Definition

Body mass index (BMI) is widely used to determine obesity and overweight because it is inexpensive, reproducible, and convenient. BMI is calculated using the individual's height, weight, age, and sex.^1^ For individuals aged 2 to 20, overweight and obesity are determined by calculating the individual's BMI and comparing it to age and sex-standardized growth charts distributed by the Centers for Disease Control and Prevention. Children and adolescents are considered to have obesity if their BMI is greater than or equal to the 95th percentile for BMI by age and sex based on the 2000 CDC Growth Charts.^2^[[br]] [[br]] ---- 1. Child and Teen BMI Categories [https://www.cdc.gov/bmi/child-teen-calculator/bmi-categories.html][[br]] 2. Child and Teen BMI Calculator. Center for Disease Control and Prevention. [https://www.cdc.gov/bmi/child-teen-calculator/index.html]

Numerator

Number of individuals surveyed or measured who are obese (BMI greater than or equal to the 95th percentile for BMI by age and sex based on CDC Growth Charts).^1^[[br]] [[br]] ---- 1. Child and Teen BMI Calculator. Center for Disease Control and Prevention. [https://www.cdc.gov/bmi/child-teen-calculator/index.html]

Denominator

Total number of youth surveyed or measured for height and weight.

Data Interpretation Issues

Three sources of data are used for this indicator. First, third, and fifth grade students from randomly selected public elementary schools throughout the state were weighed and measured. Adolescent data is from the Youth Risk Behavior Survey and the Prevention Needs Assessment. Height and weight for these surveys are self-reported.

Why Is This Important?

The number of children with obesity is increasing in the United States.^1^ This is a serious health problem, where 1 in 5 children and adolescents are affected. Many factors contribute to weight in childhood, including genetics, behaviors, certain medications, childcare and school environments, health and affordable food access, safe and convenient access to places for physical activity, and built environment design.^2^ Having obesity in childhood is associated with many health conditions, including high blood pressure and cholesterol, type 2 diabetes, asthma, joint problems, and gallbladder disease. There have also been associations with psychological problems (such as anxiety and depression), low self-esteem and quality of life, social problems, and having obesity in adulthood.^3^[[br]] [[br]] ---- 1. CDC [https://www.cdc.gov/obesity/strategies/early-care-education/helping-young-children-thrive/index.html Helping Young Children Thrive][[br]] 2. CDC [https://www.cdc.gov/healthyschools/obesity/index.htm Obesity][[br]] 3. CDC [https://www.cdc.gov/obesity/basics/consequences.html Consequences of Obesity]

Other Objectives

[https://health.gov/healthypeople/objectives-and-data/browse-objectives/overweight-and-obesity/reduce-proportion-children-and-adolescents-obesity-nws-04/ '''Healthy People Objective NWS-04''']:[[br]] Reduce the proportion of children and adolescents with obesity.[[br]] '''U.S. Target:''' 15.75%[[br]] '''State Target:''' 10%

How Are We Doing?

Among adolescents in 2023, 10.4% of Utah public school students in 8th, 10th, and 12th grades had obesity; boys were more likely to have obesity than girls (12.9% compared to 7.8%). The obesity rate in 2023 among adolescents in 8th, 10th, and 12th grades was lower in Summit County (6.1%) and Utah County (8.6%) than the state rate (10.4%). The percentage of children with obesity in Utah increased dramatically in the first decade of the century. From 1994 to 2010 the number of obese third-grade boys increased by 97%, from 6.0 percent in 1994 to 11.8% in 2010. The percentage of third-grade girls with obesity increased by 40% over the same time. In 2010, 8.4% of third-grade girls had obesity compared to 6% in 1994. Childhood obesity in Utah seems to have leveled off since 2010. In 2018, 12.1% of third-grade boys and 8.3% of girls had obesity.

How Do We Compare With the U.S.?

In 2023, 12.6% of Utah high school students had obesity, as indicated by being in the 95th percentile for body mass index, based on sex- and age-specific reference data.^1^ This is lower than the U.S. average of 15.9% of high school students.^2^[[br]][[br]] ---- 1. Utah Department of Health and Human Services Public Health Indicator Based Information System [https://ibis.utah.gov/ibisph-view/query/builder/yrbs/YRBS/OverWt.html/ Youth Risk Behavior Survey Query - Obese][[br]] 2. 2023 YRBS

What Is Being Done?

