US Pharm. 2015;40(5):11.

In 2012, more than 33% of children and adolescents were overweight or obese. In adolescents aged 12 to 19 years, obesity increased from 5% in 1980 to 21% in 2012. According to the 2013 National Youth Risk Behavior Survey, 14% of high school students were obese.

Health Education: Instruction in health topics was a requirement for 69% of high school students, covering 14 topics on nutrition and dietary behavior (53%) and 13 topics on physical activity (38%). Despite this, 14% of students did not eat breakfast, 19% did not drink milk, and 11% drank a can, bottle, or glass of soda three or more times per day. About 52% of high school students did not try to lose weight, whereas the rest resorted to weight-control behaviors such as not eating for 24 hours (13%), taking diet pills (5%), and vomiting or taking laxatives (4.4%). Except for not attempting to lose weight, the prevalence of such behaviors was significantly greater among boys.

Ethnicity and Grade Level: Not eating for 24 hours was the most common behavior in high school students who wanted to control their weight. Asians (21.4%) topped the list, followed by whites (16.2%), non-Hispanic blacks (13.3%), Hispanics (12%), and American Indians (12%). Taking diet pills was most common among Asians (11.2%), followed by whites (7.1%). Vomiting or taking laxatives was most common among whites (6.7%), followed by Hispanics (5.4%), Asians (5.1%), and non-Hispanic blacks (3.7%). The prevalence of not eating for 24 hours decreased as students advanced from 9th grade to 12th grade (9th, 14%; 10th, 13.7%; 11th, 12.5%; 12th, 11.7%). However, the reverse order obtained in students who took pills to lose weight (9th grade, 3.4%; 10th, 4.6%; 11th, 5.5%; 12th, 6.8%). Adolescents who were African American, American Indian, or Hispanic, especially if living in poverty, experienced worse outcomes in various areas, including obesity.

Physical Activity: A two-pronged approach involving dietary control and increased physical activity has been documented to be effective for slowing the rate of weight gain. Although physical education was a requirement for nearly all students (95%), 52% took no physical education classes during the week and 46% did not play on a sports team, whether school- or community-run.

Health Effects: A 2-year-old child who is obese is more likely to be obese as an adult, and the same holds true for adolescents. Obese youths (70%) had at least one risk factor for cardiovascular disease, such as high cholesterol or high blood pressure; they also exhibited an increased likelihood of social and psychological problems, such as stigmatization and poor self-esteem.

To comment on this article, contact