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Pediatric Health Coaching Could Transform Prevention

Tatyana Meshcheryakova March 18, 2026 No Comments

Despite decades of research on prevention and treatment, many families still receive only brief advice about nutrition and exercise during routine pediatric visits. While doctors understand what interventions can help, the healthcare system often lacks the structure and resources needed to support families through meaningful, long-term lifestyle changes. A growing group of experts believes that pediatric health coaching could help close this gap, offering continuous support to children and their families while strengthening the healthcare workforce.

Recent research has also revealed troubling trends in pediatric diabetes. An analysis of children enrolled in public insurance programs found that diabetes prevalence rose steadily between 2016 and 2021. Even more concerning was the sharp increase in cases of type 2 diabetes, a condition once considered almost exclusively an adult disease.

These findings are significant because public programs such as Medicaid and Children’s Health Insurance Program insure nearly half of the country’s children. Health trends in these populations often reflect broader national patterns. Although physicians and pediatric specialists understand how lifestyle habits affect long-term health, clinical visits rarely provide enough time to address the complex factors influencing a child’s behavior.

Typical pediatric appointments last about 15 minutes. In that short window, clinicians must evaluate growth, address medical concerns, discuss vaccinations, and offer general health advice. Conversations about diet, physical activity, sleep patterns, stress, and family dynamics are often limited.

As a result, families may leave appointments with recommendations such as “eat healthier” or “exercise more,” but without the ongoing guidance needed to implement those changes. This creates what researchers call an implementation gap — a disconnect between medical knowledge and real-world behavior change.

Healthy lifestyle changes are rarely as simple as they sound. Daily habits are shaped by a wide range of social, environmental, and emotional factors.

Families may struggle with busy schedules and limited time for home-cooked meals, financial stress, limited access to healthy foods, school environments that restrict physical activity, cultural traditions around food, emotional relationships with eating, and more.

As Dr. Arielle Levi explains, behavior change requires addressing more than just diet or exercise:

Health coaching goes deeper than simply encouraging behavior change. We’re looking at mindset, family dynamics, and the stories families carry about health. When we work with children, we’re really coaching the entire family.

Addressing these factors requires time, trust, and consistent communication, resources that traditional clinical settings often lack. Pediatric health coaching focuses on helping families create sustainable lifestyle habits through structured, ongoing support. Rather than simply instructing patients what to do, coaches work collaboratively with families to identify achievable goals and develop personalized strategies for reaching them.

Key components of health coaching often include motivational interviewing to explore readiness for change, family-centered goal setting that involves parents and caregivers, habit-building strategies that focus on small, sustainable steps, regular check-ins between clinical appointments, and coordination with physicians and care teams.

The goal is to empower families to take ownership of their health decisions while maintaining accountability and encouragement along the way.

In an interview with The American Journal of Managed Care (AJMC), Dr. Thea Runyan, DrPH, MPH, NBC-HWC, and cofounder and CEO of the Pediatric Health Coach Academy, emphasizes that these programs already have strong evidence behind them:

We know intensive lifestyle behavior change works. It’s recommended by national clinical guidelines, yet many families can’t access these programs because they aren’t covered by insurance.

One of the biggest barriers to implementing health coaching is the lack of reimbursement. Although intensive behavioral programs are recommended by organizations such as the U.S. Preventive Services Task Force and the American Academy of Pediatrics, many insurance plans do not cover coaching services.

This leaves a major gap in care. Dr. Runyan notes:

The services we’re promoting — including one-on-one health coaching — often aren’t covered. That creates a huge access gap for families who could benefit from sustained behavioral support.

Expanding the pediatric health coaching workforce could help fill this void. Trained coaches could support families between clinical visits, helping them implement lifestyle changes that physicians simply do not have time to manage.

Health coaching may also help address disparities in child health outcomes. By working closely with families over time, coaches can identify barriers that clinicians may not see during short office visits. These might include transportation issues, financial constraints, limited access to healthy foods, or high levels of household stress.

Because coaching emphasizes collaboration and cultural understanding, it can help families develop solutions that work within their specific circumstances. This personalized approach may be particularly valuable for underserved communities where rates of obesity and metabolic disease are often higher.

New medications for obesity and diabetes, particularly drugs known as GLP-1 receptor agonists, have attracted significant attention in recent years. While these treatments can be effective for some patients, experts caution that medication alone cannot solve the broader childhood obesity crisis.

Lifestyle habits, environmental factors, and family dynamics still play a critical role in long-term health outcomes. Without consistent behavioral support, even effective medications may fail to produce lasting results. Health coaching could serve as a complementary strategy, helping families maintain healthier habits that reinforce medical treatments.

Dr. Levi highlights the importance of engaging children in ways that feel motivating and positive:

When health coaches are properly trained, kids genuinely look forward to meeting with them. That engagement is incredibly powerful because meaningful change happens when children actually want to participate.

The steady rise in childhood obesity and pediatric diabetes signals that traditional approaches may no longer be enough. While medical research continues to advance, the challenge of translating knowledge into everyday behavior remains one of the biggest barriers to improving child health.

Ultimately, preventing chronic disease may require more than clinical expertise — it may require reimagining how healthcare supports families in their daily lives.

