Children's Rates of BMI Change Prepandemic and During Two COVID‐19 Pandemic Periods, IQVIA AEMR, January 2018‐November 2021

Abstract

Objective

Many U.S. youth experienced accelerated weight gain during the early COVID‐19 pandemic. Using an ambulatory electronic health record dataset, we compared children's rates of BMI change in three periods: prepandemic (January 2018‐February 2020), early pandemic (March‐December 2020), and later pandemic (January‐November 2021).

Methods

We used mixed‐effects models to examine differences in rates of change in BMI, weight, and obesity prevalence among the three periods. Covariates included time as a continuous variable; a variable indicating in which period each BMI was taken; sex; age; and initial BMI category.

Results

In a longitudinal cohort of 241,600 children aged 2‐19 years with ≥4 BMIs, the monthly rates of BMI change (kg/m²) were 0.056 (95%CI: 0.056, 0.057) prepandemic, 0.104 (95%CI: 0.102, 0.106) in the early pandemic, and 0.035 (95%CI: 0.033, 0.036) in the later pandemic. The estimated prevalence of obesity in this cohort was 22.5% by November 2021.

Conclusions

In this large geographically‐diverse cohort of U.S. youth, accelerated rates of BMI change observed during 2020 were largely attenuated in 2021. Positive rates indicate continued weight gain rather than loss, albeit at a slower rate. Childhood obesity prevalence remained high, which raises concern about long‐term consequences of excess weight and underscores the importance of healthy lifestyle interventions.

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