Healthy Behaviors for Fighting Teenage Obesity

Many health agencies refer to obesity in America as an epidemic. According to the Centers for Disease Control and Prevention (CDC), roughly 42% of Americans are considered obese, an increase of more than 10% over the past two decades. The problem affects every demographic, including children. Among the young ages, 2 to 19, the prevalence of obesity was just over 19% as recently as 2018, affecting about 14.4 million children, according to the CDC. Teenagers, in particular, are among the groups most impacted.

Prevention is one of the most effective ways to combat the obesity epidemic, particularly for young people. Healthy behaviors, including maintaining a balanced diet and exercising, are key to reducing the risk of obesity and its negative impact on health. Practicing these behaviors at a young age is critical, as obese children are more likely to remain obese as they get older. Families, educators, nurses, and other health care professionals have an important role in helping teenagers and younger children live healthier lives and overcome obesity by promoting healthy behaviors and strategies.

Teenage Obesity: Prevalence and Impact

Children are generally considered obese if their weight is more than 20% greater than the ideal weight for their height and age, according to the American Academy of Pediatrics (AAP). The CDC reports that the percentage of children affected by obesity more than tripled over the past few decades. In the early 1970s, the percentage of obese children was just over 5.2%. Today, nearly 1 in 5 children are considered obese.

The prevalence of obesity among children varies by age group. According to the CDC, 13.4% of children ages 2 to 5 were obese as of 2017-18. The percentage of children ages 6 to 11 considered obese was 20.3% during this timeframe Teenagers had the highest prevalence of obesity, with 21.2% of children ages 12 to 19 considered obese. Numbers steadily climbed each year since 2000.

The State of Childhood Obesity project provides a few other notable statistics regarding teenage obesity:

• According to the 2019 Youth Risk Behavior Surveillance System, 15.5% of high school students were considered obese, while another 16.1% were overweight.
• Teenagers in minority groups—including Native American (21.3%), Black (21.1%), and Latino (19.2%) teens—tend to experience higher rates of obesity than white teenagers (13.1%).
• Obesity rates are higher among teen boys (22.5%) than girls (19.9%).

Causes of Obesity in Teens

Biological and behavioral factors contributing to obesity in teenagers are:

• Genetics
• Metabolism
• Negative childhood events
• Poor sleep habits
• Community and neighborhood design and safety
• Diet
• Physical activity

Unhealthy dietary habits and lack of exercise are among the most common causes of childhood obesity. Teenagers are at particular risk of spending too much time on sedentary activities, such as watching television or using mobile devices like phones and tablets. According to a 2019 report by Common Sense Media, teenagers spend upward of seven hours a day on a screen, while many experts suggest that children should be limited to no more than two hours of screen time a day. Conversely, practicing healthy behaviors, such as eating a balanced diet and getting enough exercise, are key to helping teenagers prevent and overcome obesity.

Effects of Obesity in Teens

Obesity can take a significant toll on a teenager’s physical, mental, and emotional health. It can put a child at increased risk for many chronic health issues, such as:

• Diabetes
• Hypertension and other forms of heart disease
• Chronic joint pain
• Breathing problems, such as asthma and sleep apnea

Obese children also have a greater risk for severe illness from COVID-19 infection, according to the American Academy of Pediatrics. In addition to physical health, obesity can negatively impact a teenager’s emotional health. Social stigmas related to being overweight may subject obese teenagers to low self-esteem and bullying, which can lead to poor school performance and persistent psychological problems such as anxiety and depression.

If left unaddressed, obesity can have far-reaching negative effects throughout a teenager’s life. Weight discrimination can reduce an overweight teen’s chances of acceptance at a prestigious university or landing a good job compared with thinner peers, according to the AAP.

Resources for More Information about Teenage Obesity

The issue of teenage obesity is pervasive. It can stem from many different causes and have numerous adverse health impacts. The following are additional resources to better understand the scope and impact of obesity among teenagers and children of all age groups:

• Childhood Obesity Facts, Centers for Disease Control and Prevention: The CDC provides many facts and figures related to childhood obesity, with detailed breakdowns based on gender, socioeconomic status, and other factors.
• Body-Mass Index (BMI) in Children, American Academy of Pediatrics: The AAP provides information on childhood obesity and body mass index (BMI), including a tool to calculate a child’s BMI based on age, height, and weight.
• Prevention and Management of Childhood Obesity and its Psychological and Health Comorbidities, National Center for Biotechnology Information: This article provides additional information and statistics on the negative health impacts of obesity in children, including its effects on their physical and mental health.

Healthy Behaviors to Combat Teenage Obesity

Although teenage obesity is a serious issue, teens and the people in their lives can employ strategies to help prevent and overcome it.

Healthy Behaviors for Teenagers

Incorporating healthy behaviors can help teenagers overcome or minimize the risk of obesity. These include:

Diet

The Dietary Guidelines for Americans, 2020-2025—a product of the U.S. Department of Agriculture (USDA) and the U.S. Department of Health and Human Services (HHS)—provide guidance on healthy dietary habits, including information geared toward teens and other children. The guidelines emphasize eating fruits and vegetables, whole grains, various lean proteins, and low-fat and fat-free dairy products while limiting foods and beverages with added sugars, solid fats, and sodium.

Physical Activity

The Physical Activity Guidelines for Americans from the HHS recommends that children ages 6 to 17 participate in at least 60 minutes of moderate to vigorous physical activity every day. While any kind of physical activity is beneficial, ideal activities include aerobic exercise (running, swimming, biking), muscle-strengthening activities (climbing, pushups), and bone-strengthening activities (basketball, tennis).