Your responses and feedback are welcome!

Source: “How Health Coaching Could Help Close the Behavior-Change Gap in Pediatric Obesity,” AJMC, 3/10/26
Source: “White Paper: A Workforce Strategy for Pediatric Obesity and Chronic Disease Prevention,” Pediatric Health Coaching, undated.
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The D-Word Makes an Appearance

Pat Hartman March 17, 2026 No Comments

Check out that headline: “Why Is the American Diet So Deadly?” The adjective isn’t “detrimental” or even “dangerous,” but a much more loaded d-word: deadly. Who wrote this thing, anyway? Some show-offy apprentice reporter who thinks that it’s cool to shock the reader? But wait, the “deck” or subhead injects an element of intrigue:

A scientist tried to discredit the theory that ultra-processed foods are killing us. Instead, he overturned his own understanding of obesity.

Of course, no one here suggests that anyone who writes about any topic under the sun must be a professional in that field. Still, it is reassuring that this author possesses credentials up to here. Dhruv Khullar is a practicing physician trained at the Yale School of Medicine and Massachusetts General Hospital, and also holds a master’s degree in public policy, and serves as an associate professor, and a director, and an associate director, and a fellow, and a journalist, all with different institutions.

So, what’s the bad news?

The bad news is contained within a prodigious magazine article, with a word count of 6,393 and a 46-minute listening time. The question: Why does the American diet cause people “to gain weight and develop chronic diseases at such staggering rates?” The author interviewed a man who was taking part in a month-long program designed to shed light on that topic. In order to preserve the strict routine that accounted for every morsel of food taken in, and for each and every unit of expended energy, no patient enrolled in the study was allowed to leave the premises unsupervised.

Visiting him there, Dr. Khullar observed the strict routine that recorded not only those activities but many other measurable factors. Even when the patient had a meal, his visitor had to leave the room, because being observed with the food would influence a person’s behavior, and this experiment was tight, down to the last calorie.

At this point in time, America had pretty much gotten used to the idea that sugar-filled beverages and saturated fats were at the root of the country’s obesity trend. However, the principal investigator of this National Institutes of Health study, Kevin Hall, had another villain in mind, and its name was ultra-processed food. Rather than just sugar and fat, chemical modifications and industrial techniques were beginning to look like the root of the problem.

The author consequently interviewed Hall about the work that he and others had been doing to verify their suspicions:

In recent years, dozens of studies have linked ultra-processed fare to health problems such as high blood pressure and heart attacks, and also to some problems that one might not expect: cancer, anxiety, dementia, early death.

There was even an inexplicable difference between the sexes. Women who consumed the highest amounts of ultra-processed foods had a much greater likelihood of suffering from depression, while men who overindulged in that stuff developed a noticeably increased amount of colon cancer.

Investigating the investigators

Dr. Khullar was even allowed to visit the institution’s kitchen, where cooks followed meticulous instructions designed to isolate the effect of processing. Like an Olympic race that would determine a world championship, cooking time was controlled with a stopwatch.

Consulting research that had been done in many different parts of the world, the visitor learned that it was now considered counterproductive to label individual ingredients, like saturated fat, as the villains. Around 2009, the trend toward laying the blame on processing really took off. Brazilian epidemiologist Carlos Monteiro…

[…] reasoned that something very bad had happened when industrial food systems started churning out cheap, convenient, and tempting foods. He argued that scientists should classify foods by their most unnatural ingredients and by their means of production.

In order to discuss this meaningfully, degrees of processing were delineated. Group 1 means processed minimally or not at all, like eggs and vegetables. Group 2 is the ordinary, traditional stuff that is in everybody’s kitchen: like sugars, oils, butter, and salt. Mix Group 1 with Group 2 ingredients, and you’ve got Group 3 — “processed, but not automatically unhealthy.”

But once we enter the territory where foods are “refined, bleached, hydrogenated, fractionated, or extruded — in other words, when whole foods are broken into components or otherwise chemically modified,” then ultra-processed is the applicable term.

If you can’t make it with equipment and ingredients in your home kitchen, it’s probably ultra-processed.

(To be continued…)

Your responses and feedback are welcome!

Source: “Why Is the American Diet So Deadly?,” NewYorker.com, 01/06/25
Source: “Dhruv Khullar,” NewYorker.com, undated
Image by Leonardoscish/Pixabay

Study: Reducing Parent Stress May Help Prevent Childhood Obesity

Tatyana Meshcheryakova March 13, 2026 No Comments

Childhood obesity has become a growing concern in the United States and around the world. According to the Centers for Disease Control and Prevention (CDC), child and teen obesity is at a record high. While experts have long emphasized healthy eating and regular physical activity as key prevention strategies, new research suggests another factor may play a critical role: parent stress.

A recent study published in the journal Pediatrics indicates that helping parents manage stress more effectively could significantly reduce the risk of obesity in young children. Researchers from Yale University found that parental stress may influence children’s eating habits, family routines, and long-term health outcomes more than previously understood.

Rajita Sinha, who led the research team, said:

It’s the third leg of the stool… We already knew that stress can be a big contributor in the development of childhood obesity. The surprise was that when parents handled stress better, their parenting improved, and their young child’s obesity risk went down.

