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Accountability * Integrity * Reliability
United States Government Accountability Office
Washington, DC 20548
October 7, 2005
Subject: Childhood Obesity: Most Experts Identified Physical Activity
and the Use of Best Practices as Key to Successful Programs
In the past 30 years, the number of obese children' has increased throughout the
United States, leading some policy makers to rank childhood obesity as a critical
public health threat. The rate of childhood obesity has more than tripled for children
between the ages of 6 and 11 and also increased for children of other ages over the
same period.2 According to a 2005 Institute of Medicine (IOM) report, there are
approximately 9 million children nationwide over the age of 6 who are considered
obese.3 An important consequence of childhood obesity is the increasing number of
children experiencing illnesses and other health problems associated with obesity,
such as hypertension and type II diabetes. The rise in obesity-related health
conditions also introduces added economic costs. Between 1979 and 1999, obesity-
associated hospital costs for children between the ages of 6 and 17 more than tripled,
from $35 million to $127 million.4 Moreover, because studies suggest that obese
children are likely to become overweight or obese adults-particularly if the children
are obese during adolescence-the increase in the number of obese children may
'In this report, the term "obese" refers to children who are considered both overweight and at risk for
overweight according to the Centers for Disease Control and Prevention (CDC) standards for child-
specific body mass index (BMI) scores, as well as both overweight and obese adults. BMI is an indirect
measure of body fat calculated as the ratio of a person's body weight in kilograms to the square of a
person's height in meters. According to CDC's 2000 growth charts, children are overweight when their
BMI is at or above the 95h percentile for their age and gender, while children between the 85' and 95th
percentile are considered at risk of being overweight. BMI for children, also referred to as BMI-for-age,
is gender and age specific because the percentage of body fat in children changes as they grow and
because body fat in girls and boys differs. Adults are considered overweight when their BMI is
between 25.0 and 29.9 and obese when their BMI is 30.0 or above. In addition, in this report, the term
"children" refers to anyone under the age of 18.
2These data are for children at or above the 95th percentile of BMI for age and gender. Cynthia L.
Ogden, Katherine M. Flegal, Margaret D. Carroll, and Clifford L. Johnson, "Prevalence and Trends in
Overweight Among US Children and Adolescents, 1999-2000," JAMA, vol. 288, no. 14 (2002) and Allison
A. Hedley, Cynthia L. Ogden, Clifford L. Johnson, Margaret D. Carroll, Lester R. Curtin, and Katherine
M. Flegal, "Prevalence of Overweight and Obesity Among US Children, Adolescents, and Adults, 1999-
2002," JAMA, vol. 291, no. 23 (2004).
3Institute of Medicine, Preventing Childhood Obesity: Health in the Balance (Washington, D.C.:
National Academies Press, 2005).
4These data are in 2001 dollars and reflect the change from 1979-1981 to 1997-1999. Guijing Wang and
William H. Dietz, "Economic Burden of Obesity in Youths Aged 6 to 17 Years: 1979 - 1999," Pediatrics,
vol. 109 (2002).
GAO-06-127R Childhood Obesity
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United States. Government Accountability Office. Childhood Obesity: Most Experts Identified Physical Activity and the Use of Best Practices as Key to Successful Programs, text, October 7, 2005; Washington D.C.. (https://digital.library.unt.edu/ark:/67531/metadc299223/m1/1/: accessed April 21, 2019), University of North Texas Libraries, Digital Library, https://digital.library.unt.edu; crediting UNT Libraries Government Documents Department.