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Kids and teens' rate of body mass index (BMI) increase almost doubled during the pandemic compared with prior years, and the percentage with obesity also increased, researchers found.

Among those ages 2 to 19 years, the monthly BMI increase rose from 0.052 (January 2018-February 2020) to 0.100 (March 2020-November 2020), reported Samantha Lange, MPH, of the CDC, and colleagues.

Moreover, the estimated proportion of those with obesity rose from 19.3% in August 2019 to 22.4% in August 2020, the authors wrote in the .

In addition, among younger groups of children, ages 3-5 and 6-11, the authors found "the difference in the rate of BMI change increased with increasing BMI category," so those with severe obesity had higher increases than those who were overweight.

The researchers noted that during the pandemic, kids were likely away from "structured school settings" and may have experienced "increased stress, irregular mealtimes, less access to nutritious foods, increased screen time, and fewer opportunities for physical activity."

"The present study is the largest and first geographically diverse analysis to assess the association of the COVID-19 pandemic with BMI and the first to show results by initial BMI category," the authors wrote.

Lange's group examined data from IQVIA's to examine data from a pre-pandemic time period and compare it with data from during the pandemic. The cohort was comprised of 403,202 individuals ages 2 to 19 (51% male), and about two-thirds were white. Obesity prevalence was 16.1%, while 4.8% had severe obesity.

The authors also divided the children and teens into BMI categories, and found significant increases in the rate of BMI among all categories except underweight. Among those with overweight, moderate obesity, and severe obesity, the rates of BMI increase more than doubled, the team said, and even those with healthy weight had a rate of BMI change that almost doubled (ratio 1.78).

These changes were most pronounced among elementary school children ages 6 to 11, whose rate of BMI change more than doubled versus the pre-pandemic rate (ratio 2.50).

The authors concluded that obesity prevention efforts are critical for young children during public health emergencies, such as the COVID-19 pandemic.

"These efforts could include screening for BMI, food security, and other social determinants of health by health care providers; increased access to evidence-based pediatric weight management programs and food assistance resources; and state, community, and school efforts to facilitate healthy eating, physical activity, and chronic disease prevention," Lange and co-authors wrote.

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