While other countries are beginning to remove the restrictions put in place to reduce the spread of the novel coronavirus, the pandemic is still active in the U.S., and America’s children are suffering after months under the precautions which keep them stuck at home, often trapped indoors. Kids who otherwise would be playing sports, or at least running around at recess and playing in public parks, are sitting indoors, reading books and playing video games and eating for comfort: a perfect formula for losing muscle and gaining fat. In an interview for USA Today, economist Diane Whitmore Schanzenbach, a Northwestern University professor, said, “We were making slow and steady progress until this. It’s likely we will have wiped out a lot of the progress that we’ve made over the last decade in childhood obesity.”
Obesity has long been a topic which is difficult to discuss in the U.S. Obese people are often scorned as immoral “gluttons,” and the illnesses they suffer as a result of their obesity – including a higher risk of death or disability from COVID-19 – are often dismissed by those who feel obese people have “brought it on themselves.” The fact that during the pandemic the country also has an extremely controversial President who is himself morbidly obese, a fact which he frequently tries to deny, showing that he is self-conscious about it himself, is making the matter even harder to deal with. One of the President’s frequent defenders, Sean Hannity, recently spoke dismissively of reports of obesity contributing to the danger the President was in when he contracted the coronavirus, pretending to be unfamiliar with the term, pronouncing it “obessity.”
According to a report from the Robert Wood Johnson Foundation, the biannual study done by the Health Resources and Services Administration found that in 2019, 14.3% of all American youth between the ages of ten and seventeen were obese. 12.9% of Oregonian youth were obese, which ranks it 36th worst out of 50 states. By comparison, Kentucky has the highest rate at 23.8%, and Utah has the lowest at 9.6%.
This was already a concern, since childhood obesity is a strong indicator for obesity later in life. It is even more of one during the pandemic, since obesity puts a person at greater risk of diabetes, high blood pressure, heart disease and cancer – all of which make a person more likely to be severely harmed or killed by COVID.
HRSA said they expect the 2018-2019 rates of youth obesity to go higher in 2020.
Meanwhile, the Centers for Disease Control and Prevention this week redefined who was at elevated risk from COVID-19: it’s now 72% of all people in the country, because they now consider anyone with a body mass index of 25 or higher to be at risk. Previously, they had set the limit at a BMI of 30.
BMI is a controversial measure, since it has been found to rate a very muscular person as “obese” and a person whose muscles are wasting to not be obese, but the CDC considers it useful and reliable enough to use it to set the cutoff of who is at greatest risk.
Dr. Lisa Denike, Chair of Pediatrics at Northwest Permanente in Portland, told USA Today that due to pandemic precautions children are “gaining not insignificant amounts of weight. We’ve seen kids gain 10 to 20 pounds in a year, who may have had a BMI as a preteen in the 50 or 75th percentile and are now in the 95th percentile. That’s a significant crossing of percentiles into obesity.” One of her patients, an eleven-year-old boy, gained 40 pounds. Obese people are always at risk of developing Type II diabetes, and according to Dr. Denike, “I suspect he will in the coming years as his parents already have it. He’s home in an environment struggling with parents with the same issues rather than learning in health class and having activity outside. Kids are reflections of what their parents do.”
Youth obesity is more common in lower class families. A child in a household under the Federal poverty line is twice as likely to be obese, and therefore to be at greater risk from the novel coronavirus, according to the Robert Wood Johnson Foundation study.
Jamie Bussel, a senior program officer at the Foundation, told USA Today that the high rate of obesity is strongly suspected to be the reason rates of severe illness and death from COVID-19 are so high among poor people and also people of color: “In both cases, these outcomes reflect decades of disinvestment in specific communities and specific groups of people, often driven by the systemic racism and discrimination that are still so prevalent in our society.”
Diane Whitmore Schanzenbach, director of Northwestern University’s Institute for Policy Research, said, “We know that families switch to lower-quality food when they face food insecurity – that is, more calorie-dense foods and less variety.”
Dr. Imelda Dacones, CEO of Northwest Permanente, expressed concern for the mental as well as physical health of obese youth. She told USA Today that if a person “had some tendency to use food for not so good things” already, that was likely to be made worse by the stress of the pandemic. “It’s driving kids as well as adults to do more unhealthy things.” Dacones said also that since a larger portion of the Black and Hispanic populations is among the lower income levels, the problem is worse for those ethnic groups. She pointed out a study with found that the number of people in California classified as food insecure increased from one in nine families to one in six.
Schanzenbach agrees, saying that a Northwestern University study identified 41% of African American households with children, 40% of Hispanic, and 23% of white were food-insecure earlier in the year. “Even though it’s not as bad as it was during the peak of the pandemic, food insecurity rates are still awful,” Schanzenbach said.
Meanwhile, Jim Baugh, founder and president of PHIT America – a group which was formed to promote the physical fitness of American youth and which speaks of the country suffering an “inactivity pandemic” – expresses concern over the shrinking number of elementary schools which offer P.E. classes (fewer than half) and the reduction of recess time, saying that the U.S. is ranked 47th out of 50 developed countries in children’s fitness. The group is gathering signatures on a petition to demand that elementary schools provide at least half an hour of recess time, three times a week.
Zhen Yan of the University of Virginia School of Medicine thinks a lack of activity among children is very urgent, and not something to set aside for later, after doing research on the effectiveness of exercise in combating COVID-19. Yan says bluntly that “we must increase their physical activity and get them healthier. Too many kids already have preexisting conditions such as obesity.”
Obesity makes children susceptible to mental as well as physical illness, a study in Annals of Behavioral Medicine concluded. UConn Rudd Center for Food Policy and Obesity conducted the study, which found that the social stigma of obesity leaves children with “increased vulnerability to distress”. Binge eating, in particular, has increased generally since the pandemic began, but is three times as frequent among obese youth than others.
Young people with eating disorders are likely to develop worse ones, Denike says, since these youths “seek areas to control during stressful times.” Not being adults, they have a “limited menu of options” in finding some aspect of life that they can control, and food intake – either self-denial resulting in anorexia and bulimia, or excessive eating resulting in obesity – is one thing they can control.
Tierney Sadler, a self-employed writer in Virginia, grew up as an obese child, and describes herself as “morbidly obese” today. She remembers the childhood she experienced with painful clarity: the bullying of her classmates, the well-meaning but painful and humiliating care of her parents, which included being put on a diet when she was in kindergarten. “It was never going to be good enough, and I couldn’t shake that,” she told USA Today. “Obese kids have a lot of company today, but back in the ’60s, if you were the one fat kid, it really kind of does a number on you.”
Sadler urged parents to try to shield their children from the most upsetting elements of the pandemic, especially their own anxiety: “Food is one of the ways we comfort ourselves. There are a lot of things children absorb from their parents, who may be unemployed and terrified of the whole COVID thing. Their pores are so wide, they can suck in all that negative energy.”
The National Eating Disorder Association reports a near-doubling of telephone calls and online chats over 2019.
John M. Burt