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The Obesity Care Advocacy Network (OCAN) needs your help to address obesity. Visit our Action Center to use your voice on important obesity issues.

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Obesity Care Now

07.06.21 OCAN OMB equity comments.pdf

#### **RE: Methods and Leading Practices for Advancing Equity and Support for Underserved Communities through Government [OMB-2021-0005-0001]**

The Obesity Care Advocacy Network (OCAN) appreciates the opportunity to offer comments in response to the RFI on Methods and Leading Practices for Advancing Equity and Support for Underserved Communities Through Government.

**Obesity and Health Equity**

Obesity also disproportionately impacts communities of color that already face systemic inequities in care. Addressing the disease must be part of our response on health equity issues. Racial and ethnic minorities experience disproportionately poorer health outcomes for infectious and chronic diseases. Race and ethnicity affect both obesity prevalence and obesity treatment outcomes.


Comments: OMB Advancing Equity and Support for Underserved Communities

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Release: TOS Promotes National Childhood Obesity Awareness Month in September

*Original Post: [Morning Consult](https://morningconsult.com/opinions/childhood-obesity-and-covid-19-two-pandemics-collide-this-back-to-school-season)*

As kids and teens return to school during the ongoing COVID-19 pandemic, advocates, politicians, school administrators and others are rightfully focused on addressing the achievement gap in schools. We’ve seen this gap widen after a year of remote learning, and it has placed an even [greater strain on children of color](https://www.nwea.org/content/uploads/2021/06/Understanding-the-initial-educational-impacts-of-COVID19-on-communities-of-color.Resear-hBrief.pdf). As we work to close the achievement gap, we must also address the health gap our children face, which is in part driven by another pandemic: childhood obesity.

For years, inequities in our country and health system have given rise to disproportionate rates of childhood obesity among students of color. Obesity is a complex disease that puts children at risk for [other conditions](https://www.cdc.gov/obesity/childhood/causes.html) like type 2 diabetes, asthma, anxiety and depression. Disparities in rates of obesity among Black and Hispanic children are [present by age 2](https://www.nytimes.com/2020/06/15/well/family/the-impact-of-disparities-on-childrens-health.html), largely driven by long-standing systemic inequities such as limited access to quality health care, lower rates of insurance coverage and less access to quality education. And now, as we see children with obesity are also at a [higher risk for severe outcomes from COVID-19](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7657263/), we have been reminded of the urgency of addressing obesity as a disease.

The prevalence of childhood obesity [increased](https://pediatrics.aappublications.org/content/147/5/e2021050123) from 13.7 percent up to 15.4 percent in just the first nine months of the pandemic. Experts have concluded that some efforts to reduce COVID-19 transmission [likely contributed](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7657263/) to this change, as sedentary behaviors increased with remote learning and access to fresh, affordable food, often provided by schools, declined. This increase in obesity was most pronounced in youth ages 5-9 and those who are Hispanic, non-Hispanic Black, publicly insured or from lower-income families – which exacerbates inequities in the same populations that have been [disproportionately impacted by COVID-19](https://www.cdc.gov/coronavirus/2019-ncov/community/health-equity/racial-ethnic-disparities/disparities-illness.html).

We know that COVID-19 and its implications for our children are far from over and will continue to take a toll on their physical and mental health. We are already seeing this come to light, as [pediatric emergency room visits for mental health increased](https://www.cdc.gov/mmwr/volumes/69/wr/mm6945a3.htm) 31 percent from April to October in 2020. And we know that weight stigma, bias and bullying associated with obesity can further [compound mental health challenges](https://pediatrics.aappublications.org/content/140/6/e20173034) for children living with the disease.

Given the unique challenges for children living in the midst of these health crises, it has never been more important to address the disease of obesity in children. We must work in partnership with health care and community wellness providers to implement a continuum of care approach for childhood obesity. This means that a full spectrum of prevention and treatment options should be available to children and families dealing with obesity, as is the case with other chronic conditions. We must also encourage public and private health insurers to cover these obesity prevention and treatment options.

Pediatricians also play a critical role. Regular childhood wellness visits provide an opportunity for doctors to [build healthy habits](https://www.npr.org/sections/health-shots/2021/08/16/1025121359/dont-focus-on-kids-weight-gain-focus-on-healthy-habits-instead) with families, and to prevent, diagnose, treat and manage this disease early on, reducing the risk of developing obesity into adulthood and potentially avoiding future health risks from the disease. Pediatricians should also be trained to refer children to community-based interventions as appropriate.

Schools and out-of-school time providers, health departments, businesses and other community groups are also valued partners that can work together to improve child health by providing access to low-cost physical activity opportunities and healthy, affordable food options. For instance, the YMCA’s [Healthy Weight and Your Child](https://www.ymca.org/what-we-do/healthy-living/fitness/healthy-weight-and-your-child) program is an evidence-based lifestyle change intervention designed to address childhood obesity by empowering children and families through education, healthy eating and physical activity. Furthermore, opportunities for physical activity at school and after-school settings — sometimes the only safe opportunity that children have to play outside — must be a high priority as students return.

