Background: The COVID-19 pandemic has presented a great challenge to children and their families with stay-at-home orders, school closures, decreased exercise opportunities, stress, and potential overeating with home confinement. Our study describes the body mass index (BMI) changes over an entire decade, including a year of the COVID-19 pandemic at a large children's hospital. Methods: With our retrospective observational study, data were extracted from Cincinnati Children's Hospital's Epic electronic medical record, a free-standing children's hospital with 670 inpatient beds and >1.2 million patient encounters per year. Children aged 19 years and under with at least one height and weight were included in the analysis. Results: In all, 2,344,391 encounters were analyzed with 712,945 visits in years 2018-2021. The prevalence of overweight/obesity was relatively stable with a gradual rise from 35% to 36.4% from 2011 to 2020. However, the year of the COVID-19 stay at home and restrictions (2020-2021) showed an increase in overweight/obesity to 39.7% (8.3% increase), with the greatest increase in those with Class 3 obesity from 3.0% to 3.8%. When viewing the change in BMI percentile during the pandemic year compared with the 2 years prior, there was a significantly increasing trend (p< 0.0001). Conclusions: Children attending a large children's hospital showed an increase in overweight/obesity during the COVID-19 pandemic. These data suggest greater efforts are needed to reverse the increase in weight status from the COVID-19 pandemic as obesity is a risk factor for poor outcomes with COVID-19.
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