Previous studies have shown that children with overweight parents are more likely to develop obesity themselves, but stress appears to amplify that risk. When parents are overwhelmed or chronically stressed, family habits can shift in ways that affect children’s health.

Common patterns linked to high parental stress include greater reliance on fast food or convenience meals, less consistent family routines, reduced time for physical activity, and lower levels of positive parenting behaviors, such as patience, warmth, and active listening. These factors can shape children’s eating patterns and lifestyle habits at a young age, setting the stage for long-term health outcomes.

Traditional childhood obesity prevention programs typically focus on nutrition education and increasing physical activity. While these strategies are important, they often fail to create lasting change.

The Yale research team wanted to see whether addressing parent stress directly could improve outcomes. To test this idea, researchers conducted a 12-week randomized prevention trial involving 114 parents with children between the ages of two and five who were already overweight or at risk of obesity. The families represented a diverse range of ethnic and socioeconomic backgrounds.

Parents were assigned to one of two groups (both groups attended weekly sessions lasting up to two hours). The Parenting Mindfully for Health (PMH) program combined mindfulness training, behavioral self-regulation strategies, and guidance on healthy eating and physical activity. The standard health counseling group received education on nutrition and exercise only.

Researchers tracked several factors during the study, including parent stress levels, children’s weight changes, parenting behaviors such as patience, warmth, and communication, and children’s healthy and unhealthy food intake. Children’s weight was also measured three months after the program ended.

The results were striking. Parents who participated in the stress-management program experienced lower stress levels, improved positive parenting behaviors, and healthier food choices for their children. Most importantly, their children showed no significant weight gain three months after the program ended.

In contrast, parents in the standard counseling group did not show improvements in stress or parenting behavior. Their children also experienced significant weight increases, with researchers noting a six-fold higher risk of moving into the overweight or obesity category by the three-month follow-up.

According to Sinha, the combination of mindfulness and self-regulation tools helped parents maintain healthier family habits. She said:

The combination of mindfulness with behavioral self-regulation to manage stress, integrated with healthy nutrition and physical activity, seemed to protect young children from some of the negative effects of stress on weight gain.

The findings highlight how family dynamics and emotional well-being influence childhood health outcomes. Young children rely heavily on their parents to establish daily routines, such as meal planning, grocery shopping, physical activity, and sleep schedules. When parents are under chronic stress — from work, finances, or daily responsibilities — those routines can break down.

The study builds on ongoing work at the Yale Stress Center, an interdisciplinary research group that examines how stress affects physical and mental health.

While the study focused on a structured intervention program, its findings point to several practical strategies families can adopt to support healthier lifestyles:

Make Stress Management a Priority. Simple stress-reduction techniques, such as mindfulness exercises, deep breathing, or short daily breaks, can help parents stay calm and present.
Maintain Consistent Family Routines. Regular meal times, bedtime schedules, and family activities create structure that supports healthy habits.
Focus on Positive Parenting. Warmth, patience, and communication can improve children’s emotional well-being and encourage healthier behavior.
Model Healthy Habits. Children often mirror their parents’ behaviors, including food choices and physical activity levels.
Seek Support When Needed. Parenting can be demanding. Support groups, counseling, or community programs can help families manage stress and build healthier routines.

Looking ahead, future research will examine the long-term impact of stress-management programs like Parenting Mindfully for Health. Larger studies following families over two years are already underway.

If these findings continue to hold, childhood obesity prevention programs may soon expand beyond diet and exercise to include family well-being and stress management, recognizing that a healthy home environment can be just as important as what’s on the dinner plate.

Your responses and feedback are welcome!

Source: “The weight of stress: Helping parents may protect children from obesity,” Yale News, 3/6/26
Source: “Mindfulness Intervention for Parent Stress and Childhood Obesity Risk: A Randomized Trial,” Pediatrics, 3/6/26
Source: “Parents’ stress may be quietly driving childhood obesity, Yale study finds,” ScienceDaily, 3/8/26
Image by Ketut Subiyanto/Pexels

Come At It Sideways

Pat Hartman March 12, 2026 No Comments

In both scientific literature and in mass-market publications and media presentations, there are tons of articles about obesity and young people. This piece by several authors, originally published in the Journal of Adolescent Health, was also placed online by ScienceDirect.com. The full title is “Weight Stigma in Adolescents With Obesity From Low-Income Backgrounds: Qualitative Perspectives From Adolescents and Caregivers.”

It begins by affirming that “Weight stigma is a common experience for adolescents at high weight statuses.” High weight “status” sounds rather impressive, but it only means heavy. Status is a neutral word that simply indicates an individual’s standing in a ranked array. Here, it carries no connotation of being famous, influential, wealthy, etc.

The case is, in fact, exactly the opposite. As society operates today, high weight status coexists with low societal status and low economic status, and quite often with racial minority status. The information was collected from 29 adolescents who had been referred to weight management, and 26 of their caregivers.

The interesting aspect is that the material is derived from a “secondary analysis,” meaning that the subjects were not being directly or intentionally interviewed on the topic of weight stigma. Despite the fact that weight stigma was “not a focus of the interviews,” the young participants nevertheless did make a significant number of remarks incidental to the primary material of the interviews.

