Pediatricians and public health experts predict a potentially dramatic increase in childhood obesity this year as months of pandemic eating, closed schools, stalled sports and public space restrictions extend indefinitely.

About one in seven children have met the criteria for childhood obesity since 2016, when the federal National Survey of Children’s Health changed its methodology, a report out Wednesday by the Robert Wood Johnson Foundation found. 

While the percentage of children considered obese declined slightly in the last 10 years, it is expected to jump in 2020.

“We were making slow and steady progress until this,” said Diane Whitmore Schanzenbach, a Northwestern University economist and professor. “It’s likely we will have wiped out a lot of the progress that we’ve made over the last decade in childhood obesity.”

The trend, already seen in pediatric offices, is especially concerning as the Centers for Disease Control and Prevention this week expanded its definition of those at elevated risk of severe COVID-19 disease and death to include people with a body mass index of between 25 and 30. Previously, only those with a BMI 30 and higher were included. That could mean 72% of all Americans are at higher risk of severe disease based only on their weight.

Obesity is a top risk factor for nearly all of the chronic health conditions that make COVID-19 more dangerous, including diabetes, hypertension. heart disease and cancer. And childhood obesity is a leading predictor of obesity later in life.

BMI factors in weight and height to measure body fat. It can, however, overestimate body fat in people with muscular builds and underestimate it in those who have lost muscle, according to the National Institutes of Health. 

Children are “gaining not insignificant amounts of weight,” said Dr. Lisa Denike, who chairs pediatrics for Northwest Permanente in Portland, Oregon. “We’ve seen kids gain 10 to 20 pounds in a year, who may have had a BMI as a preteen in the 50 or 75th percentile and are now in the 95th percentile. That’s a significant crossing of percentiles into obesity.”

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Denike said one 11-year-old patient at his recent physical was found to have gained 40 pounds. Type 2 diabetes rates in children are rising, and even though the boy doesn’t have it now, Denike said, “I suspect he will in the coming years as his parents already have it.”

“He’s home in an environment struggling with parents with same issues rather than learning in health class and having activity outside,” she said. “Kids are reflections of what their parents do.”

Racial, socioeconomic disparities  

Disparities in childhood obesity rates have existed for decades and now mirror the disproportionate way COVID-19 is affecting people of color and those with low incomes, said Jamie Bussel, a senior program officer at the Robert Wood Johnson