Non-Pharmacological Treatments for Obesity

Abstract

Definition and Prevalence of Obesity in Children and Adolescents Body mass index (BMI) measurement (weight in kilograms/height in meters2) and interpretation against national or international standards (overweight is BMI ≥85th percentile and obesity is BMI ≥95th percentile) is a relatively simple and accurate way to determine the prevalence of overweight and obese children (Cole et al., 2000; Dietz & Bellizzi, 1999; Reilly et al., 2010). The prevalence of obesity in children and adolescents has increased dramatically in the U.S. from the 1970s until now (Ogden et al., 2002; Ogden et al., 1997; Troiano et al., 1995) and upward trends in the prevalence of overweight and obese children have been noted in populations worldwide (Cole et al., 2000; James, 2008; Reilly & Dorosty, 1999; Wang et al., 2002). The latest estimates from U.S. National Health and Nutrition Examination Survey (NHANES) put the prevalence of those ages 2–19 years with BMI ≥85th percentile at about 30% and BMI ≥ 95th percentile at close to 20% (Ogden et al., 2010). The prevalence is much higher in certain groups such as in the Hispanic population whose prevalence is about 40% and 25% for overweight and obese youth, respectively. Furthermore, the prevalence of overweight and obesity in the United States has not gone down significantly in any group since the 1970s (Ogden et al., 2010). Another disturbing trend is the mean BMI for overweight and obese youth has been increasing over time, meaning that the heavy are getting heavier (Anderson & Butcher, 2006). The failure to reverse trends in overweight and obesity is evidence that, to the extent we in the healthcare profession are treating obesity in youth, we are doing so unsuccessfully. The causes for this epidemic of overweight and obese youth are thought to be multifactorial. Anderson and Butcher reviewed potential causes of obesity trends in youth and found that there are multiple changes in the lifestyles of families in the U.S. that coincide with the rise in obesity (Anderson & Butcher, 2006). These lifestyle changes along with changes in food consumption have at least contributed to the increase of weight in young people, including; eating away from home more often; drinking more high calorie beverages; eating more processed, calorie dense food; watching a screen for more minutes per day; walking to school less often; eating larger portion sizes; and riding in a car more (Anderson & Butcher, 2006). When facing these powerful cultural forces, clinicians are at a great disadvantage.