Double duty

In other words, two different batches of scientists plumbed the same cache of raw material for two different scholarly investigations, allowing the second group to highlight a situation without even having done the pertinent research on it; thus approaching their topic sideways, or even through the back door. PubMed said,

The present study sought to characterize weight stigma experiences and internalization in adolescents from low-income backgrounds. This was done by reporting on teen’s experiences of weight stigma in daily life and in conversations with health-care professionals, and examining the effect of internalization of this stigma.

So, again, given the broader focus of the primary study, weight stigma was not a concern of the interviews. Science is strict, of course, but as any good detective knows, people who are being questioned will often reveal the most useful information when not talking directly about the “subject at hand.” This collection of interviews turned out to be the perfect illustrative example:

However, almost all participants identified weight stigma and bias as influencing their lives and medical care. Identified themes included the following: (1) difficulty identifying preferences regarding weight-related terminology; (2) commonality of experienced weight stigma; and (3) significant effect of internalized weight bias on adolescent daily living.

In the discussion, the authors characterized the presence of weight stigma as “nearly ubiquitous” amongst the overweight low-income youth of America. Again, these authors emphasized the point: Given that weight stigma was not “a topic within the interview guide,” the discovery of so much of it was “particularly stark.” It was pointed out that attitudes characterized as almost hostile were experienced, “including in health-care settings.”

The participant demographics are described as follows:

65.5% of adolescents identified their gender as female, 34.5% male, and 0% other… 37.9% of adolescent participants identified as Hispanic/Latino, 24.1% identified as Black/African American, 24.1% identified as multiracial, 10.3% identified as non-Hispanic White, and 3.4% identified as Asian.

The authors emphasized the point again, that “nearly all adolescents in the present study identified instances of weight stigma and bias, despite no direct questions regarding this topic.”

Your responses and feedback are welcome!

Source: “Weight Stigma in Adolescents With Obesity From Low-Income Backgrounds: Qualitative Perspectives From Adolescents and Caregivers,” ScienceDirect.com, May 2025
Source: “Weight Stigma in Adolescents With Obesity From Low-Income Backgrounds: Qualitative Perspectives From Adolescents and Caregivers,” PubMed.com, May 2025
Image by DeeDee51/Pixabay

More Obesity-Associated Dangers and Costs

Pat Hartman March 10, 2026 No Comments

Here is a fact about the great majority of news items that fall under the heading of dangers associated with obesity. By strange coincidence, they also belong in the category of obesity costs. For example, a story last fall was headlined, “Obese Children Face Nearly 5-Fold Higher Risk of Fractures, Study Finds.”

Nobody wants to see children suffer fractures, and everyone knows that the repair of broken bones must be paid for somehow. In the journal Scientific Reports, orthopedic surgeons published an article explaining that childhood obesity will influence the details and nuances of fracture patterns not only in specific cases, but also in relation to the overall risk of injury.

The study subjects included almost 18,000 hospitalized children classified as obese, and for comparison purposes, more than 3,000 healthy children. It comes as no surprise that, among these hefty young patients, leg fractures occur much more frequently than other kinds. But broken arms, as well as fractures in the torso and spine, happen very often, too. The least likely bone damage-causing incident for an obese child would be a head injury.

The overweight children tend to have dyslipidemia, which might be caused by heredity, lifestyle, or a combination of the two factors. Among other effects, it causes elevated cholesterol and triglyceride levels. Then, the news gets worse, because as it turns out, even the pre-born are also at risk. The researchers concluded that…

Proactive weight management and careful clinical assessment could play a vital role in safeguarding children’s musculoskeletal health.

Speaking of births…

Over the years, it has become more and more obvious that Cesarean sections lead to obesity, and vice versa. Once a pregnant obese patient’s weight is known, the medical profession is able to predict with startling accuracy the percentage of likelihood that a C-section will be needed. According to Dr. Melissa Riegel, of the Society for Maternal-Fetal Medicine,

Failed induction of labor (IOL) is a leading indicator for cesarean delivery, and cesarean delivery is 80% more likely in patients with obesity undergoing IOL, than in normal-weight patients.

About these cases, many more details are available, but what it all boils down to is that obese mothers and their infants face unfavorable odds for a trauma-free birth experience, and the phrase “maternal morbidity and mortality” is frequently used. Dr. Riegel summed up the situation for a journalist by saying,

There is a role for translational work to investigate the specific biological changes in patients with obesity that might contribute to an increased risk of cesarean delivery and there is also a role for investigating the effectiveness of different labor induction interventions specifically in patients with obesity.

It is also very obvious that pregnant obese women need “clear counseling” (at the very least), but it is equally evident that, by the time an egg has been fertilized, the opportunity for meaningful behavioral change has pretty much passed. It also goes without saying that every stage and aspect of the pregnancy will rack up bills more substantial than those issued to mothers whose weight is in the healthy range.

Your responses and feedback are welcome!

Source: “Obese Children Face Nearly 5-Fold Higher Risk of Fractures, Study Finds,” MedicalDialogues.in, 08/21/25
Source: “Dyslipidemia,” MerckManuals.com, July 2025
Source: “High Cesarean Rates Persist in Obesity Despite Standardized Protocols,” SMFM.org, 03/15/24
Image by taynaraakemi/Pixabay

What, More Costs?

