Alarming Harvard study predicts over half of US children will be obese by age 35. Time to embrace the “Nanny State?”

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The News:

Nearly three in five children in the US today are destined to be obese when they reach their 35th birthday, according to a new projection that Reuters reports. Computer modeling, using current national data, estimated that 57% of children ages 2 to 19 in 2016 will be obese by the time they are 35 years old.

To put that in perspective, the current rate of obesity among 35-year-olds is 35% to 40%, lead study author Zachary Ward of the Center for Health Decision Science at the Harvard TH Chan School of Public Health in Boston told Reuters Health.

“It seems the excess weight gained in childhood puts kids on a trajectory that persists,” Ward said, recommending that “children with obesity now could benefit from early intervention” such as a better diet with fewer sugar-laden snacks and improved physical education programs in schools.

Non-Hispanic blacks and Hispanics were more likely to be obese than whites and those disparities were already present at age 2, the researchers report online Wednesday (November 29, 2017) in The New England Journal of Medicine.

The estimate comes at a time when obesity rates have stabilized among children ages 6 to 11 and even declined for ages 2 to 5. But rates have continued to rise among older Americans. About 6% of US children, 4.6 million, already have severe obesity (BMI, 35 or higher).

“Severely obese children are at especially high risk for adult obesity,” the study team writes.

Their chances of not being obese at age 35 are just 21% for 2-year-olds, dropping to about 6% for 19-year-olds.

The new analysis was an attempt to predict how a child’s current weight might influence his or her obesity risk in adulthood. It used height and weight data from a nationally representative sample of 41,567 children and adults.

“In some ways, this is a surprising finding just because of the sheer magnitude of the problem,” Ward said. “In other ways, it’s not surprising when you look at how trends in weight gain and obesity have been going over the past 40 years. In some parts of the country, we’re already approaching that level of obesity. But this could be a new normal, the way some trends are going.”

The researchers projected that among obese children, the likelihood that they would continue to be obese by age 35 increased with age. Obese 2-year-olds had a 75% chance; obese 19-year-olds had an 88% chance.

Conversely, children who were not obese had a lower risk of being obese at 35, and those odds continued to decline with age–from 58% for children at age 2 to 44% for 19-year-olds.

“Only those children with a current healthy weight have less than a 50% chance of becoming obese by the age of 35 years,” the study team notes.

The research does not examine solutions. But the authors cite a 2015 study in the journal Health Affairs that discussed the possible strategies for addressing childhood obesity.

Steve’s Take:

I was driving back to my apartment the other day and noticed two high school kids, riding their skateboards down Encinitas Boulevard after their lunch break. Each looked ordinary enough. They appeared healthy and happy for, probably, 15-year-olds. But each had a huge, super-size cola drink in hand after lunch at the nearby fast-food pizza restaurant.

I had just read the Harvard study earlier that morning and it struck me: at least one of these kids is likely to be obese by age 35. Wham! What a horrific thought.

I’m fairly certain my reaction will be widespread. I thought things were improving; that we had stabilized child obesity, and yet the Harvard team revealed a picture that looks flat-out ominous.

When I got back to my apartment I read the Health Affairs article cited by Harvard’s researchers about what might be done to prevent this mind-boggling catastrophe. I think we can all agree that as a nation, let alone as parents, we can’t just sit idly by and do nothing. Here’s my take-away.

The study in Health Affairs indicates that, “Primary prevention of childhood obesity should be the remedy of choice.”

Four of the interventions studied have the potential for cost saving–that is, the interventions would cost less to implement than they would save over the next ten years in healthcare costs–and would result in substantial numbers of childhood obesity cases prevented.

The primarily Harvard-affiliated team said reversing the tide of the childhood obesity epidemic will require sustained effort across all levels of government and civil society for the foreseeable future.

They warn that, “To make such efforts effective and sustainable during a period of constrained public health resources, policymakers need to integrate the best available evidence on the potential effectiveness, reach, and cost of proposed obesity strategies to prioritize the highest-value interventions.”

The authors said that a number of preventive interventions would have substantial population-level impacts and would be cost-saving. An extremely important question for policymakers therefore is:

Why are they not actively pursuing cost-effective policies that can prevent childhood obesity and that cost less to implement than they would save for society?

Another seemingly obvious conclusion is that while many of the preventive interventions in childhood do not provide substantial healthcare cost savings (because most obesity-related healthcare costs occur later, in adulthood):

“childhood interventions have the best chance of substantially reducing obesity prevalence and related mortality and healthcare costs in the long run.”

The focus of action for policymakers clearly should be on implementing cost-effective preventive interventions, ideally ones that would have broad population-level impact. Particularly attractive are:

  • an excise tax of, say, a penny-per-ounce on sugar-sweetened beverages;
  • setting nutritional standards for all food and beverages sold in schools (outside of meals);
  • and the elimination of the tax subsidy (deduction in most cases) that food companies tap when they advertise unhealthy food to children.

“Yes, there are some health effects for children with severe obesity, but for the most part the health risks to them start happening later in life,” the authors emphasize.

Bottom Line:

Okay. Maybe we don’t need to embrace the nanny state, a conservative term of British origin that conveys a view that a government or its policies are overprotective or interfering unduly with personal choice, especially when it gives too much advice or makes too many laws about how people should live their lives.

Steve's Take: We don't need a #NannyState, but we do need a #HealthyState to fight #Obesity Click To Tweet

The term applies particularly to eating, smoking, or drinking alcohol. And the classic accusation of trying to create a nanny state is when the government announces new guidelines on healthy eating.

But as I wrote back in June, it’s high time we catch up with many of our other “rich-nation” colleagues around the world and face one intractable dilemma. And it’s obvious, but hard to face, let alone deal with.

Simply put, the problem is that as people live longer, they require more health care due to the presence of one or more additional diseases or disorders concurrent with a primary disease or disorder such as cancer. These comorbidities, as they are known, automatically jack up the cost of care.

This is especially true about the litany of diseases undeniably triggered by obesity.

To prevent healthcare costs from mushrooming out of control the entire US healthcare system must shift in a fundamental manner not seriously addressed in either Obamacare or the recent GOP proposals to repeal and replace it.

We need to alter the national mindset such that everyone unconsciously practices preventive care, taking full responsibility for their own health and the health of their children.

I’m not advocating for the nanny state. Far from it. Rather, it’s the emergence of the healthy state I’m championing, and we need to embrace the notion now.

If we don’t, over half of our children will fall prey to the disease itself, plus become subject to all the other diseases directly attributable to being obese. This will contribute to the healthcare cost dilemma here, which will persist as a thorny, national scourge for which there will continue to be plenty of debate, but very likely no cure under the current administration.

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