Overweight Among U.S. Children and Adolescents

Continuing increases in overweight among children and

adolescents are of public health concern. Older children who

are overweight are at greater risk of becoming overweight or

obese adults. This is of concern because the risk for adverse

health outcomes increases with overweight and obesity in

adulthood. In adults, overweight and obesity are associated

with increased risk for heart disease, diabetes, high blood

pressure and stroke, high blood cholesterol, certain types of

cancer, arthritis, and breathing problems.

Overweight prevention should focus on improving the

balance between caloric intake and energy expenditure. The

Dietary Guidelines for Americans recommend that children

and adolescents 2 years of age and older choose a healthful

assortment of foods that includes vegetables; fruits; grains

(especially whole grains); fat-free or low-fat milk products;

and fish, lean meat, poultry, or beans. The guidelines also

recommend that children get at least 60 minutes of physical

activity daily and limit inactive forms of play such as

television watching and computer games.

Defining overweight in children and

adolescents

Measurements of height and weight help to assess the

overall health and nutritional status of children and

adolescents. To identify children and youth who are

overweight, measures of height and weight are combined in

the body mass index (BMI). BMI is calculated as weight in

kilograms divided by the square of height in meters. BMI is

now the recommended tool to screen for overweight in

children.

The 2000 CDC growth charts show BMI-for-age. These

charts can be used to identify children and adolescents with

expected growth patterns and those who may require further

evaluation. However, growth charts are only a first level

screening tool. Further clinical assessment by a health care

provider should be done when values fall outside the

expected range.

Using age- and sex-specific reference data from the

2000 CDC BMI-for-age growth charts, children and youth

can be categorized as acceptable, underweight, at risk of

overweight, or overweight. At age- and sex-specific BMI

values below the 5th percentile, children may be

underweight. From the 5th up to the 85th percentile, they

have an acceptable weight. From the 85th to 95th percentile,

they are at risk of being overweight. At the 95th percentile

and above, children and adolescents are classified as

overweight.

National data on overweight among children

and adolescents

The most accurate national data on overweight come

from heights and weights measured as part of the National

Health and Nutrition Examination Survey (NHANES) and

previous health examination surveys.These surveys show the

current prevalence of overweight and trends in overweight

over time.

Prevalence of overweight

The prevalence of overweight by age, sex, and raceethnic group is shown in table 1, based on data from

NHANES III (1988–94). Within every age and sex group

about 10 percent of children and adolescents were

overweight. There were some race-ethnic differences in the

percentages of overweight boys and girls (table 1). Among

boys, the highest percentage of overweight occurred among

Mexican Americans. Among girls, the highest percentage of

overweight occurred among non-Hispanic blacks followed

by Mexican Americans. The lowest percentage of overweight

occurred among non-Hispanic white girls.
Trends from the 1960s to the 1990s

The percentage of overweight children and adolescents

increased over three decades from the 1960s to the 1990s

(figure 1). As shown in the figure:

+ The percentage of overweight children (6–11 years of

age) increased from 4 percent in 1965 to 13 percent in

1999.

+ The percentage of overweight adolescents (12–19 years of

age) increased from 5 percent in 1970 to 14 percent in

1999.

+ The increase was similar among boys and girls.

Table 1. Percentage of overweight children and adolescents by

sex and race-ethnic group, United States, 1988–94

Sex and race-ethnic group 6–11 years 12–19 years

Boys

Total ..................... 11.8 11.3

Non-Hispanic white ............ 10.9 11.6

Non-Hispanic black ............ 12.3 10.7

Mexican American ............ 17.7 14.1

Girls

Total ..................... 11.0 9.7

Non-Hispanic white ............ 9.8 8.9

Non-Hispanic black ............ 17.1 16.3

Mexican American ............ 15.3 13.5

Figure 1. Trends in overweight (BMI ≥ 95th percentile):

United States

1963-70 1971-74 1976-80 

1988-94 1999 

15 

10 

5 

0 

Boys 6-11 Girls 6-11 Boys 12-19 Girls 12-19 

years years years years 

SOURCE: CDC/NCHS; NHES II/III (1963-70), NHANES I (1971-74), NHANES II (1976-80), 

NHANES III (1988-94), NHANES 1999 

For more information about NHANES, please visit the

NHANES Web site:http://www.cdc.gov/nchs/nhanes.htm.

To learn more about the CDC growth charts, visit the

Web site: http://www.cdc.gov/growthcharts

02-0422

Percent