Indiana ranks in the middle of the U.S. when it comes to childhood obesity rates for those 10-17 years old, with about 2-in-13 youth being dangerously overweight.

Along with the physical dangers of being obese, obesity in youth can also be damaging to a child’s mental health as they make their way through adolescence and into adulthood, health officials said.

As has been shown in annual studies, obesity in children also shows disparities by race and income, with low-income children more likely to be seriously overweight and with Black and Hispanic children having much higher rates of obesity.

The new numbers from the Robert Wood Johnson Foundation’s newest annual report, which draws data from the 2019-2020 National Survey of Children’s Health, along with analysis conducted by the Health Resources and Services Administration’s Maternal and Child Health Bureau.

Indiana’s obesity rate for youth 10-17 years old was 15.6%, which put it slightly behind the national average of 16.2%.

Obesity is defined as having a Body Mass Index of 30 or above, a ratio of a person’s weight against their height. A person is considered underweight with a BMI lower than 18.5, overweight at 25-30 and obese at 30-plus.

Indiana is actually best in the local region, lower than Illinois at 17.4% and Ohio at 17.2%, with Michigan one slot ahead of the Hoosier start at 15.7%. To the south, Kentucky is worst in the nation at 23.8%.

Although Indiana is slightly better than the national average when it comes to youth age 10 and older, Indiana’s adult obesity rate is 35.3%, above the national average and one of the worst in the nation.

“The state of childhood obesity in America is an urgent call to action for leaders at all levels and across all sectors,” said Jamie Bussel, senior program officer at the Robert Wood Johnson Foundation who leads the Foundation’s efforts to prevent childhood obesity. “Obesity is a symptom of deep-rooted challenges that have only been made worse by the pandemic and are a warning sign that our nation’s policies are failing our kids. We must make real, systemic change to set kids on a path to better health.”

The Robert Wood Johnson Foundation’s study shows continuing disparities by income and race.

High-income youth have the lowest obesity rate at 8.6%, while the lowest income bracket has the highest obesity rate at 23.1%.

Obesity was also higher among Black and Hispanic children, at 23.8% and 21.4%, respectively, sharply higher than white children at 12.1% and Asian children at 8.1%.

Obesity in children brings many of the same dangers as obesity in adults, said Dr. Duane Hougendobler, chief of pediatrics for Parkview Physicians Group.

While children won’t have the same risk factors of things like heart attack or stroke that adults would have as they age — obesity is a long-term chronic problem that bogs down and strains the body and its organs — it can present short-term complications to kids, too, he said.

“The risk of obesity is with the whole glucose and fat metabolism. You have high cholesterol and high lipids. For kids, more unique to kids, is much more lower self-esteem, depression,” Hougendobler said.

Children can also potentially suffer some orthopedic issues if their weight causes discs to slip, fat deposits on their liver can cause liver damage at a young age and breathing issues include obstructive sleep apnea can impact a child and their ability to rest, which then impacts growth, metabolism and brain function.

“A lot of stress on the system that you can’t undo,” Hougendobler said.

Mental health is also a risk factor, as being overweight as a child can lead to teasing, bullying and lower self-esteem in youth, which may open the door to conditions including anxiety and depression.

“Part of what we’re doing in PPG now, anyone 11 or older kind of gets a quick mental health screen for anxiety and depression. It helps us kind of cue into when these kids are having issues. I would say weekly I have a conversation or more about bullying and all the stuff that happens around their life, then you get the self-esteem issues especially with the young ladies. That is not the style you see in the magazine and movies and stuff so they really feel it. It’s a big issue and we tell parents to watch for that,” Hougendobler said.

Obesity can impact anyone, but childhood obesity can often be a familial issue. Children with obese parents may be more likely to become obese themselves.

There can be genetic components that play into that, but often the impact on children can be attributed to lifestyle factors in their home, such as how active the family is and what kind of food is being consumed in the house.

Children do have some ability to control how active they are, whether they actively play or get exercise during their day, but diet is often dependent on their parents because kids don’t get to do the grocery shopping.

Low-income families tend to have higher obesity rates because many low-income families also consume higher quantities of low-quality food that’s high in fats, carbohydrates and sugars. With less nutritional value and more filler, families may find their waistlines expanding faster.

“We’re really coming down on sugars are the big culprit, so trying to stay as low-carb a diet as they can,” Hougendobler said. “It just means instead of having snacks that are high in sugar, let’s have fruits or vegetables or things like that, pushing more to fruits, vegetables, whole grains.”

Sugar doesn’t mean candies and baked goods and sodas. Other high-carbohydrate foods including breads and pastas can cause weight gain, so finding substitutes to those starchy foods can be helpful.

Hougendobler said families who want to change their diet should do so slowly. Extreme changes are likely to fail, so households should aim to improve one thing at a time, a month at a time, until eventually their diet is better.

He also advised parents to cut down on their kids ability to snack. Setting up one place in the house to eat, like the kitchen table, and not allowing food elsewhere helps to cut back on snacking. If children have to get up and go to a boring place to eat, they often won’t, as opposed to chomping chips in front of the TV.

Physical activity is also key to fighting obesity, and kids should be active at least an hour a day. Playing outside, going for walks, even doing chores can also help kids stay active.

Screen time is a risk factor — children that spend more than four hours a day in front of screens are much more likely to be overweight than kids who get less than two hours of screen time per day. Hougendobler also advised to not put a TV in a child’s room, as it’s been shown to greatly increase their screen time as opposed to TVs located in communal parts of the house.

COVID-19 has likely exacerbated the problem, as stay-at-home orders and advice kept youth at home where it’s likely they were less active. Now that students are back to school, playing at recess, taking part of physical education class and staying active are key, Hougendobler said.

Some children will grow out weight problems as they enter high school. Children sometimes develop a “pre-puberty pudge,” Hougendobler said, but then as they hit their growth spurt will reach a more healthy weight and weight distribution.

Hougendobler expressed the importance of annual physicals with a doctor, because then a primary care physician can continue to monitor a child’s weight and height to determine whether they are seeing improvement or at risk of carrying obesity into adulthood.

The Robert Wood Johnson Foundation also offered some national policy suggestions for fighting childhood obesity.

Those include making free school meals for all students — which has been available during the pandemic — a permanent feature in public schools to ensure students have access to healthy meals if they need them; extending eligibility of the low-income WIC food program from 2 years old to 6 years old; continuing programs that can reduce poverty for low-income families such as the expanded Child Tax Credit; and closing the Medicaid gap for low-income families to ensure they maintain access to health care services.

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