A study published in Pediatrics suggests that childhood obesity increased during the pandemic—likely because of children having to stay at home, as well as other societal conditions surrounding Covid-19 shutdowns, Kim Tingley reports for the New York Times Magazine.

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Childhood obesity increases

For the study, researchers measured the body mass index (BMI) of patients ages 2 to 17 in the Children's Hospital of Philadelphia care network, which includes 29 clinics in the Philadelphia area, between January 2019 and December 2020.

The researchers classified any child with a BMI equal to or higher than the 95th percentile as obese. They then compared average obesity rates from June 2019 to December 2019, before the Covid-19 pandemic began, to June 2020 to December 2020, after the pandemic had struck.

In total, the researchers analyzed 500,417 visits and found that obesity rates increased from 13.7% to 15.4%. The increase was relatively higher in children ages five to nine and in children who were Hispanic, non-Hispanic Black, publicly insured, or from low-income families.

Similarly, a separate study published in April in the journal Diabetes Care found that, compared to previous years, 2020 saw a greater increase in the number of children who arrived at Children's Hospital Los Angeles with a severe case of diabetic ketoacidosis stemming from new-onset Type 2 diabetes.

According to Lily Chao, interim medical diabetes director at the hospital and lead author on the study, the increase could be related to children eating poorer-quality food and not moving as much during pandemic-related lockdowns. Another factor may be that parents delayed seeking care for their children's symptoms until they reached diabetic ketoacidosis out of fear of contracting the coronavirus.

Discussion

According to the authors of the Pediatrics study, it's likely that social distancing efforts undertaken to stem the coronavirus's spread contributed to increases in childhood obesity.

"Families with children have faced the difficulties of managing virtual schooling, limited physical activity, and increased reliance on more heavily processed and calorie-dense foods," the researchers wrote. "For disadvantaged families, many of the risk factors that have been shown to promote weight gain during the summer months are present in this pandemic."

The absence of in-person schooling also likely contributed to childhood obesity increases, Tingley reports. Typically, schools serve more nutritionally balanced meals than the ones children eat elsewhere, and schools also require children to eat on a regular schedule and prevent them from snacking throughout the day. Further, schools offer students the opportunity for physical activity, which some children don't otherwise have, Tingley writes.

Brian Jenssen, a pediatrician at Children's Hospital of Philadelphia and lead author on the Pediatrics study, said the study shows how societal influences can drive childhood obesity—especially because so much of the weight increase occurred in patients who were just five to nine years old. "They're not making those individual choices," he said. "They're influenced by the environment." (Tingley, New York Times Magazine, 6/29).