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Childhood Obesity Committee Recommends Straight Talk

Medical experts say it's time to stop cushioning the blow for children with weight problems and their parents and use the "O" words -- "overweight" and "obesity" -- when they apply.

The recommendation comes from a committee formed by the American Medical Association and the federal Centers for Disease Control and Prevention to study childhood obesity. Members include obesity experts from 14 professional organizations including the American Academy of Pediatrics.

Ostrich Mentality Won't Help

To avoid upsetting kids and their parents, the CDC has historically avoided using the term "obese" to label any child -- no matter how much he or she might weigh.

Instead, it applies the term "at risk of overweight" to children whose body-mass index would place them in the "overweight category" (between the 85th and 94th percentiles), and it uses the term "overweight" only with children whose BMI indicates they actually are obese (95th percentile or higher).

That policy was crafted partly out of the desire to avoid angering or humiliating children, and partly because growing children sometimes fall into weight categories that might suggest there is a problem when they are simply going through a normal growth phase. Identifying overweight and obese children is not as straightforward a process as it is with adults.

Further, there is concern that children who are labeled "overweight" or "obese" might resort to extreme measures that could lead to eating disorders such as bulimia.

Still, committee members believe that it is important to use clear language and engage in frank discussions, especially in light of an obesity epidemic that appears to be careening out of control.

More Than 50% of US Kids Affected

Such hesitancy to name the problem only contributes to people failing to face it head on, said one expert, who noted that a physician would not be evasive about using precise terminology in discussing any other disease or condition.

For example, it would be ludicrous to imagine a doctor telling a person who has cancer that he is "at risk of having cancer."

Currently, about 17 percent of US children are in the highest category (95th percentile or higher), and that almost 34 percent are in the second-highest category (between the 85th and 94th percentiles). While that doesn't seem to make mathematical sense, it is because the percentile ranges reflect a population that overall was far fitter. They are based on growth charts from the 1960s and 1970s, before the nationwide obesity epidemic took hold.