Pat Hartman March 5, 2026 No Comments

A decade ago, we noted that not a single country on earth had been known to experience a declining rate of obesity during its most recent year. In the United States, that signified an enormous win for the food industry, which was selling an additional $20 billion worth of food per annum, thanks to the extra $400 worth of their products being consumed annually by the average American kid, as compared to the previous year.

Of course, the math varies from one country to the next, which in a sinister sense doesn’t even matter, since the overlords who rake in the profits have dominion over the whole planet anyway. While snacking or dining in jets or yachts, they regard themselves as the only genuine world citizens. In each port of call, they know how to obtain the most health-inducing vegetables, fruits, meats, seafood, and beverages to buy with the dimes and dollars of chubby little children far away.

Fun fact: Despite their busy lives, CEOs in the food industry (and every other business) tend to consult medical experts in the fitness field, and are quite likely to spend part of their colossal earnings on a staff member dedicated to helping them stay in admirable physical condition.

Inexorable math

Back in the day, it was Dr. Tim Lobstein, spokesperson for the World Obesity Foundation, who said it best: “Fat children are an investment in future sales.” Here at home, just like everywhere, obviously, every seller’s profit comes at some buyer’s expense. In our case, it was American parents and institutions — everybody who ever bought a doughnut or a burger for a child — who have paid the price.

Of course, by now, many of those overweight young people have taken over the responsibility for paying their own food bills, while in the meantime, all the dire predictions have come true.

Another dimension

In world news, massive attention has been paid lately to both the known and suspected illegal and shameful interference with children, carried out by wealthy and well-known international Important People. Meanwhile, all this time, right in front of our noses, it is totally true and inescapably obvious that children have been perfectly trained and impeccably groomed in another dimension of human behavior. Exactly as intended and predicted, the chunky cherubs of yesteryear have grown into a nation of obedient consumers of empty calories, flashy colors, and harmful, revolting additives.

The cost of obesity to society as a whole is a topic not easy to let go of. For most Americans, every dollar counts, whoever it is spent by and whatever it is spent on. We may disagree on the specifics, but ultimately, a very great majority of people agree on one basic principle: A lot of money is being spent on certain things, which they believe should be spent on something else instead.

Footnote

Incidentally, is there something perversely unmagical about the number 5? As a recent post pointed out,

The total number of babies born in the USA in a year is around 3.6 million. Since about one in five will be obese, that means around 720,000 unhappy fat kids.

In other words, each year, more than half a million young Americans mature into the ranks of the obese youth. In a strange, historically unprecedented twist of fate, a large percentage of young people are physically unfit and, in case the country might need to be defended, ineligible to join the armed forces.

Another unfortunate appearance of the numeral was spotted recently and will be explored further: “Obese Children Face Nearly 5-Fold Higher Risk of Fractures, Study Finds.”

Your responses and feedback are welcome!

Image by Open Clipart-Vectors/Pixabay

CDC: Child and Teen Obesity at Record High

Tatyana Meshcheryakova March 4, 2026 No Comments

Childhood obesity in the United States has reached a troubling new milestone. According to a recent report from the Centers for Disease Control and Prevention (CDC), more than one in five children and teenagers now live with obesity. This is the highest rate ever recorded.

For public health experts, the numbers are not just statistics. They represent a generation at heightened risk for chronic disease and long-term health complications.

The CDC’s latest data, drawn from the long-running National Health and Nutrition Examination Survey (NHANES), show that between 2021 and 2023, 21.1% of U.S. youth ages 2 to 19 had obesity. By comparison, in the early 1970s (1971–1974), that figure stood at just 5.2%.

“This is exceptionally concerning,” said Dr. David Ludwig, professor in the Department of Nutrition at the Harvard T.H. Chan School of Public Health and co-director of the New Balance Foundation Obesity Prevention Center at Boston Children’s Hospital.

Decades ago, Ludwig noted, obesity in children was rare: about one in 20. “And now we’re looking at one in five children with obesity,” he said. Even more alarming: 7% of children now live with severe obesity, up from just 1% roughly 50 years ago.

For a brief period in the early 2010s, there appeared to be progress — at least among the youngest children. Between 2009 and 2010, obesity rates among 2- to 5-year-olds were 12.1%. By 2013–2014, that number had dropped to 9.4%. Experts cautiously celebrated what seemed like a turning point.

But the optimism was short-lived. Today, obesity rates in that same age group have climbed to 14.9%.

Dr. Ludwig said:

We saw that dip and we all got excited thinking that we were beginning to turn the tide… In retrospect, that was more of a statistical aberration, more of a mirage than a true glimmer of hope because the trend overall has continued upward.

The reversal underscores how complex and entrenched the childhood obesity epidemic has become.

Interestingly, while childhood obesity continues to climb, adult obesity rates may be showing early signs of stabilization. In the most recent CDC survey (2021–2023), 40.3% of adults age 20 and older were classified as obese. That’s significantly higher than the 22.9% recorded between 1988 and 1994, but slightly lower than the peak of 42.4% seen in 2017–2018.

