In January 2023, the American Academy of Pediatrics surprised doctors and parents by changing its guidelines on treating childhood obesity to include the use of popular weight-loss drugs like Ozempic and Wegovy, also known as semaglutide, for children ages 12 years or older. And parents all over the country were faced with yet another difficult decision: Should I consider a lifelong weight-loss drug for my 12-year-old?

The fact that this is even on the table at all is a pretty shocking indictment of the state of our kids’ health. Nearly 20 percent of American children and adolescents are obese, a 300 percent increase since the 1970s. Meanwhile, a little over 42 percent of American adults are obese, a 180 percent increase since the 1970s. The United States ranks 12th worldwide in obesity prevalence. This places the U.S. among the countries with the highest obesity rates in the world.

The question is: Why? And why haven’t we been able to reduce childhood obesity rates? 

As obesity rates have skyrocketed, we as a society have also changed the way we talk about weight and obesity. Yes, there is less stigma today about weight—which is good. But people—including health experts—have stopped speaking out loud about the real health risks of obesity. Take, for example, how during the pandemic our health leaders wouldn’t tell the public that obesity is a high risk factor for contracting Covid, out of a presumed fear of stigmatizing obese people.

In the end, all of this has led to confusion about the real health risks of obesity. Parents, in particular, are left to struggle with how to navigate food and health for their children. They may be left wondering whether the entire idea of a link between weight and health may simply be misinformation. So today, we’re setting the table: Why Is childhood obesity such a big problem in the U.S.? Why is obesity problematic in the first place? What will it take to change the way Americans feed our children? And what’s at stake if we don’t?

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