“There are so many factors that have to be dealt with, particularly when you get into the more severe level of disability where there are physical, sensory, cognitive and behavioral issues. There are financial issues. There are sibling issues, other children that need attention. Unfortunately health promotion is not something that gets to a high enough level of urgency in many families, not because it isn’t important but because of all the other necessities that are essential to sustaining all the other parts of that child’s life and the family’s life.”

RISK FACTORS FOR OBESITY IN THE GENERAL POPULATION
The causes of obesity are no mystery, and yet, paradoxically, its precipitous rise is not fully understood. In simplest terms, people gain weight when they consume more calories than they expend. But the root causes behind the calorie/activity imbalance are the subject of some debate. Is it our sedentary lifestyles? Is it our highly processed foods? Or are there other factors to consider?

Commonly cited reasons for obesity include:

• The higher price of healthy foods compared to unhealthy foods
• Increased portion sizes
• Increased availability of processed foods
• Increased consumption of sugar-sweetened drinks
• Decreased physical activity
• Increased screen time

A 2006 study published in the International Journal of Obesity listed some other possible causes that are less frequently cited. They include:

• Inadequate sleep, which has been tied to weight gain.
• Increased exposure to endocrine-disrupting chemicals in food and the environment which may alter metabolism.
• Climate controlled environments which reduce the calories burned by sweating and shivering.
• Women giving birth at older ages, which correlate with heavier children.