Obesity Disproportionately Affected Black, Hispanic Children, Adolescents During COVID-19

The prevalence of childhood and adolescent obesity has significantly increased since 2011 and may have been exacerbated by the COVID-19 pandemic, a study published in Annals of Family Medicine found.

Investigators conducted the study to address the massive disruption to health care access caused by the COVID-19 pandemic, which they noted no study has covered before on a national scale.

Despite the overall obesity prevalence increasing just 1.7 percentage points, the study results showed a disproportionate percentage of obesity prevalence in Black and Hispanic youth when compared with non-Hispanic White youth. - adrian_ilie825 - stock.adobe.com

As of 2024, the CDC reported approximately every 1 in 5 US children and adolescents were obese.2 This is a stark climb from the rate of child obesity in 1975, which was nearly one-third of what it is today at 5%.3 In the US, this accounts for more than 1 in 3 Black youth, more than 1 in 4 Hispanic youth, nearly 1 in 5 non-Hispanic White youth, and 1 in 10 Asian youth.1

“What we see, though, is that over the last 10 years there's been a steady increase in obesity across the country among children and adolescents, and that's increased steadily,” lead author Michael Liu, MD, a resident at Brigham and Women’s Hospital, said in an interview with The American Journal of Managed Care® (AJMC®). “But when we account for those secular trends, where we think about trends over time, we wanted to see what actually happened during the COVID-19 pandemic.”

Researchers observed 7507 participants—54.5% of whom were children aged 2 to 11 years and 45.6% of whom were adolescents aged 12 to 19 years—using cross-sectional data from 2011 to 2023 survey cycles of the National Health and Nutrition Examination Survey. In the study, participants were stratified using the CDC’s predefined measurement of obesity and overweight, which is a body mass index (BMI) at or above the 95th percentile, and severe obesity at or above the 120th percentile.

Of the participants in the study, 13.7% were Black, 14.8% were Mexican-American, 9.3% were other Hispanic, 50.7% were White, 5.5% were Asian, and 5.9% were another race or ethnicity. Overall, the prevalence of obesity from January 2011 to March 2020 was 20.3% and increased to 22% from August 2021 to August 2023.

“Loss of space, safe spaces for physical activity with school closures, food insecurity that occurred with schools, for example, with children and youth losing access to school meals that tend to be more regulated in terms of nutrition and other health standards,” Liu said. “Also, just the economic hardships that we know disproportionately impacted Black and minority populations. And we know that stress associated with the pandemic and with economic hardships are all also associated with weight gain and increased risk for obesity.”

Despite the overall obesity prevalence increasing just 1.7 percentage points, the study results showed a disproportionate percentage of obesity prevalence in Black and Hispanic youth when compared with non-Hispanic White youth.

Obesity prevalence among Black children and adolescents rose from 22.4% to 35.8% from 2011 to August 2023. At the conclusion of the study, the obesity prevalence in Black children and adolescents was 62.73% higher than the overall prevalence across all races and ethnicities combined. Childhood and adolescent obesity are disproportionately prevalent among minority racial and ethnic groups.3 In the new study, the overall prevalence of obesity was highest among Black (35.8%), Mexican American (28.1%), and other Hispanic (25.9%) youth.1

Corresponding author Rishi Wadhera, MD, MPP, MPhil, section head of health policy research at the Smith Center, associate professor at Harvard Medical School, and general cardiologist at Beth Israel Deaconess Medical Center, attributes the spike in food insecurity at the beginning of the pandemic to the disproportionate rates of access to healthy foods and increased prevalence of obesity amongst Black children and adolescents.

“We know that Black children and adolescents are more likely to live in high-poverty neighborhoods due to systemic inequities and structural racism. Black youth are less likely to have access to nutritious foods and grocery stores and are more likely to live in pharmacy deserts,” Wadhera told AJMC. “Including the disproportionate stress imposed on minoritized populations during the pandemic, the potential onset of poor dietary patterns in response to the pandemic, and then worsening physical activity due to loss of safe outdoor spaces due to lack of green space that we know is pervasive in Black communities, to begin with, all probably contributed to this rise in obesity amongst Black children and adolescents.”

Individuals with obesity and overweight are at an increased risk of developing conditions like high blood pressure, elevated blood lipids, diabetes, and increased LDL cholesterol, all of which are significant contributors to heart disease and stroke. Other short- and long-term consequences include hyperlipidemia, sleep apnea, depression, and early mortality.3 Although the prevalence of severe obesity remained stable throughout the study period across all subgroups and overall. Yet, the striking increase in prevalence of obesity in the US during the COVID-19 pandemic was only observed amongst Black children and adolescents and not any other racial or ethnic group.

Liu said that immediate family interventions can help target contributing factors to childhood and adolescent obesity.

“These are things like encouraging regular family meals with balanced portions for children, reducing sugary drinks, limiting screen time, encouraging outdoor play—all the things that kind of target the factors that we've already talked about that contribute to weight gain and obesity risk,” Liu said. “Then at the community level, I think there's a lot to be done there, addressing the fundamental social determinants that we've talked a little bit about. Investing in poverty relief programs, investing in parks and recreation centers, supporting local farmers markets and, you know, healthy grocery stores.”

References

1. Wadhera RK. Obesity prevalence among children and adolescents in the United States, 2011 to 2023. Annals of Internal Medicine. 2025;178(10). doi:10.7326/ANNALS-25-00389

2. Childhood obesity facts. Centers for Disease Control and Prevention. April 2, 2024. Accessed June 27, 2025. https://www.cdc.gov/obesity/childhood-obesity-facts/childhood-obesity-facts.html

3. Cuevas AG, Krobath DM, Rhodes-Bratton B, et al. Association of racial discrimination with adiposity in children and adolescents. JAMA Netw Open. 2023;6(7): e2322839. doi:10.1001/jamanetworkopen.2023.22839