The most incisive guide to issues facing the American family today . . . An invaluable resource for anyone wishing to stay on the cutting edge of research on family trends.

-W. Bradford Wilcox
Associate Professor of Sociology, University of Virginia 

Avoiding Childhood Obesity in the Fatherless Home? Fat Chance!

Bryce J. Christensen and Nicole M. King

Few public-health issues have received more attention in recent decades in the United States and other affluent countries than the epidemic of obesity among children and adolescents. Too often, those who have weighed in on this issue have been too cowed by the orthodoxies of political correctness to speak of this epidemic as the inevitable consequence of the disintegration of the family. Fortunately, scholars at Harvard, Boston College, and Indiana University recently broke through this code of silence with a study clearly identifying fatherlessness as a prime cause of childhood obesity. 

The scholars responsible for this new study proceed keenly conscious that “the prevention of obesity is a national and global health priority,” a priority rendered urgent by recent survey data indicating that “in the United States, 16.9% of children ages 2–19 years and more than one-third of adults are obese.” But the researchers stress that the problem can manifest itself among children even younger than age two. Indeed, the Harvard, Boston College, and Indiana scholars cite data showing that “obesity rates among children have substantially increased worldwide over the past 3 decades” and point to research indicating that  “adverse exposures in the intrauterine and infancy periods can ‘program’ trajectories of adiposity and metabolic function throughout life and [so] may increase short- and long-term risks for obesity and its sequelae,” including “cardio-metabolic risk.” Even during childhood, the adverse sequelae of obesity may include “serious childhood morbidities, including asthma, orthopedic problems, psychosocial adversity, and . . . Type 2 diabetes.”

To identify the “early risk factors” that render young children vulnerable to obesity, the researchers scrutinize data collected between 1980 and 2008 from birth certificates linked to results of well-child visits for 200,258 Massachusetts children. The researchers analyze these data in a statistical model that adjusts for such things as mother’s age, education, and use of tobacco and the child’s sex and gestational age. Their results indicate that when their birth certificates were missing the name of a father, infants were likely to begin life with significantly lower birthweight but were subsequently significantly more likely to reach a weight-to-length ratio that put them above the ninety-fifth percentile.  

In other words, among the babies whose birth certificates carry no father’s name, the data reveal “a trend towards increased odds of early upwards crossing of major weight-for-length percentiles, an indicator of subsequent obesity risk,” a risk that remains elevated even in statistical models that adjust for the number of children the mother has previously born and for maternal age and ethnicity.

That fatherless children are often headed for obesity follows naturally, given that these children are especially likely to suffer obesity-fostering early-life disadvantages. The researchers report that in the data for children lacking a father’s name on their birth certificate, they limn a clear statistical link to “perinatal risk factors” known to conduce to childhood obesity. Compared to infants whose birth certificates bear the name of a married father, the children lacking a father’s name on their birth certificates were almost eight times more likely to be exposed to maternal smoking (Adjusted Odds Ratio of 7.63) and were only about one third as likely to be breastfed (Adjusted Odds Ratio of 0.36). 

The presence or absence of a father’s name on the birth certificate is not the whole story. Among children with a father’s name on their birth certificate, the researchers still find obesity-fostering patterns when the mothers are not married, although these patterns are “less pronounced” than they are for the other group of children.  

Overall, the researchers consider their findings to be in harmony with previous research showing that “children with divorced parents have a higher prevalence of poor health outcomes than children residing in single-parent households, who in turn have poorer health than children living with their biological, married parents.” What is more, previous studies have established that “associations between family structure and various aspects of child development” do extend to “risk for overweight/obesity.” It is entirely predictable, then, that “obese children more frequently live in households with an unmarried single parent than [do] non-obese children.” 

It is hard to quarrel with the researchers when they suggest “using missing paternal data on the infant birth certificate as a practical tool to identify children who may be at greater risk for certain perinatal precursors of childhood obesity.” But much better than identifying children at risk would be finding ways to protect them from that risk. Giving children that protection will require a cultural and legal change that gives them two married parents—and a birth certificate bearing a father’s name. 

(Erika R. Cheng et al., “Association of Missing Paternal Demographics on Infant Birth Certificates with Perinatal Risk Factors for Childhood Obesity,” BMC Public Health 16 [2016]: 453, Web.)