The Utah Department of Health and Human Services Healthy Environments Active Living (HEAL) Program plays a key role in improving the health of residents in the state of Utah. The program was formed in July 2013 (as Healthy Living through Environment, Policy, and Improved Clinical Care: EPICC), through a new funding opportunity from the Centers of Disease Control and Prevention (CDC). This allowed for the merging of three previously existing programs: the Heart Disease and Stroke Prevention Program, the Diabetes Prevention and Control Program, and the Physical Activity, Nutrition and Obesity Program, as well as the addition of a school health program. HEAL was recently restructured as part of a strategic planning process. This new program model focuses on staff and partners working together to address the social determinants of health while advancing health equity and increasing policy, systems, and environmental changes. HEAL works: In schools:[[br]] HEAL encourages [https://heal.utah.gov/schools/ schools] to adopt the [https://www.cdc.gov/healthyschools/professional_development/e-learning/CSPAP/index.html/ Comprehensive School Physical Activity Program]. This framework encourages students to be physically active for 60 minutes a day through school, home, and community activities. HEAL also works with schools to apply the [https://www.cdc.gov/healthyschools/wscc/index.htm/ Whole School, Whole Community, Whole Child Model], which emphasizes the role of the community in supporting academic and health success for students. In worksites:[[br]] HEAL offers training on developing worksite wellness programs called Work@Health. HEAL partners with local health departments to encourage worksites to complete the CDC Scorecard and participate in yearly health risk assessments for their employees. HEAL provides toolkits and other resources for employers interested in implementing wellness programs at [https://heal.utah.gov/worksite-wellness/ Worksite Wellness]. In communities:[[br]] HEAL receives federal funding to partner with worksites, community-based organizations, and local health departments to increase access to [https://heal.utah.gov/nutrition/ fresh fruits and vegetables] in worksite and community settings. HEAL also partners with local health departments to work with cities and/or counties within their jurisdictions to foster a built environment that encourages [https://heal.utah.gov/physical-activity/ physical activity]. In healthcare:[[br]] HEAL works with health care systems to establish community clinical linkages to support individuals [https://heal.utah.gov/diabetes/ at risk for or diagnosed with diabetes] or hypertension to engage in lifestyle change programs such as chronic disease self-management and diabetes prevention programs. In childcare:[[br]] HEAL works with state and local partners through the Childcare Obesity Prevention workgroup to implement policy and systems changes in early care and education across agencies statewide. Ten local health departments statewide have implemented the [https://heal.utah.gov/top-star-providers/ TOP Star Program], which aims to improve the nutrition, physical activity, and breastfeeding policies and environments to achieve best practices in childcare centers and homes.

Evidence-based Practices

The HEAL program promotes evidence based practices collected by the Center for Training and Research Translation (Center TRT). Center TRT bridges the gap between research and practice and supports the efforts of public health practitioners working in nutrition, physical activity, and obesity prevention by:[[br]] *Reviewing evidence of public health impact and disseminating population-level interventions; *Designing and providing practice-relevant training both in-person and web-based; *Addressing social determinants of health and health equity through training and translation efforts; and, *Providing guidance on evaluating policies and programs aimed at impacting healthy eating and physical activity.[[br]] [[br]] Appropriate evidence based interventions can be found at [https://hpdp.unc.edu/completed-research/center-for-training-and-research-translation-center-trt/].

Available Services

Action for Healthy Kids Program - for more information, visit [http://www.actionforhealthykids.org/] The Utah Department of Health and Human Service's obesity website is located at [https://heal.utah.gov/] Family Healthy Weight Programs - for more information, visit [https://www.cdc.gov/family-healthy-weight/php/recognized-programs/index.html] For more information about managing a healthy weight for children and adolescents, visit [https://www.nutrition.gov/topics/healthy-living-and-weight/weight-management-youth]

