Since the 1980’s, the incidence and prevalence of childhood obesity has risen dramatically, and continues to do so. Recent estimates describe an increase in the affected number of children to have risen 50% or more in the last 20 years. This now places some 17 million children at risk, and the trend is worldwide. This is considered a global epidemic, especially with urbanization of so many areas of the globe. Many factors attribute to this cause, and while genetics may play a role, behaviors are the major reason for the recent acceleration. Behavioral therapies likewise are the key areas for targeting measures of intervention.
        The more longstanding concern is that the increase in childhood obesity will lead to greater numbers of adult obesity, as well as co-morbidities. These are conditions that are linked to obesity such as diabetes, high blood pressure, elevated cholesterol, coronary disease, obstructive sleep apnea syndrome and various metabolic syndromes. Even now the occurrence of these conditions in adolescence and early adulthood are increasing, and if significant changes do not ensue, these will become major health issues in the next several decades.
        Unfortunately, there are yet to be clearly accepted definitions for childhood obesity. It appears that current standards among most pediatricians describe children as being at risk if they consistently exceed 85% of normal growth charts, and clinically overweight if they exceed 95%. These measures do not necessarily take into account height in combination with weight. Body Mass Index (BMI) is a standard used in adults that calculate figures based on height and weight. If this is more than 25, an adult is considered overweight, and if more that 30, obese. There is now a trend for similar BMI calculations for children and teens to define their status as well by the CDC and other organizations. This information can be accessed from the CDC website, http://www.cdc.gov .
        Interestingly, there are different risks for childhood obesity depending on what region of the country you live. In the US, urban and metropolitan areas have the highest risk, as does the southeastern, northeastern and midwest regions. Western regions, especially Colorado, Utah, Wyoming and New Mexico have the lowest risk. In addition, seasonal changes occur with an increase of childhood obesity in winter and fall months and a decrease during summer months. Outside of the US, trends also support a higher risk in urban areas. As described below, specific behavioral risks likely account for these regional differences in obesity prevalence.