A Quarter of Kids are Deemed Overweight, but Even Kids Who Are Not Can Have Problems

When it comes to deciding how much to eat, American kids sound a lot like Goldilocks and the Three Bears: Too much. Too little. Just right.

Starting at the top, 20 years ago, about 19 percent of American teens were considered obese. Today, the Centers for Disease Control and Prevention (CDC) says 22.2 percent are fat and getter fatter, a small but significant increase triggered at least in part by the COVID years when sitting at home and eating all day were standard.

“If these trends continue, 57% of children currently ages 2 to 19 will have obesity as adults in 2050,” stated Claire McCarthy, MD, senior faculty editor, Harvard Health Publishing.

“In a nutshell, this puts more than half of children now alive in the US at greater risk for high blood pressure, heart disease, diabetes, liver disease, and the other health complications of obesity,” Doctor McCarthy wrote.

And it is not just a problem in the USA. A four-nation meta-analysis of 32 studies including more than 63,000 children reported in the Journal of The American Medical Association in February 2023 showed precisely the same percentage across the globe.

This isn’t a problem just for the overweight kids. It affects their normal- and underweight friends as well. Given the continuing emphasis on poundage, these other children may look in a mirror, mistakenly see themselves as fat, and begin working hard to lose weight. The result? According to the American Academy of Child and Adolescent Psychiatry, about 10 in every 100 teens, mostly girls, suffers from an eating disorder such as anorexia nervosa or bulimia.

The two conditions are similarly serious but present with different behaviors and symptoms. Anorexics starve themselves on diets that feature miniscule portions such as five peas or one lettuce leaf for lunch. Bulimics eat. In fact, they may chew their way through a whole chicken or chocolate cake at one sitting. But having eaten they are frantic get rid of the food with laxatives or more commonly by forcing themselves to regurgitate. Both conditions can lead to severe underweight, malnutrition and–if left untreated–death.

Johns Hopkins pediatric psychologist Sarah Sobalvarro adds two less well-known and unlikely to be fatal conditions to the list. The first is binge eating disorder: wolfing down larger than normal portions of food in one sitting and being unable to stop oneself from eating very large portions when not hungry. The second, avoidant restrictive food intake disorder (ARFID) means avoiding specific foods because the taste, smell or texture seems unpleasant. As Harvard Health Publishing editor Claire McCarthy explains, this is more than just “picky eating” and can lead to malnutrition.

To treat all these problems, parents and other responsible adults such as teachers need to be aware of the warning signs. As anorexics continue to lose weight, they may be weak, out of breath, constipated, anxious, depressed, or contrarily hyperactive. Bulimics are likely to stock up on laxatives or disappear regularly into the bathroom right after eating. The most visible sign of their illness may be teeth damaged by frequent vomiting of accidence stomach contents. Another way to see that a kid’s in trouble is to take the simple self-test on the Anorexia Nervosa and Related Eating Disorders (SNRED) web site www.anred.com/slf_test.html The more yes answers the higher the likelihood that there’s a problem.

If you know a child who seems to fit one of these categories, talk to them—and talk to your doctor. Even if you are wrong McCarthy says doing so may “lead to an important conversation about healthy eating and body image that could help prevent a future eating disorder. And if you are right, the sooner your child gets help, the better.”