Running Head: CHILDHOOD OBESITY IN THE US
Childhood Obesity in the United States
Michael Wiley
Adler University
1
CHILDHOOD OBESITY IN THE US
2
Introduction
Although larger size was once a sign of wealth and status, modern research suggests we
must begin paying more attention to the negative adverse effects of the growing obesity epidemic
in the United States (Komaroff, 2016). The terms overweight and obesity were originally defined
by the Department of Health and Human Services and (HHS) and Department of Agriculture
(USDA) as the accumulation of extra fat (Komaroff, 2016). For children, the Center for Disease
Control (CDC; 2015) currently defines obesity as “BMI at or above the 95th percentile for
children and teens of the same age and sex,” calculated by dividing a person’s weight in
kilograms by their height in meters. According to the most recent data from the CDC (2016),
37.9% of adults in the United States over age 20 were obese as of 2013. For young people age 20
and under, 15.5% were obese as of 2011.
While these numbers show more than a third of adults currently living in the United
States are obese, less than a sixth of youth age 20 are obese. Due to these differences in obesity
rate before and after age 20 it is reasonable to assume the transition from teens to adulthood is a
pivotal time frame for researchers studying this growing epidemic. A growing body of research
on childhood obesity and its effects on young people provide clues to further understanding the
challenges of obesity in childhood. Sedentary lifestyle, energy imbalance, oversized food
portions, lack of access to healthy foods, genetic predisposition, lack of sleep, and even certain
medical conditions are all potential causes of obesity (National Institutes of Health, (2012).
There is also a growing body of research focusing on the differences between healthy and
overweight/obese children, some of which will be discussed in this paper.
A study by Davids, Lauffer, Thoms, Jagdhuhn, Hirschfeld, Domin, Hamm, and Lotze
(2010) compared the physiological differences of brain activity in normal weight versus obese
CHILDHOOD OBESITY IN THE US
3
children. Results indicated the dopamine reward systems known for stimulating appetite, food
seeking, and consumption behaviors activated at higher levels in normal weight children than
obese children when presented food stimuli. This data indicates obese children may actually
experience food as less rewarding than normal weight children due to what is referred to as
reward deficiency syndrome, known to cause high consumption of substances to achieve release
of dopamine in the dopaminergic reward system for people with the condition. Additionally,
results also showed increased activation of the prefrontal cortex (PFC) in obese children when
presented with food stimuli. Researchers speculated this may be indicative of higher emotional
and cognitive conflict when obese children consider whether or not to eat. Quite simply, results
showed obese children may struggle to achieve the same level of satisfaction from eating food as
normal weight children. As a result, they may eat more. Furthermore, the dissonance experienced
by obese children when reasoning whether or not to eat may also lead to inhibition of their
brain’s food-related reward pathways due to heightened activation of the PFC, potentially
resulting in depressed mood and lower self-esteem.
Obese children may struggle with several factors related to food consumption, including
whether or not they should eat, what to eat, how much to eat, and the cognitive and emotional
stress associated with this processing. This paper, written in response to Davids et al. 2010 study,
will examine the implications of their findings as they relate to the current state of childhood
obesity in America, how society is helping and/or harming the obesity epidemic, and describe in
detail at least one thing sport psychology professionals can do to educate people working with
this issue.
Implications of Childhood Obesity Study
CHILDHOOD OBESITY IN THE US
4
The Davids et al. 2010 study revealed the complexities of obese children and their
relationship with food. Results of the study showed normal weight children responded with
higher levels of food-related reward system activation and lower dorsolateral prefrontal cortex
activation (linked to goal selection, planning, response inhibition, and manipulation of
information) relative to obese children when presented with food stimuli. Data not only highlight
the physiological processes underlying cognition related to the level of satisfaction obese
children gain from food but also the potential emotional struggles related to their reasoning when
deciding whether or not eating is appropriate. Their research helped conceptualize the intricacies
of a dichotomy obese children experience in achieving lower levels of satiation and pleasure
from food while simultaneously struggling to decide whether or not they should eat more. This
helps professionals working with children further understand their predicament. Cognitive
differences between normal weight and obese children support the notion of physiological
processes inhibiting an obese child’s ability to monitor their food consumption habits.
Additionally, studying comorbidity of obesity and several other disorders such as depression and
eating disorders is made possible through this research.
Society and Childhood Obesity
The relationship between modern culture and childhood obesity is important. As
childhood obesity has exponentially increased over the past three decades so too have food
advertisements targeting children (Folkvord, Anschutz, & Buijzen, 2016). This has created
several debates about whether advertisements of certain foods targeting children are ethical
practices due to their growing obesity rates (Kraak & Story, 2015). As fast food and soft drink
companies create marketing campaigns directed at children to increase revenue, introduce, and
acquire new consumers to their products, research from studies such as Davids et al. (2010) calls
CHILDHOOD OBESITY IN THE US
5
into question the morality of such actions when obese children are already known to be at greater
risk for developing hypertension, Type II diabetes, nonalcoholic fatty liver disease, respiratory
and orthopedic issues, psychiatric and psychosocial issues, chronic pain, and lower quality of life
(Hansen, Hens, Peeters, Wittebrood, Van Ussel, Verleyen, & Vissers, 2016). In the United States
alone annual medical expenses related to childhood obesity already exceed $14 billion (Hansen
et al., 2016), further calling into question the importance of youth-targeted advertisements of
fatty and sugary foods when children remain highly vulnerable to developing obesity.
