Obesity in children, overweight children, childhood obesity

Weight Problems in Childhood

Determining a weight problem during childhood can be challenging. How do you know if the excess weight your child has is part of the natural growth process, and will your child just outgrow it? Obesity is defined as an excessive accumulation of body fat. Obesity is present when total body weight is more than 25 percent fat in boys and more than 32 percent fats in girls. Childhood obesity is often defined as a weight-for-height in excess of 120 percent of the ideal weight scale. Parents appear to underestimate the health risk of excess weight to their children, and the difficulty in achieving and maintaining behavioral changes associated with obesity prevention. One out of five children is considered overweight, with obesity being the number one health problem among adolescents in the United States.

According to the U.S. Department of Agriculture (USDA), there is a steady decline in the diet quality of children and adolescents as they get older. The U.S. Surgeon General recommends moderate physical activity for children every day for at least 60 minutes. If a child is unable to meet that goal, than an individualized program should be designed according to fitness level, using the general guideline as an ultimate goal. Set goals for health, not weight, as appropriate for growing children. Expecting all children to be at an ideal weight range is unrealistic and can lead to problems. It is more realistic to expect that children maintain a healthy weight. Involvement of the entire family is also a motivating factor. Weight loss programs that involve both parents and the child has shown improvement in long-term effectiveness compared to directing the program only to the child.

Risks of Being Overweight

Obesity in children and adolescents is a serious issue with many health and social consequences that often continue into adulthood. There is some chances that weight gain beginning in early childhood will persist through the life span. Along with the rise in childhood obesity, there has been an increase in the incidence and prevalence of medical conditions in children and adolescents that had been rare in the past. Pediatricians and childhood obesity researchers are reporting more frequent cases of obesity-related diseases such as type two diabetes, asthma and hypertension that once were considered adult conditions.

About one-third of the children in elementary have daily physical education, and fewer than one-fifth have extracurricular physical activity programs at their schools. Additional studies are needed to develop appropriate public health programs to better educate parents in identifying and understanding changes in their children's weight, to incorporate the family in prevention efforts, and to improve school-based obesity prevention programs that include increasing physical education classes. Many parents don’t realize that excess weight in childhood will not be automatically shed as a child grows.

Overweight and Heredity

Heredity has recently been shown to influence weight gain due to regional fat distribution, and response to overfeeding. In addition, infants born to overweight mothers have been found to be less active and to gain more weight by age three months when compared with infants of normal weight mothers. An important part of treating obesity between children and adolescents is for parents and professionals to be sensitive to the youngsters and focus on the positive. Small and achievable weight loss goals should be set to avoid discouragement and to allow for the normal growth process. Involvement of the entire family is also a motivating factor. Weight loss programs that involve both parents and the child has shown improvement in long-term effectiveness compared to directing the program only to the child.

Achieving Weight Loss

Reducing the number of calories, the child eats and implementing strategies like learning to read nutrition labels and the food guide pyramid, selecting proper portion sizes, and prepared foods. Fasting or extreme caloric restriction is not advisable for children. Not only is this approach psychologically stressful, but it may adversely affect growth and the child's perception of "normal" eating. Balanced diets with moderate caloric restriction, especially reduced dietary fat, have been used successfully in treating obesity. Diet management along with exercise is an effective treatment for childhood obesity.
Addressing healthy weight in positive ways is preferable to emphasizing obesity risks, as this can contribute to fear, shame, disturbed eating, social discrimination, and size harassment. Teaching healthy behaviors at a young age is important since change becomes more difficult with age. Behaviors involving physical activity and nutrition are the basics of preventing weight gain in children and adolescents. Families and schools are crucial in providing the foundation for those behaviors. Obesity is easier to prevent than to treat, and prevention focuses in large measure on parent education. In early childhood, education should include proper nutrition, selection of low-fat snacks, good exercise along with activity habits, and monitoring of television viewing. In cases where preventive measures cannot totally overcome the influence of hereditary, education builds self-esteem and supports psychological issues.

Body Mass Index

Height/weight measurements and BMIs need to be considered as part of an overall assessment and not as the single measurement for determining health status. Children grow and mature in different ways, and a child’s weight for height or BMI can best be evaluated in relation to his or her own growth history. Also, growth spurts may be preceded by an increase in body fat. When weights are measured in schools, we recommend measuring and tracking related factors as well, including fitness levels, eating and activity behaviors, weight loss practices, and body image attitudes.