Childhood obesity is a serious medical condition that affects children and adolescents. Children who are obese are above the normal weight for their age and height.
Childhood obesity is particularly troubling because the extra pounds often start children on the path to health problems that were once considered adult problems — diabetes, high blood pressure and high cholesterol. Many obese children become obese adults, especially if one or both parents are obese. Childhood obesity can also lead to poor self-esteem and depression.
One of the best strategies to reduce childhood obesity is to improve the eating and exercise habits of your entire family. Treating and preventing childhood obesity helps protect your child’s health now and in the future.
Not all children carrying extra pounds are overweight or obese. Some children have larger than average body frames. And children normally carry different amounts of body fat at the various stages of development. So you might not know by how your child looks if weight is a health concern.
The body mass index (BMI), which provides a guideline of weight in relation to height, is the accepted measure of overweight and obesity. Your child’s doctor can use growth charts, the BMI and, if necessary, other tests to help you figure out if your child’s weight could pose health problems.
When to see a doctor
If you’re worried that your child is putting on too much weight, talk to his or her doctor. The doctor will consider your child’s history of growth and development, your family’s weight-for-height history, and where your child lands on the growth charts. This can help determine if your child’s weight is in an unhealthy range.
Lifestyle issues — too little activity and too many calories from food and drinks — are the main contributors to childhood obesity. But genetic and hormonal factors might play a role as well. For example, recent research has found that changes in digestive hormones can affect the signals that let you know you’re full.
Many factors — usually working in combination — increase your child’s risk of becoming overweight:
- Regularly eating high-calorie foods, such as fast foods, baked goods and vending machine snacks, can cause your child to gain weight. Candy and desserts also can cause weight gain, and more and more evidence points to sugary drinks, including fruit juices, as culprits in obesity in some people.
- Lack of exercise. Children who don’t exercise much are more likely to gain weight because they don’t burn as many calories. Too much time spent in sedentary activities, such as watching television or playing video games, also contributes to the problem.
- Family factors. If your child comes from a family of overweight people, he or she may be more likely to put on weight. This is especially true in an environment where high-calorie foods are always available and physical activity isn’t encouraged.
- Psychological factors. Personal, parental and family stress can increase a child’s risk of obesity. Some children overeat to cope with problems or to deal with emotions, such as stress, or to fight boredom. Their parents might have similar tendencies.
- Socioeconomic factors. People in some communities have limited resources and limited access to supermarkets. As a result, they might buy convenience foods that don’t spoil quickly, such as frozen meals, crackers and cookies. Also, people who live in lower income neighborhoods might not have access to a safe place to exercise.
Childhood obesity can have complications for your child’s physical, social and emotional well-being.
- Type 2 diabetes. This chronic condition affects the way your child’s body uses sugar (glucose). Obesity and a sedentary lifestyle increase the risk of type 2 diabetes.
- Metabolic syndrome. This cluster of conditions can put your child at risk of heart disease, diabetes or other health problems. Conditions include high blood pressure, high blood sugar, high triglycerides, low HDL (“good”) cholesterol and excess abdominal fat.
- High cholesterol and high blood pressure. A poor diet can cause your child to develop one or both of these conditions. These factors can contribute to the buildup of plaques in the arteries, which can cause arteries to narrow and harden, possibly leading to a heart attack or stroke later in life.
- Children who are overweight or obese might be more likely to have asthma.
- Sleep disorders. Obstructive sleep apnea is a potentially serious disorder in which a child’s breathing repeatedly stops and starts during sleep.
- Nonalcoholic fatty liver disease (NAFLD). This disorder, which usually causes no symptoms, causes fatty deposits to build up in the liver. NAFLD can lead to scarring and liver damage.
- Bone fractures. Obese children are more likely to break bones than are children of normal weight.
Social and emotional complications
- Low self-esteem and being bullied. Children often tease or bully their overweight peers, who suffer a loss of self-esteem and an increased risk of depression as a result.
- Behaviour and learning problems. Overweight children tend to have more anxiety and poorer social skills than normal-weight children do. These problems might lead children who are overweight either to act out and disrupt their classrooms or to withdraw socially.
- Low self-esteem can create overwhelming feelings of hopelessness, which can lead to depression in some children who are overweight.
Whether your child is at risk of becoming overweight or is currently at a healthy weight, you can take measures to get or keep things on the right track.
- Limit your child’s consumption of sugar-sweetened beverages or avoid them
- Provide plenty of fruits and vegetables
- Eat meals as a family as often as possible
- Limit eating out, especially at fast-food restaurants, and when you do eat out, teach your child how to make healthier choices
- Adjust portion sizes appropriately for age
- Limit TV and other “screen time” to less than 2 hours a day for children older than 2, and don’t allow television for children younger than 2
- Be sure your child gets enough sleep
Also, be sure your child sees the doctor for well-child checkups at least once a year. During this visit, the doctor measures your child’s height and weight and calculates his or her BMI. An increase in your child’s BMI or in his or her percentile rank over one year is a possible sign that your child is at risk of becoming overweight.
As part of regular well-child care, the doctor calculates your child’s BMI and determines where it falls on the BMI-for-age growth chart. The BMI helps indicate if your child is overweight for his or her age and height.
Using the growth chart, your doctor determines your child’s percentile, meaning how your child compares with other children of the same sex and age. For example, if your child is in the 80th percentile, it means that compared with other children of the same sex and age, 80 percent have a lower weight or BMI.
Cutoff points on these growth charts, established by the Centers for Disease Control and Prevention, help identify children who are overweight and obese:
- BMI between 85th and 94th percentiles — overweight
- BMI 95th percentile or above — obesity
Because BMI doesn’t consider things such as being muscular or having a larger than average body frame and because growth patterns vary greatly among children, your doctor also factors in your child’s growth and development. This helps determine whether your child’s weight is a health concern.
In addition to BMI and charting weight on the growth charts, the doctor evaluates:
- Your family’s history of obesity and weight-related health problems, such as diabetes
- Your child’s eating habits
- Your child’s activity level
- Other health conditions your child has
- Psychosocial history, including incidences of depression, sleep disturbances, and sadness and whether your child feels isolated or alone or is the target of bullying
Your child’s doctor might order blood tests if he or she finds that your child is obese. These tests might include:
- A cholesterol test
- A blood sugar test
- Other blood tests to check for hormone imbalances, vitamin D deficiency or other conditions associated with obesity
Some of these tests require that your child not eat or drink anything before the test. Ask if your child needs to fast before a blood test and for how long.
Treatment for childhood obesity is based on your child’s age and if he or she has other medical conditions. Treatment usually includes changes in your child’s eating habits and physical activity level. In certain circumstances, treatment might include medications or weight-loss surgery.
Treatment for children who are overweight
The American Academy of Paediatrics recommends that children older than 2 and adolescents whose weight falls in the overweight category be put on a weight-maintenance program to slow the progress of weight gain. This strategy allows the child to add inches in height but not pounds, causing the BMI to drop over time into a healthier range.
Treatment for children who are obese
Children ages 6 to 11 who are obese might be encouraged to modify their eating habits for gradual weight loss of no more than 1 pound (or about 0.5 kilogram) a month. Older children and adolescents who are obese or severely obese might be encouraged to modify their eating habits to aim for weight loss of up to 2 pounds (or about 1 kilogram) a week.
The methods for maintaining your child’s current weight or losing weight are the same: Your child needs to eat a healthy diet — both in terms of type and amount of food — and increase physical activity. Success depends largely on your commitment to helping your child make these changes.
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