Supporting these and other programs is a critical first step to minimize the larger health inequities that make healthy eating and physical activity less attainable for children of color and of lower socioeconomic status. Much like addressing the achievement gap, closing this health gap requires a concerted effort. It will take wide-scale recognition of obesity as a disease, a continuum of care approach for childhood obesity both utilized by providers and covered by insurers, funding of community interventions for obesity prevention and treatment, and policy change to support all children in achieving their optimal health.

There are many factors to consider as schools reopen this year, but addressing childhood obesity must be a top priority.

 

*Kathleen (Katie) Adamson is the vice president of health partnerships and policy for YMCA of the USA.*

Opinion: Childhood Obesity and COVID-19: Two Pandemics Collide This Back-to-School Season

Obesity is a complex chronic disease – OCAN is leading the fight for comprehensive care.

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*Original Post: [ConscienHealth](https://conscienhealth.org/2021/10/doubling-covids-toll-mental-health-and-child-obesity/)*

The numbers make it crystal clear. One of the long-term effects of the COVID pandemic will be a jump in childhood obesity. And it’s not hard to trace that back to the mental health of children and families. Late last week a [new report](https://doi.org/10.1542/peds.2021-053760) in Pediatrics provided a stark reminder about the impact of COVID on children. Roughly 140,000 children have lost a primary caregiver to death because of the pandemic. That is 140,000 children who have lost a parent, grandparent, or another loved one who cared for them. 

Now let’s recall that [adverse childhood experiences](https://doi.org/10.1038/s41390-019-0509-2) are an important trigger for obesity. So the straight line from these devastating losses to the jump in childhood obesity rates is easy to see. 

#### Unfortunate Complacency About Children and COVID 

Early in the pandemic, some people falsely thought that children were “[essentially immune](https://www.bbc.com/news/technology-51975377)” to COVID. Now we’ve learned how wrong they were. First of all, with the Delta surge, pediatric ICUs have been [filling up](https://www.beckershospitalreview.com/patient-flow/number-of-us-children-hospitalized-with-covid-19-hits-record-dallas-out-of-pediatric-icu-beds.html). But in addition, the indirect impact on mental and physical health has been drastic. 

Obesity prevalence in kids [has clearly grown](https://conscienhealth.org/2021/09/more-obesity-in-the-pandemic-kids-yes-adults-iffy/) in the pandemic. Further, COVID has put the mental health of the world’s 2.2 billion children at risk. A new report from the UN tells us that nearly [one in five young people](https://www.unicef.org/press-releases/impact-covid-19-poor-mental-health-children-and-young-people-tip-iceberg#:~:text=1%20in%205%20young%20people%20aged%2015%E2%80%9324%20surveyed%20said%20they%20often%20feel%20depressed%20or%20have%20little%20interest%20in%20doing%20things.) often feel depressed or have little interest in life. Children’s hospitals in the U.S. have seen [dramatic increases](https://www.cnn.com/2021/07/22/health/covid-19-pandemic-mental-health-children/index.html#:~:text=Children%27s%20hospitals%20around%20the%20country%20say%20they%20have%20seen%20a%20meteoric%20rise%20in%20the%20number%20of%20children%20who%20need%20mental%20health%20help) in children seeking mental health services.  

Without a doubt, the presumption that COVID was not a threat to children has proven to be terribly wrong. 

#### Mental Health and Obesity: A Two-Way Street 

The relationship between mental health and obesity goes in two directions. Stress, distress, and adverse childhood experiences can fuel weight gain. On the other side of this link, it’s also clear that obesity can fuel mental health distress. Bullying and social isolation are significant problems for a child living with obesity. [Public health messaging](https://pubmed.ncbi.nlm.nih.gov/25955676/) that tended to blame children and parents for this metabolic disease has long been a problem. 

As just one example, [screening and singling out children with obesity in school](https://doi.org/10.1089/chi.2021.29011.editorial) was once a popular policy. Research now shows that it offers no benefit while having the potential to do a great deal of harm. 

#### World Mental Health Day 2021 

Today is World Mental Health Day. The rallying cry is to make mental health care for all a reality. Recognizing the link between obesity and mental health makes this especially important for people living with obesity. Even more so, it is important for children. Let’s resolve to live up to this challenge and take it one step further. Let’s all do our part to stop the harm that weight stigma does to children who are living with obesity. 

---

*Ted Kyle is a pharmacist and health innovator living in Pittsburgh. He is also a tireless advocate for people living with obesity. His widely-read daily commentary, published at [conscienhealth.org/news](http://conscienhealth.org/news), reaches an audience of more than 15,000 thought leaders in health and obesity.*

Doubling COVID’s Toll: Mental Health and Obesity

Obesity is a complex chronic disease – OCAN is leading the fight for comprehensive care.

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