While companies have exacerbated the problem of childhood obesity through targeting
unhealthy food advertisements at children for profit, policymakers have also developed several
methods intended to mitigate the childhood obesity epidemic. Public health initiatives
establishing common nutritional standards, creation of laws mandating promotion of physical
activity to children, using litigation to protect public health from substances such as artificial
trans-fat, and implementing laws banning sugary drinks from hospital settings are all examples
of how society has responded to the alarmingly high increases in childhood obesity recorded
over the previous 30 years (Aoki, Kappagoda, Mermin, 2013; Wojcicki, 2013). As businesses
have increased revenues through youth-targeted marketing campaigns lawmakers have increased
litigation limiting the scope of their advertisement and product placement capabilities. These are
examples of how society has both helped and harmed the childhood obesity epidemic.
Sport Psychologists Role with Childhood Obesity
It is important sport psychologists are equipped with an understanding of the childhood
obesity epidemic so they may better serve obese clients should they seek services or
consultation. One of the more innovative strategies for lowering childhood obesity issue are
integrated activity breaks (Vazou & Smiley-Oyen, 2014). Integrated activity breaks involve
CHILDHOOD OBESITY IN THE US
6
incorporating short, 10-minute physical activities, usually aerobic, into the classroom curriculum
as a means of increasing energy expenditure during a child’s school day while also addressing
the growing need to replace the physical education courses currently disappearing from schools
across the country. This idea has already been proven to increase energy expenditure amongst
both normal weight and obese children in experimental settings. Vazou and Smiley-Oyen’s
(2014) study showed that although overweight and obese children may struggle with certain
executive functions required for completion of school-related work immediately following
physical activity, the idea is worth exploring further due to the myriad of issues experienced by
obese children ultimately negatively impacting their overall quality of life. It is also important to
educate children, parents, and other professionals about healthy food choices relative to their
socioeconomic status and level of access to food. While not all families can afford healthy,
organically produced foods, there are ways to remain healthy with limited funds and/or access.
Working with families to develop healthy eating habits within their means is another important
intervention sports psychologists can do when collaborating with families.
Conclusion
Childhood obesity is clearly an issue warranting continual attention by our society. As
revenue driven marketing campaigns create potential dissonance amongst many members of
their young target audiences, it is the obligation of lawmakers and society as a whole to continue
educating the public on the best choices available for children to maintain a healthy lifestyle.
Studies such as Davids et al. (2010) further help working professionals and society as a whole
understand the real challenges obese children may encounter in relation to their food
consumption habits. Moving forward, as adults we must hold ourselves more accountable
educating both children and their caretakers about the importance of eating and exercise habits.
CHILDHOOD OBESITY IN THE US
7
References
Aoki, J. R., Kappagoda, M., & Mermin, S. E. (2013, Winter). Beyond the code book: Legal tools
for accelerating progress in obesity prevention. Journal of Law, Medicine, and Ethics, 6165. Retrieved from https://www.ebscohost.com/academic/academic-search-complete
Center for Disease Control and Prevention (2015). Defining childhood obesity. Retrieved from
https://www.cdc.gov/obesity/childhood/defining.html
Center for Disease Control and Prevention (2016). Defining adult overweight and obesity.
Retrieved from https://www.cdc.gov/obesity/adult/defining.html
Davids, S., Lauffer, H., Thoms, K., Jagdhuhn, M., Hirschfeld, H., Domin, M., Hamm, A., &
Lotze, M. (2010). Increased dorsolateral prefrontal cortex activation in obese children
during observation of food stimuli. International Journal of Obesity 34, 94-104. doi:
0307-0565/10
Folkvord, F., Anschutz, D. J., & Buijzen, M. (2016). The association between bmi development
among young children and (un)healthy food choices in response to food advertisements:
A longitudinal study. International Journal of Behavioral Nutrition & Physical Activity
13(16), 1-6. doi:10.1186/s12966-016-0340-7
Hansen, D., Hens, W., Peeters, S., Wittebrood, C., Van Ussel, S., Verleyen, D., & Vissers, D.
(2016, June). Physical therapy as treatment for childhood obesity in primary health care:
Clinical recommendation from axon (belgian physical therapy association). Physical
Therapy 96(6), 850-859. Retrieved from https://www.ebscohost.com/academic/academicsearch-complete
Komaroff, M. (2016). For researchers on obesity: Historical review of extra body weight
definitions. Journal of Obesity, 1-9. doi:10.1155/2016/2460285
CHILDHOOD OBESITY IN THE US
8
Kraak, V. I., & Story, M. (2015). An accountability evaluation for the industry’s responsible use
of brand mascots and licensed media characters to market a healthy diet to american
children. Obesity Reviews 16, 433-453. doi:10.1111/obr.12279
National Institutes of Health, (2012). What causes overweight and obesity? National Heart,
Lung, and Blood Institute. Retrieved from http://www.nhlbi.nih.gov/health/healthtopics/topics/obe/causes
Vazou, S. & Smiley-Oyen, A. (2014). Moving and academic learning are not antagonists: Acute
effects on executive function and enjoyment. Journal of Sport and Exercise Psychology
36, 474-485. doi:10.1123/jsep.2014-0035
Wojcicki, J. (2013). Healthy hospital food initiatives in the united states: Time to ban sugar
sweetened beverages to reduce childhood obesity. Acta Paediatrica 102, 560-561.
doi:10.1111/apa.12216