On kidsdata.org, indicators of childhood overweight and obesity include the percentage of public school students in grades 5, 7, and 9 scoring above the "Healthy Fitness Zone" on the body composition area* of California's physical fitness test, the FitnessGram assessment. These data are available by grade level, gender, and race/ethnicity.

More than one-third (35%) of U.S. children ages 2-19 are overweight or obese, according to a 2015-2016 survey from the Centers for Disease Control and Prevention (CDC) (1). (A Body Mass Index (BMI) at or above the 95th percentile on CDC growth charts is considered obese; overweight refers to BMI between the 85th and 95th percentiles.) The childhood obesity rate has more than tripled over the past four decades, though rates have leveled off in recent years (1, 2). While some progress has been made, data show that significant racial/ethnic and socioeconomic disparities persist in obesity prevalence (1, 2).

Compared with children at healthy weight, those who are overweight or obese are at higher risk for a range of health problems, including asthma, heart disease, and some types of cancer; they also are more likely to become overweight or obese adults (3, 4). Some obese children are diagnosed with illnesses previously considered “adult” conditions, such as high blood pressure and type 2 diabetes (3, 4). In addition, children with obesity are at increased risk for joint and bone problems, sleep apnea, and social and emotional difficulties, such as stigmatization and low self-esteem (3, 4). Obesity's impact also extends beyond the individual. U.S. medical care costs related to adult obesity are estimated between $147 billion and 210 billion annually; in California, a 5% reduction in average adult BMI could save more than $80 billion in obesity-related health care costs by 2030 (2, 5).

Many factors contribute to childhood obesity and overweight. The rise has been attributed to changes in food environments that make non-nutritious "junk" food and beverages more available, affordable, and appealing, as well as social and environmental changes that have reduced physical activity among children—e.g., increased sedentary screen time, less physical education, neighborhoods that do not promote walking or riding bikes, and decreased safe places for children to play (2, 3, 4).

In 2018, 41% of 5th graders, 39% of 7th graders, and 37% of 9th graders in California were overweight or obese. These figures have remained relatively stable since 2011. Statewide, the percentage of boys who were overweight or obese in 2018 was higher than the percentage for girls in each grade level.

Across regions and racial/ethnic groups there are wide variations in the percentage of students who are overweight or obese. For example, the percentage of 5th graders who were overweight or obese ranged from 19% to 52% among counties with data in 2018, and from 0% to 70% across school districts. Statewide, 54% of Native Hawaiian/Pacific Islander and 49% of Hispanic/Latino 5th graders were overweight or obese in 2018, compared with less than 30% of their Asian American and white peers.

California has been a leader in advancing policies to combat the overweight and obesity epidemic among children, from banning sugar-sweetened beverages and unhealthful foods in schools to requiring nutrition labeling in chain restaurants (1). While the state's child and adolescent obesity rates have leveled off in recent years, significant disparities persist by race/ethnicity and socioeconomic status (2). Reducing childhood obesity requires equitable access to safe places to play, frequent opportunities for physical activity in and out of school, affordable healthful foods and beverages, and reduced access to high-calorie and sugar-sweetened foods and drinks, among other factors (3, 4, 5). Public policy can make a difference by changing the environments in which children live, play, go to school, and make food choices.

Policy options that could promote healthy weight in childhood include:

• Continuing to enforce and extend legislation that restricts the availability of unhealthful foods and drinks in schools, improves the nutritional quality of foods and beverages sold at school, and increases the accessibility of drinking water and fresh fruits and vegetables (3, 6, 7)
• Promoting increased student participation in the School Breakfast Program, as a healthful breakfast can help regulate food intake throughout the day and decrease the risk of obesity (8)
• Funding and facilitating high-quality programs in school and child care settings that meet existing nutrition and physical activity standards, expand opportunities for daily exercise outside of physical education, and integrate food literacy education and physical activities into lesson planning (3, 6, 9)
• Encouraging shared use agreements to make school recreational facilities available outside of school hours, especially in neighborhoods that lack safe places for physical activity (10)
• Supporting and planning for a built environment in schools and communities that encourages walking, bicycling, and outdoor play (3, 4, 5)
• Promoting comprehensive cross-sector strategies to reduce consumption of sugary beverages and increase availability of healthful affordable food options (3)
• Ensuring that anti-obesity efforts effectively address racial/ethnic and socioeconomic inequities, focus on early childhood interventions—as disparities are present already in preschool—and target the cultural and environmental contexts in which obesity is most prevalent—e.g., low-income communities (11)
• Supporting public education to promote healthful eating and active living (3)
• Implementing common standards for marketing food and beverages to children and adolescents (3, 12)
• Promoting evidence-based practices to increase breastfeeding initiation, duration, and exclusivity, as these have been shown to protect against obesity (2)