Childhood Obesity

Childhood obesity occurs when a child or an adolescent has weight more than normal for his or her age and height.

Childhood obesity, a serious medical condition, can lead to health problems like diabetes, high blood pressure and high cholesterol.

An obese child can have poor self-esteem and depression.

Improving the diet and exercising helps to reduce the childhood obesity.

The main symptom of Childhood obesity is that the child weighs more than is normal for his/her age and height.

Children have different amount of body fat at various stages of development. Hence, a child carrying extra pounds may not be obese or overweight.

Your child's doctor can tell if your child is obese or overweight using growth charts or other necessary tests and whether the weight would cause health problems.

When to see a doctor

Talk to your child's doctor or pediatrician if you are concerned about your child's increasing weight. The doctor will review your child's history of growth and development, your family's weight for height history and determine whether your child is obese or not.

The main causes of Childhood obesity are:

• Too little physical activity
• Excessive calories from food and drinks

The most common cause is lifestyle issues but genetic and hormonal factors (less common) may also contribute to child's obesity.

Your child's obesity will be most certainly diagnosed by the pediatrician. The complications of obesity, if any, can be managed by the specialists.

• Body Mass Index (BMI): The pediatrician calculates your child's BMI and determines whether s/he is overweight or not with the help of BMI-for-age chart. The doctor determines your child's percentile with the help of growth chart. Children with BMI-for-age between 85th and 94th percentile are overweight while those with 95th percentile or above are obese. Since growth pattern differ among children and also BMI doesn’t take consideration of average body frame, these factors are taken in account while assessing the obesity of the children.
• Blood Tests: Blood sugar test, cholesterol test are done if the doctor finds your child to be an obese. The doctor may recommend other tests for hormonal disturbances. Ask the doctor if there are any restrictions like fasting before the blood test.

How to prepare yourself for the visit

• If the appointment with the pediatrician has been scheduled ask the doctor whether there are any pre-appointment restrictions. For example, your child may need to fast if the doctor has intended to check your child's blood sugar or cholesterol level.
• If you feel that the symptoms your child has been experiencing is unrelated make sure you ask the pediatrician. You could show the growth measurements of your child that has been recorded or a typical week's meal that your child eats. It is a good idea to bring the weight of siblings and parents.
• You could ask the doctor about the health problems that your child can have, treatment option and duration, available medications, any brochures or printed materials on obesity. You may need to write down the important information that your child's doctor provide.

What your doctor wants to know

The pediatrician, during the appointment, can ask you questions about your child's eating activity, symptoms that your child has been experiencing, any alteration on mood and thoughts or if you have tried any diets or medications to help your child lose weight.

The doctor assesses:

• Your child's lifestyles
• Other health condition he may have
• If the family has history of obesity or disease like diabetes

What you can do in the meantime

If you have time before the appointment, record the child's eating habit and daily activity.

Treatment for childhood obesity suggested by your pediatrician is dependent on your child's age and other medical conditions he/she may have. The pediatrician usually suggests you to change the child's lifestyle which includes changes in diets and increased physical activities. However in some cases, medication or weight loss surgery may be necessary.

Treatment for overweight children

Overweight children (over the age of 2) or adolescent are put on weight-maintenance program as suggested by American Academy of Pediatrics. This program helps to reduce weight and increase in height thus the BMI to be in normal range.

Treatment for obese children

The weight loss for obese children, aged 6-11, should not exceed a pound in a month whereas for older children and adolescent it is intended for up to 2 pounds a week. The children are put on a healthy diet with increased physical activity.

• Avoid foods that are high in sugar, fat or calories such as cookies. Make sure your children eat healthy diet and plenty of fruits and vegetables.
• Avoid sweetened drinks that have little nutritional value but high calorie content.
• Avoid fast food since they contain high amount of fat and calories that could make your child more obese.
• Limit the time your child spends in TV and computer. Do not let your child eat in front of TV, computer or video games since it can cause your children to eat more.
• Serve food in accordance to child's need. Remember your child doesn’t need much food as compared to adults.
• Physical activity is necessary not only for weight loss but also to maintain sleep at night, and build bones and muscles. Restrict the time your child spends being sedentary. Limit the time your child spends on videogames, computer and TV. Do not emphasize on exercise only. Try to increase your child's activity by going on hiking, climbing wall or cycling.
• Some adolescents may be prescribed with medications for weight loss. The only drug available is Orlistat that decreases absorption of fat from the gut. However, the efficacy is questioned and its longer term effects are unknown.
• Another option for severely obese adolescent could be weight loss surgery. However, its long term effect has not been studied well and its effect on growth and development has not been established yet. Also with surgery comes risk and complications. So, surgery is recommended if surgery pose less risk than presented by child's weight.

To prevent your child from Childhood obesity, following measures can be adopted:

• Encourage your child to eat plenty of fruits and vegetables
• Avoid eating fast food
• Feed your child with appropriate amount
• Restrict the time your child spends in front of TV or computer
• Avoid sweetened drinks

Lifestyle modifications are necessary in order to cope with Childhood obesity.

You can take following steps so that your child starts eating healthy diets and exercising more:

• Children usually learn from what they see. Make sure that you prioritize eating healthy food and being physically active in the family. Also, encourage your child to do regular exercise.
• To make sure your child commits to the life style changes let your child decide the physical activities he's comfortable with.
• Your child can be sensitive so take every opportunity to commend your child's accomplishment and effort. Be patient with your children and get to know how your child feels.
• Do not overly criticize your child's eating habits which can cause child to overeat. Help your child to cope up with the emotions and emphasize on positive goals only.

There are several risks and complications associated with Childhood obesity.

There are several factors which make the child prone to becoming obese:

• Foods with high calorie and fat amount such as cookies, cakes, fast food cause increase in weight. Soft drinks, chocolates, candies also contribute to weight gain
• Children with no or little physical activities are risk at becoming obese.
• Parents with overweight are more likely to develop an overweight child. This holds true where sedentary lifestyle prevails and high calorie foods are taken.
• Some children develop a habit of overeating to deal with the problems, stress or boredom. Eating frozen meals, cookies and crackers are more likely to cause weight gain

Childhood obesity can severely affect your child's physical, social and emotional well-being.

Physical complications

• Obese child with little physical activities are at increased risk to develop Type 2 Diabetes (chronic condition that increases blood sugar level).
• Obese child can have metabolic syndrome that increases your child's risk of developing different health problems. Metabolic syndrome is a condition where your child has high blood pressure, high blood sugar level, high triglycerides and excess abdominal fats. The high level of cholesterol and high blood level can cause stroke or heart attack in later life.
• Overweight child are at increased risk to develop asthma. Obstructive sleep apnea (serious disorder in breathing while sleeping) is one of the complications of childhood obesity.
• Non-alcoholic fatty liver disease (NAFLD) is also the complication of obesity. Usually no symptoms are seen but fatty acids are deposited in the liver which eventually leads to scarring and liver damage.
• Obesity can cause hormonal disturbances which may cause early puberty or menstruation.

Social and emotional complications

• Obese children are usually victims of bullying which can lead to low self-esteem and can develop depression. This cause your child to become sad, discontinue regular activities, sleep more and cry more often.
• Children with overweight are more like to have anxiety and poor social skills as compared to their normal weight peers.