Adolescents and Obesity A Resource Guide

Since 1980, the prevalence of obesity among youth ages 12-19 years has more than tripled from 5% to 16%, according to the National Center for Health Statistics. In children and adolescents, "obesity" is defined as a BMI (body mass index) greater than the 95th percentile for BMI for age. Children and adolescents with a BMI greater than or equal to 85th but less than the 95th percentile are considered "overweight."

Obesity has become the most common medical condition of children. Obesity in young people has been associated with increased serum lipids, decreased hepatic function (non-alcoholic steatorrheic hepatitis), increased blood pressure, impaired glucose tolerance and risk for diabetes mellitus type 2, sleep apnea with resultant school problems, slipped capital femoral epiphyses, Blount disease (tibia vara), and psychosocial consequences including stigmatization and victimization from bullying. There is increasing consideration of identifying the metabolic syndrome, the clustering of abdominal obesity with hypertension, insulin resistance, and dyslipidemia, in adolescents.

Obstetrician-gynecologists will be concerned with obesity in young women in evaluation of menstrual disturbances, especially when considering polycystic ovary syndrome (PCOS), in selection and follow-up of hormonal contraceptives, and in prenatal care. The ACOG Committee on Adolescent Health Care has recommended that all adolescents be screened annually by calculating BMI from height and weight and asking about eating patterns. A BMI table reproduced from the AMA Guidelines for Adolescent Preventive Services is included in the in the ACOG Tool Kit for Teen Care

The following resources are available from ACOG:

American College of Obstetricians and Gynecologists.Obesity in Adolescents. In: Guidelines for Adolescent Health Care. Washington, DC:ACOG; 2011.

American College of Obstetricians and Gynecologists. Fact sheet: media and body image. In: Tool kit for teen care. 2nd ed. Washington, DC: ACOG; 2009.

American College of Obstetricians and Gynecologists. Fact sheet: physical activity. In: Tool kit for teen care. 2nd ed. Washington, DC: ACOG; 2009.

American College of Obstetricians and Gynecologists. Fact sheet: weight management. In: Tool kit for teen care. 2nd ed. Washington, DC: ACOG; 2009.

American College of Obstetricians and Gynecologists. Primary and preventive health care for female adolescents. In: Tool kit for teen care. 2nd ed. Washington, DC: ACOG; 2009.

The resources listed below are for information purposes only. Referral to these sources and sites does not imply the endorsement of ACOG. Further, ACOG does not endorse any commercial products that may be advertised or available from these organizations or on these web sites. These lists are not meant to be comprehensive. The exclusion of a source or site does not reflect the quality of that source or site. Please note that sites and URLs are subject to change without notice.

REFERENCES FOR PROFESSIONALS

General

Bradford NF. Overweight and obesity in children and adolescents. Prim Care 2009;36:319-39.

Chaloupka FJ, Johnston LD. Bridging the gap: research informing practice and policy for healthy youth behavior. Am J Prev Med 2007;33:S147-61.

Farhat T, Iannotti RJ, Simons-Morton BG. Overweight, obesity, youth, and health-risk behaviors. Am J Prev Med 2010;38:258-67.

Gahagan S. Child and adolescent obesity. Curr Probl Pediatr Adolesc Health Care 2004;34:6-43.

Hill JO, Trowbridge FL, editors. The causes and health consequences of obesity in children and adolescents [special issue]. Pediatrics 1998;101(3 suppl).

Kiess W, Boettner A. Obesity in the adolescent. Adolesc Med 2002;13:181-90, viii.

Kohn M, Booth M. The worldwide epidemic of obesity in adolescents. Adolesc Med 2003;14:1-9.

Krebs NF, Jacobson MS. Prevention of pediatric overweight and obesity. American Academy of Pediatrics Committee on Nutrition. Pediatrics 2003;112:424-30.

Ornstein RM, Jacobson MS. Supersize teens: the metabolic syndrome. Adolesc Med Clin 2006;17:565-87.

Padgett J, Biro FM. Different shapes in different cultures: body dissatisfaction, overweight, and obesity in African-American and Caucasian females. J Pediatr Adolesc Gynecol 2003;16:349-54.

Peebles R. Adolescent obesity: etiology, office evaluation, and treatment. Adolesc Med State Art Rev 2008;19:380-405, vii.

Rao G. Childhood obesity: highlights of AMA Expert Committee recommendations. Am Fam Physician 2008;78:56-63.

Ruben AR. Undernutrition and obesity in indigenous children: epidemiology, prevention, and treatment. Pediatr Clin North Am 2009;56:1285-302.