Dr. Justin Ryder, associate professor of surgery and pediatrics at Northwestern University Feinberg School of Medicine, warned that past dips have sometimes been statistical blips rather than lasting trends. He said:

Could it just be the people who were sampled, or is it real? We won’t know until we have more data over time.

One factor that may be contributing to the stabilization in adults is the growing use of GLP-1 receptor agonists, a class of medications originally developed to treat Type 2 diabetes. These drugs mimic the GLP-1 hormone, helping regulate blood sugar and signal fullness to the brain. In recent years, several have become household names, including Ozempic, Wegovy, Mounjaro, Zepbound, and more. While these medications are increasingly common among adults, pediatric use remains more limited and carefully regulated.

So, what will it take to reverse the trend in children? Experts say the answer depends on age.

Ages 2–5: Focus on early lifestyle interventions — healthy eating habits, reduced ultra-processed foods, and increased physical activity.

Ages 6–11: Lifestyle changes remain central, though some medications may be appropriate in certain cases.

Ages 12–19: Adolescents with obesity — nearly 23% in the latest survey — may meet criteria for intensive treatment, including medications or, in some cases, bariatric surgery.

Dr. Ryder emphasized the need to apply existing clinical practice guidelines more consistently for adolescents. He said:

I think the only way that we’re going to see a downward trend in that number is if we take that adolescent group […] and actually start to apply the clinical practice guidelines and treat those kids seriously.

The contrast between potentially stabilizing adult obesity rates and record-high childhood obesity underscores a sobering reality: Prevention efforts may be arriving too late for many children. When obesity begins in childhood, it often persists into adulthood, compounding health risks over decades.

The CDC’s latest data represent more than a statistical benchmark. They serve as a warning that without sustained, multi-layered efforts, spanning families, schools, healthcare systems, and public policy, the upward trajectory is unlikely to reverse on its own.

For now, the numbers are clear: One in five American children is living with obesity. Whether this becomes a permanent feature of modern health — or a turning point that sparks renewed action — remains to be seen.

Your responses and feedback are welcome!

Source: “Rising childhood obesity ‘exceptionally concerning,’ says expert,” Harvard T. H. Chan School of Public Health, 2/26/26
Source: “US child, teen obesity rates reach record high while adult trends appear to slow, CDC report finds,” ABC News, 2/24/26
Image by Bulat Khamitov/Pexels

What Is Childhood Obesity’s Price Tag?

Pat Hartman March 3, 2026 No Comments

No regular visitor to this blog is surprised to learn that there is still more to be said about the cost of obesity to our society as a whole. We all end up paying for it in some way, shape, or form. It is important to keep making this point — but not to ignite in people the sort of anger that hangs in the atmosphere, all too ready to descend upon those who are considered unacceptable in some way, by those who are too ready to judge.

Childhood Obesity News was created because of a deeply felt need to help prevent any child from experiencing extreme unhappiness in her or his early years. Of course — and this fact is indisputable — obesity is not the most glaringly obvious potential cause of childhood misery — certainly not as noticeable as a cleft palate, for instance. And in the United States, that problem is usually repaired so early that the child does not even retain a memory of it.

But for the sake of a thought experiment, we pretend for a moment that the birth defect is left unrepaired, and pick some arbitrary numbers just to make a point. Let’s propose that the emotional cost of going through childhood with such a visible deformity is a whopping 72 Misery Units. During a year in America, around 2,500 children are born with a cleft lip and/or palate. So that would be 180,000 Misery Units collectively apportioned to all of them.

Another factor enters the picture

In that same year, about one in five of all babies born will spend their childhoods being obese. But compared to facial disfigurement, that is a relatively mild level of unhappiness — call it 8 Misery Units.

For an individual child, a cleft palate left unrepaired would undoubtedly cause a ton of misery, compared to the unhappiness experienced by one of the obese kids. That would add up to an extreme amount of grief, which society as a whole should definitely put its best efforts toward fixing. But, to add another factor into the reckoning, for every facially disfigured child born in any given year, nearly 300 are born who will join the childhood obesity ranks.

The total number of babies born in the USA in a year is around 3.6 million. Since about one in five will be obese, that means around 720,000 unhappy fat kids. In other words, approximately 300 obese children for each facially disfigured child.

And even at the relatively low number of only 8 Misery Units apiece, the childhood obesity grand total would still multiply out to a truly impressive 5,760,000 Misery Units… against a measly 180,000 Misery Units among the kids who need plastic surgery. By that standard, childhood obesity is by far the more devastating problem.

The point

Most obese children will at some point — hopefully not too often — experience unpleasant (though relatively civilized) reactions from grownups. Probably, the average overweight young teenager will be on the receiving end of heedlessly uninhibited reactions from, and interactions with, their fellow juvenile acquaintances. And strangers.

Then, most of these youngsters will probably go on to become obese older teenagers, who might seek to assuage their unhappiness by adopting or substituting new bad alcohol or drug habits for the old bad eating habits. If their obesity is beyond what the average American is willing to overlook, finding a job might be difficult. When an obese young adult decides to marry and settle down, there is a strong likelihood that the partner will also be obese, and then, an even stronger probability that the offspring of that union will also be obese.

