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# Understanding Youth and Adolescent Overweight and Obesity: Resources for Families and Communities (page 2)

By University of Florida IFAS Extension
Updated on Jul 26, 2007

How do we determine who is overweight? Let's consider the example of a woman who is 5'4" and weighs 165 pounds. When we apply the formula used to compute BMI (weight (lb) / [height (in)]2 x 703), we find that this woman has a BMI of 28.3. A healthy BMI ranges from 18.5 to 24.9, so the woman is considered overweight.

For adults, if a BMI score is between 25 and 29.9, a person is considered overweight. If a BMI score is 30 or above, this is deemed obesity. You can find a BMI calculator for adults online at http://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htm . A BMI calculator for children and teens is at http://apps.nccd.cdc.gov/dnpabmi/Calculator.aspx .

There are three categories of obesity. Class I obesity is defined as a BMI score of 30-34.9, and Class II obesity is defined as a BMI of 35-39.9. Lastly, Class III obesity, also known as morbid obesity or severe obesity, is defined as a BMI score of 40 or higher. Based on these numbers, as many as one-third of all Americans are considered obese.

### Calculating BMI for Children and Adolescents

Now let's consider the example of a child who is 13 years old, 5'4", and weighs 180 pounds. Based on her height and weight, this child's BMI is 30.9, placing her BMI-for-age at the 98th percentile for girls her age. According to the table below, because this teen's body mass is above the 95th percentile, she may be overweight. She should be seen by a healthcare provider for further assessment.

BMI-for-age weight status categories and the corresponding percentiles are shown in the following table.

 Weight Status Category Percentile Range Underweight Less than the 5th percentile Healthy weight 5th percentile to less than the 85th percentile At risk of overweight 85th percentile to less than the 95th percentile Overweight Equal to or greater than the 95th percentile

### Who is Most Affected?

Rates of youth obesity vary among different groups. According to the National Health and Nutrition Examination Survey (NHANES), African-American, non-Hispanic girls and Mexican-American boys are the groups most likely to be obese (Mullen & Shield, 2004). In the 2006 review of the NHANES, these populations continued to have the largest numbers of adolescents classified as "at risk for overweight" or "overweight" (Ogden et al, 2006, p.1551). 13% of the Caucasian adolescent girls studied were obese, but 24% of African American girls and 20% of the Mexican-American girls were obese (Kumanyika & Grier, 2006). African-American females remain at the highest risk, and have substantial rates of obesity-related diseases and causes of death. However, Mexican-American males are more likely to be obese than African-American males. Native Americans also exhibit higher risk of obesity (Mullen & Shield, 2004). Asian-American adolescents have the lowest rates of overweight and obesity.

### Influences and Causes of the Problem

Obesity rates are increasing among all ages, educational levels, and ethnic groups. There are many factors that can increase the risk of adolescent obesity, including school pressures, family conflict, and environmental influences. However, parents, the community, and schools can make a difference when it comes to preventing and solving the problem of overweight and obesity in adolescents.

#### Parental Influence

Parents play the key role in developing a healthy home environment. They shape their children's environment by deciding on the quality and quantity of foods that they provide to them. They decide when children should eat and help determine the amount and type of exercise children receive. As the number of dual-earner families has increased, changes to the family system have emerged. Overall, parents are spending less time being active with their children, cooking less nutritious food, and letting their children spend more time in front of the computer or television.

How much children exercise, how they eat, and whether or not they are overweight often has a lot to do with the examples set by their parents. It is not uncommon for obesity to run in families. Research shows that children who have one or two obese parents are more likely to be obese as adults (Guo, Roche, Chumlea, Gardner, & Siervogel, 1994). Genetics may play a part, but so does the example that parents set. Research has shown that eating dinner together as a family promotes healthful eating habits among children and adolescents. This practice increases children's consumption of whole grains, fruits, and vegetables and decreases their consumption of soft drinks and fats (Goran & Sothern, 2006).

#### Community Influences

The local community is the first social group that youth encounter beyond their families, and it plays a central role in their development. Many communities have taken active steps in response to the increase in obesity in youth and the general population. For instance, some have changed town planning practices to encourage more walking, more green space, and more recreational activities. Other communities have made policies limiting the number of fast food restaurants and vending machines in areas where youth gather, such as in and near schools and recreation centers.

Researchers are also looking at the connections between children's surroundings and their behavior. If children do not have a safe place to play near their homes, they may spend more time indoors being inactive. Unfortunately, as the numbers of pedestrian injuries and deaths climb, parents become more cautious about safety, and are more likely to keep their children away from natural environments. The community environment can affect children's weight by shaping their eating habits and level of physical activity.