Prevalence of Childhood Obesity in the United States in 1999–2018: A 20-Year Analysis

INTRODUCTION: Obesity is a public health crisis in the USA. This study aimed to estimate the prevalence of obesity and severe obesity in US children and adolescents and identify novel targetable risk factors associated with childhood obesity. METHODS: From the US National Health and Nutrition Examination Survey from 1999 to 2018, 35,907 children aged 2–19 with body mass index (BMI) data were included. Obesity and severe obesity were defined as BMI ≥95th percentile and ≥120% of 95th percentile of US Centers for Disease Control and Prevention growth charts, respectively. Trends in the prevalence of obesity and subgroup analyses according to socioeconomic factors and language used in the interview were analyzed. RESULTS: The prevalence of obesity and severe obesity increased from 14.7 [95% confidence interval: 12.9–17.0]% to 19.2 [17.2–21.0]% and 3.9 [2.9–5.0]% to 6.1 [4.8–8.0]% in 1999–2018, respectively (p = 0.001 and p = 0.014, respectively). In 2017–2018, the prevalence of obesity among children from Spanish-speaking households was 24.4 [22.4–27.0]%, higher than children from English-speaking households (p = 0.027). CONCLUSION: The prevalence of childhood obesity kept increasing in 1999–2018. The problem is worse in children from Spanish-speaking households. Novel and targeted public health intervention strategies are urgently warranted to effectively halt the rising epidemic of childhood obesity.