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U.S. Department of Health and Human Services Office of Disease Prevention and Health Promotion

Reduce the proportion of children and adolescents with obesity — NWS‑04 Data Methodology and Measurement

This objective is a Leading Health Indicator (LHI). Learn about LHIs.

On this page:  About this objective  |  Methodology  |  History

About this objective

Data

Data Source:  National Health and Nutrition Examination Survey (NHANES), CDC/NCHS

National baseline: 17.8 percent of children and adolescents aged 2 to 19 years had obesity in 2013-16

National target: 15.5 percent

Numerator
Number of children and adolescents aged 2 to 19 years with a body mass index (BMI) at or above the sex-and age-specific 95th percentile from the CDC Growth Charts; United States.
Denominator
Number of children and adolescents aged 2 to 19 years.
National target-setting method
Minimal statistical significance
National target-setting method details
Minimal statistical significance, assuming the same standard error for the target as for the baseline.
National target-setting method justification
Trend data were evaluated for this objective but it was not possible to project a target because the trend was moving away from the desired direction. The standard error was used to calculate a target based on minimal statistical significance assuming the same standard error for the target as for the baseline. This method was used because it was a statistically significant improvement from the baseline.
National data collection frequency
Other

Methodology

Methodology notes

The NHANES obtains measured weights in an examination gown and heights without shoes. BMI is calculated by dividing weight in kilograms by the square of height in meters. Children and adolescents with a BMI at or above the sex-and age-specific 95th percentile based on the 2000 CDC growth charts are considered obese.

Obesity is generally defined as excess body fat. However, since excess body fat is difficult to measure directly, obesity is often defined as excess body weight adjusted for height as measured by BMI or age and sex specific BMI percentiles for children and adolescents. BMI will be used as a proxy for obesity in children and adolescents. Among children, the marked BMI changes that occur with growth and development make it necessary to specify a high BMI relative to children of the same sex and age.

Design changes were made to the August 2021-2023 NHANES cycle to minimize in-person contact during the COVID-19 pandemic. Refer to the Data Source page for more information. Unlike previous cycles, there was no oversampling of persons with family incomes <185% of the poverty threshold. This may result in lower confidence in the estimate and insufficient power to detect differences between groups. In addition, seventeen percent of interview participants had missing family income data.

Reference: See Ogden et al. for more discussion about estimates by race and ethnicity using August 2021–August 2023 NHANES data: Ogden CL, Emmerich SD, Stierman B, Chen T-C, Simon AE, Freedman DS, et al. Obesity among children and adolescents in NHANES August 2021–August 2023: An examination of race/Hispanic origin subgroup estimates. Pediatr Obes. 2025 Oct;20(10):e70041. DOI: https://onlinelibrary.wiley.com/doi/10.1111/ijpo.70041

https://onlinelibrary.wiley.com/doi/10.1111/ijpo.70041

History

Comparable HP2020 objective
Retained, which includes core objectives that are continuing from Healthy People 2020 with no change in measurement.