Point being, even if the average case of obesity is nowhere near as harrowing as an amputated limb or visible burn scar or tragically ineradicable birthmark; even though an individual case of obesity might imaginatively be called a mere 8 Misery Unit problem, there are so many of them that society as a whole is weighed down by the cost of all those amassed, accumulated Misery Units. And incidentally, a lot of the cases involve monetary costs which, we pointedly mention again, are paid by society as a whole.

Your responses and feedback are welcome!

Image by Elf-Moondance/Pixabay

Distribution of Debt

Pat Hartman February 26, 2026 No Comments

A recent post raised the subject of how the expenses of obesity tend to be distributed throughout the entire society. A glaring example is the very noticeable cost of medical facilities, which need enormous buildings to house them, and quite a lot of space for parking lots, and huge amounts of power to keep the lights on 24/7, as well as to run all the complicated machinery.

Whether on its own premises or outsourced, a hospital must have an infallible laundry service. Even when administered by a charitable organization, this institution has to operate as a business, taking into consideration such needs as insurance and adequate staffing in every department.

It has to maintain a fleet of ambulances and other vehicles. It must stock significant amounts of supplies, from pencils and rolls of tape to bottles of vital infusions, to food for the patients, staff, and visitors. For obvious safety reasons, many items used in hospitals, like the business end of a hypodermic needle, are single-use, requiring efficient and infallible means of disposal. This is especially true of hazardous waste like used dressings (aka bandages), which, if not properly segregated from regular garbage and conscientiously destroyed, could spread the very diseases which hospitals are supposed to defeat.

A bigger size means a higher price

With large numbers of large patients, more money is necessary to keep the place functioning. The needed equipment, whether bought or rented, has to be on the premises. If not, it will need to be obtained quickly, which usually means extra expense. Or maybe because of that lack, the patient must be transferred and transported to a different facility, for a hefty price.

Because the hospital needs a piece of industrial-strength equipment designed to lift a morbidly obese patient from one surface and set that patient down undamaged on another surface, the bills of everyone in the institution must rise incrementally. The same inflexible economic rule applies to every other item added to the inventory to accommodate overweight patients, and for each obesity specialist who needs to be hired, and so on.

An awe-inspiring example

Depending on attachments and degree of customization, a hospital “bariatric bed” designed to hold someone weighing up to 600 pounds can be had for around $1,300 to $3,300 (and north of that figure). A decade ago, such a specialized item might, like some other commodities, have been proudly, truthfully, and crudely described as “a fat investment opportunity.”

From here and there

A typical paper in the field summarizes the cost of treating childhood obesity in Brazil over the decade ending in August of 2022, noting that such expenses encompass several categories including direct medical costs, procedures, inpatient hospital stays of whatever length, outpatient doctor visits, medications, preparations (like normal saline) that are not prescription drugs but nevertheless must be paid for, and miscellaneous.

Analysts then attempt to grasp the implications their statistics present, and apply the new knowledge to not only gain a more accurate understanding of the overall situation, but to update official policy according to the results of their calculations. Some of the pertinent answers they seek include an understanding of what causes regional differences in prices, how hospitalization costs are calculated, and what this says about the overall policies.

Elsewhere

A more recent report, this one from Greece, encompassed the total burden imposed by obesity on that country’s economy in the year 2024. Both direct and indirect costs were calculated, in what the author characterizes as “a societal perspective.” The amount attributable to obesity was found to be 4.92 billion euros (almost 5 billion dollars), which was equivalent to 2.07% of the country’s Gross Domestic Product for that year. The author summarized,

Obesity imposes a considerable economic burden on Greece, threatening the sustainability of the healthcare system and broader social well-being. Immediate and drastic coordinated, multisectoral, and multidisciplinary strategies are needed to curb the prevalence and fiscal impact of obesity.

At approximately the same time, this was going on in the USA, as told by Newsweek. About one out of every five children (almost 15 million altogether) fell into the obese category, most of them being from racial minorities and low-income families. This came as no surprise to anyone who had been paying attention to their unequal access to healthful foods, safe recreational spaces, or adequate medical care. Of course, COVID-19 played a role, as children experienced a rate of annual weight gain nearly double that of the pre-pandemic years.

Naturally, all of this costs the American healthcare system a lot more than would have been the case if childhood obesity were not so widespread.

Your responses and feedback are welcome!

Source: “A fat investment opportunity,” Moneyweb.co.za, 04/16/15
Source: “Amount Spent Per Hospitalization For Childhood Obesity In The Years 2012 To August 2022 In Brazil — Epidemiological Review,” Typeset.io, 03/02/23
Source: “The Economic Cost of Obesity: A Cost-of-Illness Study in Greece,” Springer.com/ 08/27/25
Source: “’Extremely Severe’ Obesity on the Rise in US Children—Study,” Newsweek.com, 07/20/25
Image by geralt/Pixabay

Childhood Obesity Treatment Gap

Tatyana Meshcheryakova February 25, 2026 No Comments

Childhood obesity continues to rise at an alarming rate in the United States, mirroring trends seen in adults but with even more concerning long-term implications. Today, more than 150 million Americans are living with obesity, including roughly 15 million children. While most people recognize that obesity is linked to serious conditions such as Type 2 diabetes, heart disease, and sleep apnea, fewer realize that these illnesses are increasingly affecting younger populations.

