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understanding the childhood obesity epidemic: environment, genetics and education

the entire society has to work together to end childhood obesity, and the onus cannot be put on parents or just one group of people.

by angelica bottaro

sep 18 2024
read time 8 minute read
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one in three children have obesity in canada, a three-fold increase in the last 30 years. getty images
roughly one-third of canadian children are living with obesity or overweight. those rates, which have nearly tripled in the last 30 years, continue to rise among children in the country at an unprecedented velocity.
many people carrying extra weight in childhood may often be told that they’ll grow out of it or that it’s just baby fat. however, as researchers continue to dig deeper into the obesity epidemic in the country, those sentiments are becoming more and more mythical.
dr. julie st-pierre, a pediatrician with a special focus on pediatric obesity and researcher and professor at mcgill university in montreal, has dedicated her life to understanding all there is to know about childhood obesity, from what it means for children and how it affects those children later in life.
as she’s discovered through her work, the epidemic is multifactorial, but generally, it comes down to genetics.
“it has always been about genes,” she said. “there are over 1,000 genes involved in the development of obesity and, of course, all those genes are in relation with the environment.”
she goes on to say that, over time, the environments in which children grow up today are pushing obesity rates higher simply because times have drastically changed.

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neda nasseri, product director of benefits at desjardins insurance and advisory board member with obesity matters; rachel atkins, board vice-chair, director of strategy, and patient advocate with obesity matters; and dr. david attalla, internal medicine and obesity medicine physician. (left to right)

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while the mantra “eat less and move more” continues to be advised by some healthcare practitioners for people living with obesity, dr. sean wharton has brought greater compassion and understanding to the healthcare community and his own clinic.
dr. sean wharton started his clinic in 2008 to put weight and its associated risks of type 2 diabetes, fatty liver disease and osteoarthritis, among others, at the forefront because people with obesity deserve medical treatment.

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“parents are struggling with different challenges that we were not seeing my generation, of the 50s and above, were not facing.”

understanding the obesity epidemic in canadian children

one in three children between the ages of 0 and 17 are living with overweight or obesity in the country. the old adage of people in larger bodies weighing more due to laziness or eating foods that cause obesity is slowly becoming archaic because, as researchers have discovered, 70 to 80 per cent of a person’s body mass index (bmi) can be attributed to their unique genetic makeup and weighing more does not equate to those things at all.
in fact, children are 15 times more likely to develop obesity if they are born with a genetic predisposition to do so. the other 20 to 30 per cent can be attributed to a child’s environment, including what they eat, how often they move, and other factors that play into the development of obesity, including screen time, metabolic health, and sleep scores.
dr. st-pierre finds that, along with genetics, the fact that times sure have changed is directly related to the obesity rates in canadian children today.
“our parents were sending us out, i would say very often. we were walking to school. we were riding our bikes. there was less transformed and ultra-transformed (processed) food from the industry. our parents were cooking a little more,” she said.
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the addition of screens to the equation also doesn’t help because too much screen time can act as a driver of anxiety or other mental health distress in children, leading to emotional eating. a lack of good quality sleep, also driven by screen time, also plays a role.
“there’s a lot of anxiety also in the kids, so mental health is an issue. it’s correlated with obesity as well. when you are sad, you tend to eat a little bit with your emotions,” dr. st-pierre said, continuing, “we know that screens are associated with impulsivity in eating and also a lack of good sleep. so, all of that is a vicious circle that the kids are facing today and that was not there 30 or 40 years ago, so it’s a major difference.”
she goes on to say that societal pressures on parents to be the “best parents” are also much more significant than they were in the past.
these pressures lead to parental anxiety and difficulties keeping up with the demands to do everything perfectly for their child, from grocery shopping and cooking healthy food to working two jobs to keep up with the economic demands of today and ensuring their kids are fulfilled in extracurricular activities outside of school, such as music and sports lessons all at the same time.
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“it keeps rising because we don’t have measures to support parents across the nation, sadly,” she said. “most of the time, measures are given to companies.”
it all comes down to education, according to dr. st-pierre, who says that parents are not given the right tools or information to provide the right interventions for their children.
“it’s definitely not the parent’s fault when you have one-third of kids across the nation who suffer from obesity or overweight,” she said. “there must be something else, and it’s a society choice that we have made to put economics in front of knowledge and health.”
she goes on to say that resources for parents on how to find the best toys for christmas are more widely available than information on childhood obesity and metabolic health, and that’s one of the contributing factors to the epidemic.

the adverse health effects of childhood obesity

many people are aware of the adverse health effects that can occur in adults living with obesity, but those are rarely talked about when speaking about the health of children who have obesity or overweight. the issue is that while children do not typically suffer from large heart attacks driven by excess weight, they are still being put at risk for severe health issues driven by obesity. one issue that dr. st-pierre notes is coordination.

