In the United States, one in five children/adolescents struggles with obesity. According to the Centers for Disease Control and Prevention (CDC), the percentage of children affected by childhood obesity has more than tripled since the 1970s1.
While there are many factors that contribute to childhood obesity, social determinants of health (SDOH)—the conditions in which we live, learn, work and play—play a significant role.
Childhood obesity outcomes and risks will vary based on the child’s racial, ethnic and/or socioeconomic groups; geographic location; and different physical abilities. Differences in SDOH affect chronic diseases, like obesity, by making it more difficult to choose healthy food options and get enough physical activity.
In addition to SDOH, excess weight gain in children and adolescents can be affected by the following factors:
The 2020-2025 Dietary Guidelines for Americans are excellent resources for members of all ages. The publications promote eating a variety of vegetables and fruits, whole grains, lean protein foods, and low-fat and fat-free dairy products. Healthy eating also means limiting foods and beverages with added sugars, solid fats or sodium2.
The Physical Activity Guidelines for Americans make the following recommendations based on the ages of members:
When people aren’t getting enough sleep, they aren’t receiving enough leptin and ghrelin—two hormones that regulate appetite—which promote overeating and weight gain by increasing feelings of hunger. Sleep deprivation is also associated with growth hormone deficiency and elevated cortisol levels, both of which have been linked to obesity. In addition, insufficient sleep can slow your metabolism and create a greater tendency to select high calorie foods4.
Children require more sleep than adults due to the development taking place in their bodies and minds. Those who aren’t sleeping enough may experience the same hormonal changes seen in adults that lead to weight gain. They also could experience increased daytime fatigue, leading to decreased levels of activity. One study found that children who went to bed later had worse diet quality5, consuming more nutrient-poor foods and fewer fruits and vegetables than children who went to bed earlier.
To ensure children are getting enough sleep, the CDC6 recommends:
|Newborn||0-3 months||14-17 hours|
|Infant||4-12 months||12-16 hours including naps|
|Toddler||1-2 years||11-14 hours including naps|
|Preschool||3-5 years||10-13 hours including naps|
|School Age||6-12 years||9-12 hours|
|Teen||13-18 years||8-10 hours|
|Adult||18-60+ years||7 hours or more|
While genetic changes in human populations occurred too slowly to cause the current obesity epidemic, variants in several genes may contribute to obesity by increasing hunger and food intake. Rarely, a specific variant of a single gene (monogenic obesity) causes a clear pattern of inherited obesity within a family7,8.
Some illnesses, such as Cushing’s disease, may lead to obesity or weight gain. Medications, including steroids and some antidepressants, also may cause weight gain. Research is still ongoing to determine the full extent that other factors (e.g., chemical exposures and the microbiome) have on obesity.
To help our members stay at a healthy weight, Highmark has created the following handouts, which are available to you at the links below as well as on our Provider Resource Center:
An excellent resource for providers to share with members is the Highmark Community Support tool , which can be used to search by ZIP Code for free and low-cost, local services, including food, housing, transportation, utility assistance, job training and more.
Disclaimer: Highmark does not recommend particular treatments or health care services. This information is not intended to be a substitute for professional medical advice, diagnosis, or treatment. You should determine the appropriate treatment and follow-up with your patient. Coverage of services is subject to the terms of each member’s benefit plan. Additionally, state laws and regulations governing health insurance, health plans and coverage may apply and will vary from state to state.