One of the most troubling aspects of obesity is that its impact compounds over time. The longer the body carries excess weight, the greater the cumulative stress placed on organs, metabolism, and overall health. When obesity begins in childhood, that timeline of exposure becomes significantly longer — often leading to more severe complications in adulthood.

Evan P. Nadler, M.D., the founder of ProCare Consultants and ProCare TeleHealth, penned an article for Clinical Leader, providing his take on why excluding children from clinical trials might present obstacles in the proper treatment of childhood obesity with weight loss drugs.

He wrote:

With most diseases, the longer you have it, the worse it gets. Obesity is no different. The damage is cumulative. It’s not just about how much you weigh — it’s about how long your body has been exposed to that weight. So one would think that the imperative to find solutions for childhood obesity would be front and center for those who are involved in clinical research involving the next generation of anti-obesity medicines. Unfortunately, that isn’t the case.

Despite this urgency, children remain largely underrepresented in the rapidly advancing field of anti-obesity drug development.

The landscape of obesity treatment has changed dramatically in recent years. Breakthrough medications have transformed how clinicians approach weight management, offering new hope for patients who previously had limited options.

Recent approvals from the U.S. Food and Drug Administration have brought injectable treatments such as semaglutide and tirzepatide into mainstream medical practice, with studies showing substantial weight loss outcomes. Researchers are also developing oral versions of these medications, along with next-generation therapies like orforglipron, maritide, and retatrutide.

Some of these emerging treatments target multiple metabolic pathways at once. In clinical trials, triple-receptor therapies have demonstrated weight-loss results comparable to bariatric surgery — an outcome that was nearly unimaginable just a decade ago.

However, most of these advancements are focused on adult populations. Currently, only a limited number of GLP-1–based medications are approved for adolescents ages 12 and older. Even then, options remain restricted, and some require daily injections, which can be difficult for younger patients to maintain. Meanwhile, several promising drugs remain years away from pediatric approval.

Why children are often left out of clinical trials

A major reason for the treatment gap lies in how clinical trials are structured. Pharmaceutical companies typically complete adult trials first before expanding research into pediatric populations. While safety considerations play a role, regulatory frameworks also contribute to delays.

In the United States, pediatric studies are encouraged but not always required early in the drug development process. Companies may postpone these trials until adult approvals are secured, which often results in multi-year delays before children gain access to new therapies.

This delay can create arbitrary access gaps. For example, a medication approved for an 18-year-old may not be available for a 17-year-old — even though the medical condition is essentially identical.

Because adult markets are larger and more profitable, pediatric studies are often deprioritized. Unfortunately, this approach overlooks the long-term health benefits of early intervention.

How Europe takes a different approach

Regulatory policies differ internationally. Within the European Union, pharmaceutical companies must submit a Pediatric Investigation Plan before completing adult trials for new medications. While the pediatric studies themselves may still occur later, the requirement ensures that children are part of the development strategy from the beginning. This structured planning process has resulted in more consistent pediatric drug research compared to the U.S., where early inclusion is often optional.

Despite groundbreaking progress in obesity pharmacotherapy, many of the newest medications still lack clear pediatric development timelines. Public regulatory databases show limited planning for children in several ongoing drug pipelines, reinforcing concerns that young patients may wait years before benefiting from new therapies.

The contrast is striking. Innovation is accelerating, yet access remains uneven.

The growing childhood obesity crisis highlights the need for a shift in how treatments are developed and approved. Early intervention — whether through lifestyle programs, behavioral care, or medical therapy — can dramatically change long-term health outcomes.

As new anti-obesity medications continue to reshape treatment possibilities, experts increasingly call for regulatory reforms that prioritize pediatric inclusion from the start. Without that change, millions of children may remain on the sidelines of one of the most significant medical advancements in metabolic health.

Dr. Nadler wrote:

So what does this all mean for children with obesity in the U.S.? Despite all the GLP-1- development, children are not part of the gameplan… The time has come for the FDA to rethink how it approaches clinical trials in children for the sake of the 15 million children with obesity…

Your responses and feedback are welcome!

Source: “The Problem With Excluding Children From GLP-1 Trials In The U.S.,” Clinical Leader, 2/19/26
Source: “Obesity and Overweight: Developing Drugs and Biological Products for Weight Reduction,” FDA, January 2025
Image by Anna Shvets/Pexels

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Investigating the investigators

Study: Reducing Parent Stress May Help Prevent Childhood Obesity

Come At It Sideways

Double duty

More Obesity-Associated Dangers and Costs

Speaking of births…

What, More Costs?

Inexorable math

Another dimension

Footnote

CDC: Child and Teen Obesity at Record High

What Is Childhood Obesity’s Price Tag?

Another factor enters the picture

The point

Distribution of Debt

A bigger size means a higher price

An awe-inspiring example

From here and there

Elsewhere

Childhood Obesity Treatment Gap

Why children are often left out of clinical trials

How Europe takes a different approach

Profiles: Kids Struggling with Weight

The Book

About Dr. Robert A. Pretlow

Presentations