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
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.