Schneider MB, Brill SR. Obesity in children and adolescents. Pediatr Rev 2005;26:155-62.

Steinbeck K. Obesity and nutrition in adolescents. Adolesc Med State Art Rev 2009;20:900-14. 

Styne DM. Childhood and adolescent obesity [special issue]. Pediatr Clin North Am 2001;48(4).

Zametkin AJ, Zoon CK, Klein HW, Munson S. Psychiatric aspects of child and adolescent obesity: a review of the past 10 years. J Am Acad Child Adolesc Psychiatry 2004;43:134-50.

Assessment

Barton M. Screening for obesity in children and adolescents: US Preventive Services Task Force recommendation statement. US Preventive Services Task Force. Pediatrics 2010;125:361-7.

Dietz WH, Story M, Leviton LC, editors. Issues and implications of screening, surveillance, and reporting of children's body mass index [special issue]. Pediatrics 2009;124(suppl 1).

Goodman E, Hinden BR, Khandelwal S. Accuracy of teen and parental reports of obesity and body mass index. Pediatrics 2000;106:52-8.

Complications

Artz E, Haqq A, Freemark M. Hormonal and metabolic consequences of childhood obesity. Endocrinol Metab Clin North Am 2005;34:643-58, ix.

Clinton Smith J. The current epidemic of childhood obesity and its implications for future coronary heart disease. Pediatr Clin North Am 2004;51:1679-95, x.

Eisenberg ME, Neumark-Sztainer D, Story M. Associations of weight-based teasing and emotional well-being among adolescents. Arch Pediatr Adolesc Med 2003;157:733-8.

Ford ES, Li C. Defining the metabolic syndrome in children and adolescents: will the real definition please stand up? J Pediatr 2008;152:160-4.

Goran MI, Ball GD, Cruz ML. Obesity and risk of type 2 diabetes and cardiovascular disease in children and adolescents. J Clin Endocrinol Metab 2003;88:1417-27.

Hannon TS, Rao G, Arslanian SA. Childhood obesity and type 2 diabetes mellitus. Pediatrics 2005;116:473-80.

Janssen I, Craig WM, Boyce WF, Pickett W. Associations between overweight and obesity with bullying behaviors in school-aged children. Pediatrics 2004;113:1187-94.

Morrison JA, Friedman LA, Harlan WR, Harlan LC, Barton BA, Schreiber GB, et al. Development of the metabolic syndrome in black and white adolescent girls: a longitudinal assessment. Pediatrics 2005;116:1178-82.

Mustillo S, Worthman C, Erkanli A, Keeler G, Angold A, Costello EJ. Obesity and psychiatric disorder: developmental trajectories. Pediatrics 2003;111:851-9.

Rimmer JH, Rowland JL, Yamaki K. Obesity and secondary conditions in adolescents with disabilities: addressing the needs of an underserved population. J Adolesc Health 2007;41:224-9.

Schwimmer JB, Burwinkle TM, Varni JW. Health-related quality of life of severely obese children and adolescents. JAMA 2003;289:1813-9.

Strauss RS, Pollack HA. Social marginalization of overweight children. Arch Pediatr Adolesc Med 2003;157:746-52.

Sukalich S, Mingione MJ, Glantz JC. Obstetric outcomes in overweight and obese adolescents. Am J Obstet Gynecol 2006;195:851-5.

Swallen KC, Reither EN, Haas SA, Meier AM. Overweight, obesity, and health-related quality of life among adolescents: the National Longitudinal Study of Adolescent Health. Pediatrics 2005;115:340-7.

Taras H, Potts-Datema W. Obesity and student performance at school. J Sch Health 2005;75:291-5.

Taylor ED, Theim KR, Mirch MC, Ghorbani S, Tanofsky-Kraff M, Adler-Wailes DC, et al. Orthopedic complications of overweight in children and adolescents. Pediatrics 2006;117:2167-74.

Thompson DR, Obarzanek E, Franko DL, Barton BA, Morrison J, Biro FM, et al. Childhood overweight and cardiovascular disease risk factors: the National Heart, Lung, and Blood Institute Growth and Health Study. J Pediatr 2007;150:18-25.

Weiss R, Dziura J, Burgert TS, Tamborlane WV, Taksali SE, Yeckel CW, et al. Obesity and the metabolic syndrome in children and adolescents. N Engl J Med 2004;350:2362-74.

