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Obesity -- Children and Teens

Definition

Obesity is a high amount of body fat. It leads to a much higher body weight than is normal. This level of body fat can cause serious health issues.

Causes

Calories are consumed from food and drinks. They are necessary for physical activity and all basic body functions. A healthy weight is reached by balancing the number of calories you eat and the number of calories you use.

Weight gain occurs when the number of calories eaten is greater than the number of calories used. If this happens regularly, it will lead to obesity. Calorie imbalances happen most often with eating too much food and low levels of physical activity. Less often, it may be caused by a medical condition or medication.

Risk Factors

Factors that may increase your child's risk of being obese include:

  • Sleep problems such as poor sleeping habits or lack of sleep
  • Large birth weight
  • Lack of exercise
  • High level of sedentary activities like watching TV, playing on the computer, or playing video games
  • High consumption of fast food
  • High consumption of sugar-sweetened drinks
  • Overeating or binging—short periods when a very large amounts of food are eaten
  • Stressful life events or change
  • Family and peer problems
  • Low self-esteem
  • Depression and other emotional problems
  • Family history
  • Genetic factors
  • Ethnicity: African American, Hispanic, Native American
  • Taking certain medicines
  • Having certain illnesses or conditions

Symptoms

The main symptom of obesity is increased weight. The midsection is the most common area to increase in thickness. There will also be obvious areas of fat deposits all over the body.

Obese Body
IMAGE
Copyright © Nucleus Medical Media, Inc.

Complications of Untreated Obesity

Excess weight increases the chance of a child having:

Diagnosis

The doctor will ask about your child's symptoms and medical history. A physical exam will be done.

Your doctor may use the body mass index (BMI). This is a tool to determine if a child's weight is ideal or outside of the desired range. BMI is based on height and weight. Normal values are based on a child's sex and age. In children, the BMI results are compared to the results of other children and teens in the same age range. This will account for growth and body changes as a child ages. BMI levels for anyone under age 20 are as follows:

  • Underweight —BMI at or below the 5th percentile for the age group
  • Desired weight —BMI between the 5th-84th percentiles for the age group
  • Overweight —BMI between the 85th-94th percentiles for the age group
  • Obese —BMI at or above the 95th percentile for the age group

Fat may need to be measured. This can be done with:

  • Tape measurements of the waist, hip, and abdomen—used to estimate the amount of fat deposited in the skin and inside the abdominal cavity
  • Skinfold caliper—a small tool that measures the fat just beneath the skin
  • Electrical measurements—a small electrical pulse can help measure the amount of fat tissue and non-fat tissue in the body

Your child's bodily fluid may be tested. This can be done with blood tests to look for other conditions that may increase body weight.

The doctor may also do other tests to check for complications of obesity. These may include checking your child's blood pressure, glucose, and cholesterol levels.

Treatment

Personal habits, lifestyle, and family culture can all influence obesity. This means that a mix of treatment approaches may be best. To help your child manage weight, encourage healthy behaviors in your child and your family:

Your doctor may recommend the following:

Diet

Your doctor may refer your child to a dietitian. A dietitian can help make a diet plan for your child. The plan may include a daily calorie goal, healthy food options, and tips to change your child’s diet.

Have your child follow basic healthy eating habits, such as:

  • Eat a diet low in saturated fat. Check food labels. Saturated fats are common in processed snacks and fried foods.
  • Avoid trans fats. These are also common in snack foods like cookies, crackers, cakes, and donuts.
  • Limit sugar-sweetened beverages. This includes sodas, sport drinks, and juices. Encourage your child to drink water.
  • Switch to low-fat or non-fat dairy products.
  • Limit refined carbohydrates. This includes sugars, white rice, and white bread.
  • Eat a high-fiber diet. This includes plenty of fruits, vegetables, and whole grains.
  • Eat a diet that is low in sodium.
  • Eat breakfast every day.

Children rarely prepare their own foods. It is important that a parent participate in healthier eating habits. For example:

  • Pay attention to how food is prepared. Foods cooked or seasoned with high amounts of fat can quickly increase calories.
  • Limit fast food, take-out, and dining out.
  • Give your child healthy lunches and snacks to take to school. This may keep your child from buying unhealthy options at school.
  • Don’t use sweets as a reward for good behavior or test scores. Think of other, more active rewards.
  • Set a good example. Prepare healthy meals at home. Children are strongly influenced by their parents behavior. Eat together as a family.
  • When grocery shopping, choose healthy foods. Focus on unprocessed foods. Teach your child how to make good choices in the grocery store.
  • Teach your child about proper portion sizes. Your child may be able to continue eating favorite foods, just in smaller portion sizes. Also, cook less food at mealtime and don't bring it all to the table.
  • Focus on healthy foods your child can eat. Don’t eliminate all sweets and treats. Overdoing this may make your child want them more. Include occasional treats in proper amounts.

In more severe cases, your child may have to follow a meal plan.

Physical Activity

Encourage your child to participate in physical activity. Sign older children up for sports or activities. Develop some family-based activities that everyone can enjoy.

General guidelines for your child include:

  • Get at least one hour of physical activity every day.
  • Limit time in front of a TV, game, or computer screen to 1-2 hours per day. If your child is under two years old, avoid screen time.

In more severe cases, your doctor may provide a specific activity plan.

Counseling and Support

Your child may struggle with weight loss or being obese. Some support options or actions include:

  • A weight-loss program and active video gaming. Your child may also be referred to a therapist. This type of support may give your child insight into losing weight. Therapy that includes the whole family may also be helpful.
  • Ask friends and family members to support your child. Time and motivation will keep your child on track.
  • Make sure a healthy lifestyle is promoted at school or other organizations your child is involved with. Help your child to feel confident in making healthy choices even when the other children are not.

Other Treatment

Some children who are obese may already have serious conditions due to weight. This may include problems with the heart or lungs, diabetes, or bone and joint problems. These conditions may require separate treatment.

Other children may have a hard time losing weight despite following guidelines. For these children, other options may be considered, such as:

  • Medication may assist weight loss when added to lifestyle changes, but teens need to be closely monitored for side effects.
    • Note: Over-the-counter and herbal products that are marketed as weight loss drugs may not be effective and some may be dangerous. Talk to the doctor before your child takes any of these.
  • Bariatric surgery may be an option for some obese children and teens. This surgery will change the size of the stomach. This option is generally only considered if all other options have failed.

Prevention

To help reduce your child’s chance of being overweight or obese:

  • Encourage your child to eat a healthy diet. It should be rich in fruits, vegetables, and whole grains.
  • Choose lean meats, poultry, and fish.
  • Serve reasonable portion sizes. Eat healthy meals together as a family.
  • Limit sugar-sweetened drinks. Encourage your child to drink water.
  • Encourage your child to get at least 60 minutes of activity most days of the week. The activity should be moderate to vigorous intensity. Ask your doctor for specific guidelines if your child is younger that 2 years old.
  • Limit screen time to two hours a day.
  • Make sure your child is getting enough sleep.
  • Set a good example for your children. Choose healthy food options. Be physically active.

Revision Information

  • Reviewer: Kari Kassir, MD
  • Review Date: 03/2014 -
  • Update Date: 05/05/2014 -
  • American Heart Association

    http://www.heart.org

  • Healthy Children.org—American Academy of Pediatrics

    http://www.healthychildren.org

  • Dietitians of Canada

    http://www.dietitians.ca

  • Health Canada

    http://www.hc-sc.gc.ca

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