The Prevalence of Overweight and Obesity among Adolescents and the Factors That Contribute to Its Development
1. Introduction
Overweight and obesity are severe public health problems in the United States, with over two-thirds of American adults classified as overweight or obese (1). The prevalence of overweight and obesity has been increasing steadily over the past few decades and now affects children and adolescents as well as adults (2, 3). Insidious rates of overweight and obesity among adolescents call for the active involvement of clinicians, patients, and their family members in fighting the epidemic.
2. Overweight and Obesity in Adolescents as a Nutrition Issue
-A. Background
According to the National Institutes of Health (NIH), overweight is defined as a body mass index (BMI) at or above the 85th percentile for age and gender, while obesity is defined as a BMI at or above the 95th percentile for age and gender (4). In 2010, 16.9% of children and adolescents aged 2-19 years were obese, while 31.8% were overweight (5). The prevalence of overweight and obesity has been increasing steadily over the past few decades. In 1980, 5% of adolescents were obese, while in 2000, 15% of adolescents were obese (6). The rate of increase has been especially steep in recent years; between 1988-1994 and 2007-2008, the prevalence of obesity increased by 50% among adolescents aged 12-19 years (7).
Overweight and obesity are serious public health problems because they are associated with a number of chronic diseases, including type 2 diabetes, cardiovascular disease, hypertension, dyslipidemia, strokes, sleep apnea, nonalcoholic fatty liver disease, certain types of cancer, and joint problems (8-11). In addition, overweight and obesity are associated with psychological problems such as low self-esteem, poor body image, depression, and eating disorders (12-14). Adolescents who are obese are also more likely to become obese adults (15).
The costs associated with overweight and obesity are also staggering. In 2008, the estimated annual medical costs attributable to obesity were $147 billion (16). These costs include direct medical costs such as hospitalizations, medications, and physician visits, as well as indirect costs such as lost productivity due to absenteeism from work or school. Given the significant personal and societal costs of overweight and obesity, it is imperative that we take steps to prevent and treat this problem.
-B. The Prevalence of Overweight and Obesity among Adolescents
As noted above, the prevalence of overweight and obesity has been increasing steadily over the past few decades. In 2010, 16.9% of children and adolescents aged 2-19 years were obese, while 31.8% were overweight (5). Obesity rates vary by age group; adolescent girls aged 12-19 years have the highest rates of obesity at 18.8%, while boys aged 6-11 years have the lowest rates at 11.3% (5). Obesity rates also vary by race and ethnicity; Hispanic boys have the highest rates at 17%, followed by black girls at 14%, white girls at 13%, Hispanic girls at 12%, black boys at 10%, and white boys at 8% (5). Interestingly, there has been a recent decrease in the prevalence of obesity among 2- to 5-year-olds; between 2003-2004 and 2011-2012, the prevalence declined from 14% to 8% (18).
-C. The Causes of Obesity among Adolescents
There are a number of factors that contribute to the development of obesity among adolescents. These include genetic factors, family history, psychological factors, social factors, and environmental factors.
The role of genetic factors in the development of obesity is complex and not well understood. Studies that have been conducted on twins suggest that there is a heritable component to obesity, but the specific genes involved have not been identified (19, 20). Family history is also a risk factor for obesity; children with obese parents are more likely to be obese than children with non-obese parents (21).
Psychological factors such as stress, depression, and anxiety can also lead to weight gain. Individuals who are under chronic stress tend to overeat or eat unhealthy foods as a way of coping with their stress (22). Depression and anxiety can also lead to overeating or unhealthy eating habits (23, 24).
Social factors such as peer pressure and media influences can also contribute to the development of obesity. Adolescents who are overweight or obese often face discrimination and ridicule from their peers, which can lead to social isolation and further weight gain (25-27). The media also plays a role in the development of obesity; exposure to images of thin models and celebrities can lead to body dissatisfaction and weight gain (28-30).
Environmental factors such as availability of healthy food options and opportunities for physical activity also play a role in the development of obesity. Individuals who live in food deserts or don’t have access to healthy food options are more likely to be obese than those who do have access to healthy food options (31, 32). Sedentary lifestyles are also a risk factor for obesity; individuals who spend a lot of time sitting or lying down are more likely to be obese than those who are physically active (33, 34).
-D. The Treatment and Management of Obesity in Adolescents
The treatment and management of obesity in adolescents is a complex issue. A variety of treatment modalities are available, but there is no one “best” treatment for all adolescents. Treatment should be individualized based on the adolescent’s age, health status, psychological status, social circumstances, and preferences.
Medical treatment of obesity usually involves a combination of lifestyle changes and medication. Lifestyle changes that are typically recommended include increased physical activity, decreased screen time (television, computer, etc.), and healthier eating habits. Medications that are sometimes used to treat obesity include appetite suppressants, anti-obesity drugs, and insulin sensitizers. Surgery is also an option for some adolescents with severe obesity; however, surgery is usually only considered as a last resort after other treatment modalities have failed (35).
Behavioral therapy is another important part of the treatment of obesity in adolescents. Behavioral therapy can help adolescents change their eating and exercise habits by teaching them how to set goals, make plans, and cope with difficult situations (36). Cognitive-behavioral therapy can also be helpful in treating co-occurring disorders such as depression and anxiety (37).
-E. Prevention of Obesity among Adolescents
Prevention of obesity is critical given the significant personal and societal costs associated with this condition. There are a number of ways to prevent obesity, including primary prevention (i.e., preventing the development of obesity in individuals who are not yet obese) and secondary prevention (i.e., preventing weight gain in individuals who are already overweight or obese).
Primary prevention of obesity involves creating environments that support healthy eating and physical activity. This can be done by ensuring that healthy food options are available and affordable, by providing opportunities for physical activity, and by decreasing screen time. It is also important to educate adolescents and their families about the importance of maintaining a healthy weight.
Secondary prevention of obesity involves early identification and treatment of overweight and obese individuals. This can be done by screening adolescents for overweight and obesity and referring them to treatment if necessary. It is also important to educate adolescents and their families about the risks associated with overweight and obesity and the importance of maintaining a healthy weight.
3. Conclusion
Overweight and obesity are serious public health problems that have a significant personal and societal cost. The prevalence of overweight and obesity has been increasing steadily over the past few decades, and now affects children and adolescents as well as adults. There are a number of factors that contribute to the development of obesity, including genetic factors, family history, psychological factors, social factors, and environmental factors. Treatment of obesity usually involves a combination of lifestyle changes, medication, and behavioral therapy. Prevention of obesity is critical given the significant personal and societal costs associated with this condition.