Williams J, Wake M, Hesketh K, Maher E, Waters E. Health-related quality of life of overweight and obese children. JAMA 2005;293:70-6.

Epidemiology

Ackard DM, Neumark-Sztainer D, Story M, Perry C. Overeating among adolescents: prevalence and associations with weight-related characteristics and psychological health. Pediatrics 2003;111:67-74.

Amisola RV, Jacobson MS. Physical activity, exercise, and sedentary activity: relationship to the causes and treatment of obesity. Adolesc Med 2003;14:23-35.

BeLue R, Francis LA, Colaco B. Mental health problems and overweight in a nationally representative sample of adolescents: effects of race and ethnicity. Pediatrics 2009;123:697-702.

Berkey CS, Rockett HR, Colditz GA. Weight gain in older adolescent females: the internet, sleep, coffee, and alcohol. J Pediatr 2008;153:635-9, 639.e1.

Daratha KB, Bindler RC. Effects of individual components, time, and sex on prevalence of metabolic syndrome in adolescents. Arch Pediatr Adolesc Med 2009;163:365-70.

Gauthier BM, Hickner JM, Ornstein S. High prevalence of overweight children and adolescents in the Practice Partner Research Network. Arch Pediatr Adolesc Med 2000;154:625-8.

Goodman E, Whitaker RC. A prospective study of the role of depression in the development and persistence of adolescent obesity. Pediatrics 2002;110:497-504.

Gordon-Larsen P, Adair LS, Nelson MC, Popkin BM. Five-year obesity incidence in the transition period between adolescence and adulthood: the National Longitudinal Study of Adolescent Health. Am J Clin Nutr 2004;80:569-75.

Haas JS, Lee LB, Kaplan CP, Sonneborn D, Phillips KA, Liang SY. The association of race, socioeconomic status, and health insurance status with the prevalence of overweight among children and adolescents. Am J Public Health 2003;93:2105-10.

Harris KM, Perreira KM, Lee D. Obesity in the transition to adulthood: predictions across race/ethnicity, immigrant generation, and sex. Arch Pediatr Adolesc Med 2009;163:1022-8.

Johnson WD, Kroon JJ, Greenway FL, Bouchard C, Ryan D, Katzmarzyk PT. Prevalence of risk factors for metabolic syndrome in adolescents: National Health and Nutrition Examination Survey (NHANES), 2001-2006. Arch Pediatr Adolesc Med 2009;163:371-7.

Larson N, Story M. The adolescent obesity epidemic: why, how long, and what to do about it. Adolesc Med State Art Rev 2008;19:357-79, vii.

Li J, Hooker NH. Childhood obesity and schools: evidence from the national survey of children's health. J Sch Health 2010;80:96-103.

Ogden CL, Carroll MD, Curtin LR, Lamb MM, Flegal KM. Prevalence of high body mass index in US children and adolescents, 2007-2008. JAMA 2010;303:242-9.

Patrick K, Norman GJ, Calfas KJ, Sallis JF, Zabinski MF, Rupp J, et al. Diet, physical activity, and sedentary behaviors as risk factors for overweight in adolescence. Arch Pediatr Adolesc Med 2004;158:385-90.

Van Cleave J, Gortmaker SL, Perrin JM. Dynamics of obesity and chronic health conditions among children and youth. JAMA 2010;303:623-30.

Treatment/Prevention

Active healthy living: prevention of childhood obesity through increased physical activity. Council on Sports Medicine and Fitness; Council on School Health. Pediatrics 2006;117:1834-42.

Barlow SE. Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Expert Committee.

Pediatrics 2007;120(suppl 4):S164-92.

Copperman N, Jacobson MS. Medical nutrition therapy of overweight adolescents. Adolesc Med 2003;14:11-21.

Gonzalez-Suarez C, Worley A, Grimmer-Somers K, Dones V. School-based interventions on childhood obesity: a meta-analysis. Am J Prev Med 2009;37:418-27.

Inge TH, Krebs NF, Garcia VF, Skelton JA, Guice KS, Strauss RS, et al. Bariatric surgery for severely overweight adolescents: concerns and recommendations. Pediatrics 2004;114:217-23.

Inge TH, Zeller M, Garcia VF, Daniels SR. Surgical approach to adolescent obesity. Adolesc Med Clin 2004;15:429-53.

Khan UI, Collier M. Medical interventions in adolescent obesity. Adolesc Med State Art Rev 2008;19:406-20, viii.