Health Program Information

HEAL is a program within the Utah Department of Health and Human Services Office of Health Promotion and Prevention. HEAL focuses on enabling education and promoting change for public health by engaging its three main audiences: individuals, partners, and decision makers. HEAL champions public health initiatives and addresses the challenges of making health awareness and access truly universal and equitable in eight key areas: nutrition, heart health, diabetes, physical activity, schools, childcare, community health workers, and worksites. Staff from the HEAL Program work with healthcare providers, including diabetes educators, dietitians, pharmacists, community health centers, community health workers, worksites, and health plans to improve the care provided to Utahns across the state. [https://heal.utah.gov/about-us/ '''Overarching Goals''']:[[br]] Healthy People: Increase access to resources that empower all people in Utah to reach their full health potential. Healthy Communities: Increase the capacity of communities to support and promote healthy living for all individuals. Equitable Society: Increase opportunities for people who are under-resourced and under-represented in Utah to live healthy and thriving lives.[[br]] [[br]] ---- Information for school wellness policies is available at Action for Health Kids, [http://www.actionforhealthykids.org].[[br]] Information specifically for Utah is available at [https://heal.utah.gov].

Utah was not able to use the 2015 data as number of responses was too small to be considered reliable.

Data Notes

Childhood obesity is determined by calculating BMI using the height, weight, age, and sex of the child. The child is considered to be obese if the resulting BMI is greater than or equal to the 95th percentile for age and sex based on the Centers for Disease Control and Prevention Growth Charts (2 to 20 years: Boys Body Mass index-for-age percentiles and 2 to 20 years: Girls Body Mass index-for-age percentiles).   [[br]][[br]] The Youth Risk Behavior Surveillance survey is performed only in odd-numbered years.[[br]] YRBS BMI data should be used with caution since individual height and weight are self-reported. U.S. data from [https://yrbs-explorer.services.cdc.gov/#/ YRBS Explorer]

Data Notes

Childhood obesity is determined by calculating BMI using the height, weight, age, and sex of the child. The child is considered to be obese if the resulting BMI is greater than or equal to the 95th percentile for age and sex based on the Centers for Disease Control and Prevention Growth Charts (2 to 20 years: Boys Body Mass index-for-age percentiles and 2 to 20 years: Girls Body Mass index-for-age percentiles).   [[br]] The Youth Risk Behavior Surveillance (YRBS) survey is performed in odd-numbered years. [[br]] [[br]] YRBS BMI data should be used with caution since individual height and weight are self-reported. *Use caution in interpreting; the estimate has a coefficient of variation > 30% and is therefore deemed unreliable by Utah Department of Health and Human Services standards. **The estimate has been suppressed because 1) the relative standard error is greater than 50% or 2) the observed number of events is very small and not appropriate for publication.

Data Source

Utah Department of Health and Human Services Youth Risk Behavior Surveillance System (YRBSS)

The obesity rate in 2023 among adolescents in grades 8, 10, and 12 was significantly lower than the state in Summit County (6.1%) and Utah County (8.6%).

Data Notes

Childhood obesity is determined by calculating BMI using the height, weight, age, and sex of the child. The child is considered to be obese if the resulting BMI is greater than or equal to the 95th percentile for age and sex based on the Centers for Disease Control and Prevention Growth Charts (2 to 20 years: Boys Body Mass index-for-age percentiles and 2 to 20 years: Girls Body Mass index-for-age percentiles).   [[br]] [[br]] Based on the Prevention Needs Assessment Survey, Form B. *Use caution in interpreting; the estimate has a coefficient of variation > 30% and is therefore deemed unreliable by Utah Department of Health and Human Services standards. **The estimate has been suppressed because 1) the relative standard error is greater than 50% or 2) the observed number of events is very small and not appropriate for publication.

Data Source

Prevention Needs Assessment Survey

Data Notes

Childhood obesity is determined by calculating BMI using the height, weight, age, and sex of the child. The child is considered to be obese if the resulting BMI is greater than or equal to the 95th percentile for age and sex based on the Centers for Disease Control and Prevention Growth Charts (2 to 20 years: Boys Body Mass index-for-age percentiles and 2 to 20 years: Girls Body Mass index-for-age percentiles).   [[br]] [[br]] In 2018 height and weight measurements were collected from 3,944 1st, 3rd, and 5th grade students in 69 randomly selected public elementary schools in Utah.

Data Source

Utah Department of Health and Human Services, Office of Health Promotion and Prevention, Healthy Environments Active Living (HEAL) Program Height/Weight Measurement

References and community resources

Utah Department of Health and Human Services, Healthy Environments Active Living Program. [https://heal.utah.gov/]