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Childhood obesity is stealing years of life and diminishing the potential of an entire generation. The rise in pediatric Type 2 diabetes and fatty liver disease—historically common only among adults—underscores the urgency of the crisis. These are not passing concerns. Today's obese child will become tomorrow's heart disease, stroke, or cancer patient.
Modern medicine has rushed into the breach with aggressive treatments. Bariatric surgery has increased fivefold among adolescents since 2012, while the FDA approved weight loss drug Wegovy for teens, and Ozempic is being tested on children as young as 6 despite the drugs' long-term effects being unknown. While we understand the need for medical intervention to improve children's health, surgery and medication should not be the norm for our kids.
The factors fueling the childhood obesity epidemic are unsurprising. Two thirds of calories consumed by children come from ultra processed foods, which are high in sugar, and low in nutrients. Meanwhile, just a quarter of children engage in the CDC's recommended 60 minutes of daily physical activity. Schools have cut physical education classes even as high costs have sidelined many potential athletes as sport participation rates are low and declining. Moreover, the digital age has children spending up to nine hours per day on screens, replacing active learning and playtime with sedentary swipes and clicks.
The response to this crisis must be as multifaceted as the problem itself. Amsterdam's whole-system approach, which reduced the number of overweight children by 12 percent, relies on public, private, and community organizations uniting to improve children's physical activity, diet, and sleep. Similarly, Indianapolis' Jump IN for Healthy Kids program offers a promising multi-sector model. In both cases, schools are recognized as an essential partner that provides a foundation for lifelong wellness.
Access to nutritious foods varies by neighborhood and income, resulting in predictable health disparities. Yet a 2018 study found socioeconomic factors are not the direct driver of these gaps. Instead, the difference is largely driven by demand, with education and access to nutrition guidance shaping consumer preferences along socioeconomic lines. Schools can help eliminate disparities by increasing nutrition education. On average, American students receive less than eight hours of nutrition education annually, well below the 40-50 hours shown to change behavior. Research also shows effective nutrition education programs engage families as partners; video lessons can extend learning into the home.
Schools cannot do this work alone. The Food as Medicine movement aims to foster healthier eating by "prescribing" fresh fruit and vegetables as part of disease management and incentivizing insurers and Medicaid to cover costs. Benefits are often complemented with nutrition counseling, cooking classes, and personalized diet plans. Early results are encouraging. One study found that a yearlong prescribed dietary program led to remission of diabetes in nearly half the participants. Expanding these benefits to families with young children has the potential to reduce childhood obesity and instill lifelong healthy eating habits.
Ensuring physical education as a meaningful priority is also crucial. Despite state mandates, PE is often the first casualty when schools face budget cuts, a leading cause of why only half of American high schoolers attend PE classes in a typical week.
Enforcing existing requirements would go a long way toward improving overall youth health—students with PE classes three times weekly are far more likely to meet the 60-minute daily activity standard. But we also need to champion innovative strategies that meet kids where they are and weave physical activity into childhood learning and leisure. Integrating technology into PE instruction can engage digital natives and transform sedentary screen time into active learning. Innovation in PE classrooms can also ensure teachers are supported to deliver standards-aligned instruction.
Some districts are already taking steps in this direction. In Alexandria, Va., high school students can earn PE credit for workouts that take place outside school hours, with physical activity and heart rates monitored by personal fitness devices. Such efforts could be augmented with digital lessons designed to build key athletic skills and assess student learning. States could also promote short physical activity breaks throughout the school day. Colorado is currently the sole state to require this, and only at the elementary level. Policies to encourage these types of efforts will ensure all children get the exercise they need to be healthy—and research suggests increased physical activity may also boost student learning and mental health.
Our children deserve a future where health is a given, not a goal. We need a bold commitment to restoring physical and wellness education as a core function of America's schools, paired with innovative partnerships that engage the whole community in tackling the childhood obesity epidemic at its roots. The need is clear, the stakes are high, and the time for action is now.
Anna Chapman is a Harvard-educated psychiatrist, philanthropist, and founder of Green Beetz, which provides educators with a free ready-to-teach curriculum for fourth-seventh graders about the modern food system, nutrition, and sustainability.
Joe Titus is the CEO of Hiveclass, a digital physical education platform that works nationwide with schools and libraries to make quality instruction in physical education accessible to kids everywhere.
The views expressed in this article are the writers' own.
