A weighty issue: addressing pandemic-related obesity in primary care

Brian Jenssen, MD, MSHP Brian Jenssen, MD, MSHP Brian Jenssen, MD, MSHP, is a primary care pediatrician at Children’s Hospital of Philadelphia, assistant professor at the Perelman School of Medicine at the University of Pennsylvania, Medical Director for Value-based Care in CHOP’s Care Network, and a faculty member at PolicyLab and the Center for Pediatric Clinical Effectiveness.

In addition to getting your patients vaccinated against the novel coronavirus, making sure they’re up to date on their other vaccines, and being extra alert for pandemic- induced (or -exacerbated) mental health problems, here’s one more item for your checklist: heightened risk of obesity.

Strategies to protect families from COVID-19, like “shelter-at- home” recommendations, made it difficult for youth to engage in physical education and physical activity for all of 2020 and much of 2021. The pandemic also disrupted family routines and with more time at home, increased access to unhealthy snacks.

To explore this issue further, my colleagues and I looked at rates of obesity for patients visiting Children’s Hospital of Philadelphia’s Care Network. We measured body mass index (BMI) for patients aged 2 to 17 years monthly from January 2019 to December 2020 and compared them to obesity rates prior to the pandemic.

What we found is concerning. Average obesity prevalence increased from 13.7% to 15.4% and was particularly pronounced among patients aged 5 to 9 years and Hispanic, non-Hispanic Black, publicly insured, and lower-income youth. While a 2% increase may seem small, this translates to an additional 6 000 children in the CHOP Care Network, or an additional 1.5 million children nationally, who are now obese. Our study also suggests that during the pandemic, preexisting disparities in obesity significantly widened.

A similar study that examined the BMI changes in 432 302 children in IQVIA’s Ambulatory Electronic Medical Records database also found that kids who were obese before the pandemic gained significantly more weight during 2020 than their peers who began the pandemic at a healthy weight.

What can a busy pediatrician do? Pediatricians can immediately help by educating families about these concerns and recommending virtual activities that promote increased physical activity. They can connect families to nutritious meals offered through community settings and focus on ways to remain safe and active outside the home, such as going to parks, walking, and biking. Pediatricians can also advocate for broader policies to promote better nutrition and greater physical activity, as well as advocate for high-quality recess in schools.

References and additional reading

Jenssen B, Kelly M, Powell M, et al. COVID-19 and changes in child obesity. Pediatrics. 2021;147(5); e2021050123.

Lange S, Kompaniyets L, David S. Freedman D, et al. Longitudinal trends in body mass index before and during the COVID-19 pandemic among persons aged 2-19 years — United States, 2018–2020. MMWR Morb Mortal Wkly Rep. 2021;70(37):1278-1283.

Jenco M. Report: COVID pandemic exacerbating obesity risk factors. AAP News. https://publications.aap.org/aapnews/news/15867. October 13, 2021. Accessed December 7, 2021.

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