Rising Obesity Rates in U.S. Children and Adolescents

The percentage of children and adolescents affected by obesity has more than tripled since the 1970s, according to the CDC; nearly 1 in 5 American youth are obese. According to data from the National Health and Nutrition Examination Survey, around 18% of youth ages 2 to 19 years were obese and nearly 6% were severely obese in 2015-2016. Rates of obesity and severe obesity in adolescents (ages 12 to 19 years) are even higher.

Newly published data in the Journal of the American Medical Association highlight urbanization levels and socioeconomic status as factors that influence rates of obesity in youth. Researchers reported that severe obesity in youth was significantly greater in rural, non-metropolitan areas than in large metropolitan areas. With regard to socioeconomic status, rates of obesity were highest when the education level of the head of the household was low. For example, obesity rates varied from around 22% in families with a household head having grade school education to high school diploma, to 18% in families led by a person with some college, to 12% in households led by a college graduate.

According to the CDC, obesity in youth has a high risk of progression to adult obesity, with 50% to 70% of obese pediatric patients becoming obese adults. Prevention and treatment of obesity in youth is crucial to avoiding the risks of premature morbidity and mortality associated with adult obesity, such as type 2 diabetes, heart disease, and cancer.

Recommended treatment plans for children and adolescents with severe obesity stress the importance of a multidisciplinary team providing a family-based, multifaceted approach that includes dietary modifications, physical activity, and psychosocial support. When behavioral and lifestyle interventions aren’t successful, pharmacologic or surgical interventions may be considered, but behavioral and pharmacological strategies show low success rates for achieving and maintaining weight loss in adolescents with extreme obesity.

These low success rates have led to a marked increase in the rate of bariatric surgery in adolescents. Bariatric surgery does produce substantial weight loss and leads to resolution of comorbid diseases in adolescents, but long-term outcome data are scarce. These surgeries are irreversible, with lifelong consequences, including the risk of nutritional deficiencies or need for reoperation.

For more than 25 years, the Hayes Medical Technology Directory has been the premier resource for health technology assessments for both payers and providers. We assess the full body of peer-reviewed, published evidence with a scientifically rigorous methodology. The unbiased evidence assessments provided by Hayes are a “deep dive” into the published, peer-reviewed literature, performed with scientific rigor by clinical experts and PhD-trained scientists. Hayes gives you the information you need to make informed, evidence-based decisions on patient selection criteria for interventions such as bariatric surgery.

To learn more about bariatric surgery in adolescents, access the recent Hayes Medical Technology Directory report, Comparative Effectiveness Review of Bariatric Surgeries for Treatment of Obesity in Adolescents.