Kohn M, Rees JM, Brill S, Fonseca H, Jacobson M, Katzman DK, et al. Preventing and treating adolescent obesity: a position paper of the Society for Adolescent Medicine. J Adolesc Health 2006;38:784-7.

Love-Osborne K. An approach to obesity management in primary care: yes, we can make a difference. Adolesc Med State Art Rev 2009;20:91-108, ix.

Murray PJ. Bariatric surgery in adolescents: mechanics, metabolism, and medical care. Adolesc Med State Art Rev 2008;19:450-74, ix.

Neumark-Sztainer D. Preventing obesity and eating disorders in adolescents: what can health care providers do? J Adolesc Health 2009;44:206-13.

Roth CL, Reinehr T. Roles of gastrointestinal and adipose tissue peptides in childhood obesity and changes after weight loss due to lifestyle intervention. Arch Pediatr Adolesc Med 2010;164:131-8.

Shaya FT, Flores D, Gbarayor CM, Wang J. School-based obesity interventions: a literature review. J Sch Health 2008;78:189-96.

Story M, Sallis JF, Orleans CT. Adolescent obesity: towards evidence-based policy and environmental solutions. J Adolesc Health 2009;45:S1-5.

Zidenberg N, Wright S. Care of the overweight adolescent including polycystic ovarian syndrome. Clin Obstet Gynecol 2008;51:249-56.

Wisotsky W, Swencionis C. Cognitive-behavioral approaches in the management of obesity. Adolesc Med 2003;14:37-48.

Xanthakos SA. Nutritional deficiencies in obesity and after bariatric surgery. Pediatr Clin North Am 2009;56:1105-21.

Ward-Begnoche W, Speaker S. Overweight youth: changing behaviors that are barriers to health. J Fam Pract 2006;55:957-63

BOOKS - Books listed in this resource guide often may be found in university, secondary school, and/or public libraries along with similar books on this topic.

Professionals

Burniat W, Cole TJ, Lissau I, Poskitt EM, editors. Child and adolescent obesity: causes and consequences, prevention and management. New York (NY): Cambridge University Press; 2002.

Fibkins WL. Teen obesity: how schools can be the number one solution to the problem. Lanham (MD): Rowman & Littlefield Education; 2006.

Hassink SG. Pediatric obesity: prevention, intervention, and treatment strategies for primary care. Elk Grove Village (IL): American Academy of Pediatrics; 2007.

Institute of Medicine (US). Preventing childhood obesity: health in the balance. Washington, DC: National Academies Press; 2005.

Parents

Berg FM. Underage and overweight: America’s childhood obesity crisis--what every family needs to know. New York (NY): Hatherleigh Press; 2004.

Hassink SG, editor. A parent’s guide to childhood obesity: a road map to health. Elk Grove Village (IL): American Academy of Pediatrics; 2006.

Rimm SB, Rimm E. Rescuing the emotional lives of overweight children: what our kids go through--and how we can help. Emmaus (PA): Rodale; 2004.

Tartamella L, Herscher E, Woolston C. Generation extra large: rescuing our children from the epidemic of obesity. New York (NY): Basic Books; 2004.

Organizations/Websites (Many of these have a broad variety of patient/family educational materials about obesity, nutrition, diet, and exercise.)

American Academy of Child and Adolescent Psychiatry
www.aacap.org

American Academy of Family Physicians
www.aafp.org

American Academy of Pediatrics
www.aap.org

American Alliance for Health, Physical Education, Recreation & Dance
www.aahperd.org

American Dietetic Association
www.eatright.org

American Heart Association
www.heart.org

Centers for Disease Control and Prevention: Bam! Body and Mind
www.bam.gov

Centers for Disease Control and Prevention: Healthy Youth
www.cdc.gov/HealthyYouth/index.htm

Center for Young Women’s Health
www.youngwomenshealth.org

ETR Associates
www.etr.org

Journeyworks Publishing
www.journeyworks.com

National Agriculture Library: Nutrition.gov
www.nutrition.gov

National Association for Health and Fitness
www.physicalfitness.org

National Child Obesity Foundation
www.ncof.org

National Heart, Lung and Blood Institute
www.nhlbi.nih.gov

NHLBI Health Information Center
www.nhlbi.nih.gov/health/infoctr/index.htm

The Obesity Society (formerly American Obesity Association)
www.obesity.org

United States Department of Agriculture: MyPyramid.gov
www.mypyramid.gov 

Contact:

Caitlin Phelps, MA
Director of Gynecology
clinical@acog.org

Lyndona Charles
Special Assistant, Gynecology and Ethics
lcharles@acog.org