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“some kids who develop severe obesity at the age of 10 years old, they will not be as good as others in different physical activities at school or even after school,” she said.
children with obesity can also go on to develop type 2 diabetes, insulin resistance, a metabolic disorder known as dyslipidemia that results in abnormally high or low levels of lipids in the blood and high blood pressure.
even children under the age of five can develop significant health issues, such as fatty liver disease, that can become so dangerous a child will need a liver transplant in early adulthood.
“(it’s) tragic,” dr. st-pierre said. “it’s the fatty liver among our cohorts of patients in montreal. it’s 54 per cent. so, more than half of our patients suffering from obesity actually present with fatty liver, and they’re children. the youngest ones i’ve seen were around 18 months of age.”
chronic inflammation is also a catastrophic issue that can develop in children living with obesity, leading to children requiring more intensive care if they happen to get sick with a viral or other type of infection. since children are already more susceptible to complications in those types of illnesses, having obesity can increase that risk.

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“this is something very neglected across the country that will … hit us dramatically in the next 10 or 15 years,” said dr. st-pierre, describing how detrimental the situation will be if nothing is done to address it.
mental health also suffers in children with obesity, with those in that demographic being subject to bullying, feeling ostracized by peers, and dealing with poor body image. these effects all contribute to higher rates of anxiety, depression, and other mood changes that can contribute to a worsened quality of life in children. in some cases, these children develop suicidal thoughts or ideations.

according to research, the odds of suicidal ideation in adolescents with obesity are almost double what they are in those who do not have obesity in the same age group.

“the odds of being depressed and having ideas of dying are stronger in this … population, and nobody pays attention to that,” said dr. st-pierre.
having obesity as a child also increases the risk of a person having it as an adult significantly, with roughly 80 per cent of children with obesity still having an increased body mass by age 21, which can contribute to even worse health outcomes simply because living with a disease for longer leads to a higher risk of complications.

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“every case is unique,” said dr. st-pierre. “other factors may contribute, but in general, we can say that the later it comes on, the easier it is to address and support a person living with the disease.”

what needs to be done to end childhood obesity in canada

the lack of awareness surrounding the detrimental effects of childhood obesity is the first step towards making a change because if people are unaware of the problem, there’s no pathway toward a solution.
“the first and most important action to be done is to raise awareness across the nation, not only in healthcare professionals but the entire society, that obesity is a disease,” said dr. st-pierre. “it is a complex disease that we have well-understood, well-studied solutions to support the patients.”
she goes on to say that educating healthcare professionals also needs to be done because 50 per cent of those who are paid to help people living with obesity still have fatphobia.
people with darker skin tones are also heavily discriminated against if they’re living with obesity, more so than other ethnic backgrounds, which dr. st-pierre describes as a “fat phobic and racist approach” to healthcare that needs to be addressed immediately.

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“this has to stop,” she said. “but it will stop only by educating our healthcare professionals about that.”
the current level of support for those living with childhood obesity is also severely lacking in the country, and without multidisciplinary approaches being available, children with obesity and their parents will continue to have no one to turn to for resources, assistance, or access to the proper medical care.
“dieticians, sports specialists, pharmacists, also a nurse, are all very important as well, in the team, so that is not reimbursed across canada,” dr. st-pierre said. “it’s an issue in pediatrics. it’s an issue in adults.”
she goes on to say that this type of multi-level care is the “cornerstone of the management and treatment or even prevention” of childhood obesity and other diseases. without it, people often lack the knowledge needed to care for themselves or their children with obesity adequately.
as for parents, the best they can do is advocate for their children, learn as much as they can about 2022年世界杯名单猜测 and how to implement that in a modern society and wait for the day when the healthcare system acknowledges what needs to be done and takes action toward fundamental change.

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“if parents work together to get information, they will find different ways to address this pandemic,” dr. st-pierre said.
the entire society has to work together to end childhood obesity, and the onus cannot be put on parents or just one group of people. but as dr. st-pierre notes, “we did it all wrong so far, and that’s what we’re starting to learn.”

“we have made choices in our society that increases chronic diseases earlier and earlier in life. there’s no magic wand. we need to change a lot of things in the society model. but starting to raise awareness is definitely the first step.”

angelica bottaro
angelica bottaro

angelica bottaro is the lead editor at healthing.ca, and has been content writing for over a decade, specializing in all things health. her goal as a health journalist is to bring awareness and information to people that they can use as an additional tool toward their own optimal health.

read more about the author

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