Etiology, Treatment and Prevention of Obesity in Childhood and Adolescence: A Decade in Review

Abstract

Childhood obesity has become an epidemic on a worldwide scale. This article gives an overview of the progress made in childhood and adolescent obesity research in the last decade, with a particular emphasis on the transdisciplinary and complex nature of the problem. The following topics are addressed: 1) current definitions of childhood and adolescent overweight and obesity; 2) demography of childhood and adolescent obesity both in the US and globally; 3) current topics in the physiology of fat and obesity; 4) psychosocial correlates of childhood and adolescent overweight and obesity; 5) the three major obesity-related behaviors, i.e. dietary intake, physical activity and sleep; 6) genes components of childhood and adolescent obesity; 7) environment and childhood and adolescent obesity; and 8) progress in interventions to prevent and treat childhood obesity. The article concludes with recommendations for future research, including the need for large-scale, high dose and long-term interventions that take into account the complex nature of the problem.

Figure 1

Increasing prevalence of BMI ≥ 85th percentile in youth, 1986–2008 Data from the Longitudinal Survey of Youth 1986–1998 and NHANES 1998–2008

Figure 2

Percentage of Male Children Meeting Criteria for Overweight by Country‡ Percentage of Female Children Meeting Criteria for Overweight by Country‡ ‡ Data source: International Task Obesity Task Force (2009), except for Russia (Wang, Monteiro, & Popkin, 2002), Israel and Lithuania (Lissau, et al., 2004). +BMI percentile calculated for most countries, including the US, using IOTF cut-offs (Cole, 2000).

Figure 3

Decline in time spent (in mean minutes per day) in Moderate to Vigorous physical activity, United States, 2003–2004‡ ‡ Data source: Troiano et al, 2008 * Females significantly less active than males at all ages

Figure 4

Significant differences in time spent (mean minutes per day) in Moderate to Vigorous Physical Activity by obesity status and ethnicity, United States 2003–2006‡ ‡ Data source, Belcher, et al, in press *BMI percentile negatively associated with MVPA in all race/ethnic groups for both genders (p<.05 for all)

Figure 5

Increases in amount of time (mean hours/day), spent in sedentary behavior by gender and age, United States, 2003–2004‡ ‡ Data source: Matthews et al, 2008 * Females significantly more sedentary at all ages (6–11, p = 0.002, 12–15, p = 0.003, 16–19, p = 0.028. ** p for trend of increasing sedentary behavior, p < 0.001