, and it happened.

What we are seeing in our offices – which mainly serve black and brown children – was predictable. As a result of what has become an unnecessarily prolonged crisis, countless children in this country have been deprived of nutrition and the opportunity to practice physical activities that they previously received at school.

The loss of structured face-to-face learning, in turn, interrupted other aspects of children’s lives – what used to be bedtime at 8 pm on a school night became 9 pm or later, until there was no time to sleep. As parents struggled to work from home while supervising online learning, meal times changed, portion sizes became larger and snacks became more common.

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The changes in all houses took place in a scenario of record unemployment and skyrocketing food insecurity. In our practices, we have seen food budgets gradually tighten and families seek more processed, cheaper and more calorie foods in an attempt to feed their children.

All of this – unemployment, food insecurity, deprivation of face-to-face learning and the interruptions that came with it – disproportionately affected black and brown communities.

Higher rates of obesity

It is the children in those same communities who had the highest rates of obesity before the pandemic began and who are at the greatest risk of suffering the consequences for their entire lives. In the United States, 18.5% of all children aged 2-19, or 13.7 million children, currently have obesity. For Hispanic children, the prevalence of obesity is 25.8%, compared to 22% for non-Hispanic blacks and 14.1% for non-Hispanic white children, according to the US Centers for Disease Control and Prevention.
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In addition, although Covid-19 in general spared the majority of the pediatric population, it is children who suffer from obesity who are at the greatest risk of serious complications, including intubation and ICU admission.
In addition to Covid-19, the growing list of complications from childhood obesity is known to include diabetes, fatty liver disease, high cholesterol, chronic kidney disease, musculoskeletal problems and decreased self-esteem, among many others.

Previously healthy children are sick

While these may seem far-off consequences, they are manifesting now. In the past few months, our clinics have filled with previously healthy children who now have high blood pressure, high pre-diabetes and diabetes markers, children who purposely started skipping meals after noticing their own weight gain and children for whom the extra pounds translated yourself in sleep apnea.

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The American Academy of Pediatrics recently urged its more than 60,000 pediatric members to continue to examine, advise and treat obesity as it arises, even in a pandemic, through interim guidance. But pediatricians cannot solve this crisis alone.

As we begin the work of guiding families towards building healthier habits, an increase in mental health conditions, such as depression and anxiety in children and their parents, as well as the same disorders that led children to gain weight in the first place. instead, make obesity more difficult to treat.

Mental health problems make everything worse

Depression can make it very difficult to plan meals, just as anxiety can sometimes lead to overeating. And recommending that a child eat more vegetables is an impossibility for a mother who does not have access to fresh fruits and vegetables and is simply trying to feed hungry bellies and keep the lights on; and indoor physical activity can be a Herculean task for a family of eight living in a single room.

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Like many problems, the childhood obesity epidemic has been brewing for a long time and was exacerbated by the Covid-19 pandemic. As we begin to imagine a post-pandemic world, however, we have the opportunity to make significant improvements in childhood obesity and, therefore, in the long-term health of a generation.

Now is the time to support national health recommendations with the financial relief that parents need to implement them. Schools will also need improved and sustained funding if they are to provide healthy school meals for the many children who have spent most of 2020 at home. We must also find ways to keep afloat the many small primary care offices across the country that provide primary care services and serve as safety nets for the most vulnerable among us.

Although a vaccine will soon be available to many people and the end of the pandemic seems more tangible, the consequences of disrupting life will remain with us for many years to come. The health of a generation of children depends on our vision, investment and commitment now.

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