Childhood Obesity Update: Declining rates of obesity among young children, ages 2-5

By Mollie Grow, MD, MPH, FAAP

Efforts to prevent childhood obesity increasingly have shifted to younger age groups. We have seen some decline in rates of childhood obesity among young children overall1 and among children enrolled in WIC,2 with cautious optimism that multiple, coordinated and concerted efforts are making a difference. In Washington, children ages 2-4 in WIC have a 13.6% obesity rate, which has been mostly stable since 2000 and is lower than the national WIC average of 14.5%.3  A great website to review trends in obesity by state is The State of Obesity.

We have had excellent leadership among early learning sites in our state, with Danette Glassy, MD, FAAP taking an active national role in addressing health in early learning settings and serving as an author of the guide Caring for our Children. Pooja Tandon, MD, MPH, FAAP, a University of Washington faculty pediatrician, studies physical activity for children in day care, and has documented the need for more attention to outdoor time and active play. Both of them helped produce a statewide Survey of Nutrition and Physical Activity in Child Care in 2014 which identified areas where child care programs could use more support.

Our state updated Washington Administrative Codes (WACs) for child care a few years ago and is now seeking to integrate them across child care sites in partnership with the Department of Early Learning.


WA-PLAY (for Washington Physical Activity for the Young): in 2012 WCAAP and the UW/Seattle Children’s Hospital (SCH) residency program received funding from the American Academy of Pediatrics to develop materials and training on active play for 0-5 year olds. The WA-PLAY grant led to resident training at child care sites, and the program continues today. We also developed materials for parents, which are available for all to use through the SCH website. Recently we got booster funding to update these materials and disseminate them. See the SCH website. (Scroll down to the “Toys and Play” chapter on the page.)

Institute for Healthy Childhood Weight: New materials have been developed nationally by the AAP, which launched the Institute for Healthy Childhood Weight several years ago. There’s a motivational interviewing practice app called Change Talk, and multiple helpful algorithms.

In Washington, the WCAAP has also shared policy advocacy with the Childhood Obesity Prevention Coalition. In the current legislative session, the coalition is requesting support for legislation on physical education assessment and Healthy Kids, Healthy Schools grants.

There certainly is room for progress on many fronts (among them social determinants of health that affect obesity), but it’s heartening to know about the promising work seeking to tackle this epidemic and ways we can be involved in the office and community.