Screen Time

Teenagers should reduce the amount of time they spend in front of a screen.According to the AAP, the number of hours a child spends on a screen is directly related to BMI and calories consumed per day. Johns Hopkins Medicine recommends no more than two hours of daily screen time for children. Replacing just one hour of screen time with an hour of physical activity has numerous health benefits.

Sleep

Getting enough sleep also minimizes a teenager’s risk of becoming overweight or obese. The American Academy of Sleep Medicine recommends teenagers get eight to 10 hours of sleep per day. Additionally, obese children often suffer from sleep apnea or some other form of disrupted breathing during sleep, which may further exacerbate the issue.

Tips and Strategies for Parents and Families

Teenagers need support from people around them, particularly family members, to prevent or overcome obesity. The AAP provides these tips for parents and families to help teenage children practice healthy behaviors:

• Make healthy foods easily accessible: Have fruits, vegetables, and other low-calorie snacks readily available to encourage healthier eating habits and reduce the tendency to graze on snacks with limited nutritional value.
• Limit screen time: Parents should monitor screen time and enforce limitations to ensure that their teenager isn’t spending more than two hours per day in front of a screen. This is a challenging task since screens are often used for schoolwork, blurring the line between entertainment and education.
• Promote physical activity: Parents should encourage teenagers to find time for exercise, whether through organized sports, family walks or hikes, visits to a local park, or playing in the backyard.
• Encouragement: Simply encouraging healthy behaviors and providing positive feedback—while avoiding criticism of bad habits—is beneficial to establishing healthier habits. Set an example by eating healthy foods and participating in physical activity.

Tools and Approaches for Teachers and Educators

According to the CDC, most children spend six hours a day in school and consume about half of their daily calories at school. Therefore, teachers and educators have an important role in helping teenagers overcome obesity.

• Nutrition education programs can help students develop healthy dietary habits, including recognizing when their emotions are influencing their eating habits.
• The Salad Bars to Schools program is a public-private partnership that promotes and sponsors salad bars in schools to get students to eat more fruits and vegetables and other healthy food items. As of 2018, the program helped get salad bars into more than 5,000 schools nationwide.
• Teachers and other school staff can positively influence students by modeling healthy behaviors, such as being physically active and consuming healthy foods.

Additional Resources to Help Teens Practice Healthy Behaviors

Support from parents and educators is crucial for preventing and countering obesity in teenagers. Both groups can help teens develop habits to improve their diet and remain active. The following resources can help guide families and schools to reduce the risk of obesity in teenagers:

• Healthy Active Living for Families, American Academy of Pediatrics: The AAP provides a list of tips for families to help their children eat healthier and remain active.
• Tips to Help Children Maintain a Healthy Weight, Centers for Disease Control and Prevention: The CDC provides guidance on how to help children get enough exercise and develop healthy eating habits, including suggestions for low-calorie snacks, with links to additional resources.
• School Nutrition, Centers for Disease Control and Prevention: The CDC provides recommendations for schools to implement policies and practices to create an environment that supports students in making healthy lifestyle choices, with links to information on school meals, healthy eating learning opportunities, and more.

Promoting Healthy Behaviors

No child is the same. Parents and children must work with nurses and other health care professionals to develop healthy lifestyle habits based on their individual needs. Health care interventions for childhood obesity typically focus on long-term behavioral adjustments (eating healthier, exercising) and weight maintenance therapies, which can include counseling.

The medication also can be beneficial—particularly for weight loss management and the treatment of obesity-related health conditions—but should be used in conjunction with other treatments. Screenings can help pinpoint the severity of a child’s weight problem and assess the risk for chronic health conditions related to obesity. These screenings, which the AAP recommends, can be performed during wellness visits:

• All children should receive an annual obesity screening using the BMI formula. Pediatricians with expertise in this area can help obese children within their practice or refer them to a comprehensive weight management program.
• Children ages 10 and older who are at or near the threshold for obesity using the BMI formula should undergo screening with a fasting glucose test every two years. Those found to have Type 2 diabetes or prediabetes can be referred to a pediatric endocrinologist.
• All children should receive screenings for high blood pressure annually.

Nurses are a critical resource for obesity interventions for children. Due to the size and skill set of the workforce, nurses are uniquely equipped to lead such interventions, working directly with patients and carrying out initiatives across the community, health care, and education settings.

School nurses also are valuable allies in the fight against childhood obesity. They can develop, promote, and implement a host of obesity prevention strategies in schools, including the following:

• School wellness policies that include guidance on nutrition and physical activity
• Individual counseling to support healthy behaviors
• Obesity education to students, parents, and school communities
• Safe walk-to-school and bike-to-school programs
• Nutritional school meals
• Referrals to health care providers for further assessment and treatment

In cases of children with severe obesity—approximately 4.5 million children nationwide, according to the AAP—weight loss surgery may be necessary. These children are at even greater risk for chronic health conditions, such as diabetes and high blood pressure, and traditional diet and exercise may not be enough to help them. In such cases, the AAP recommends a team-based approach involving primary care providers, surgeons, mental health specialists, and dietitians, as well as families, to make an informed decision about whether surgery is the right option.

Addressing Teenage Obesity

Obesity affects millions of teenagers and other children across the country, as well as their families. Fortunately, many strategies exist to help overcome this epidemic. Promoting and practicing healthy behaviors, such as eating nutritious food and getting enough exercise are two of the most effective ways to address teenage obesity. These measures, along with others, can reduce the risk of obesity and its associated health complications.

Children must practice these behaviors at a young age to prevent becoming obese adults. Nurses play a vital role in supporting teenagers and their families in the fight against obesity. By educating and providing guidance to parents and teens, nurses are instrumental in helping teens develop healthy behaviors. Meta Description Healthy behaviors are critical to combat teenage obesity. Learn more about this epidemic and how families, schools, and nurses are helping teens fight it.