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Childhood obesity is becoming an obesity epidemic. It’s the #1 preventable disease amongst children around the globe. The World Health Organization reports that there are over 42 million obese children in the world under the age of five.Â
Despite this, the situation only continues to get worse. Why? And how can we diagnose and fix it?
What is Childhood Obesity?
Childhood obesity is a severe health condition in which a child is well above the normal weight for their age and height. Generally, an overweight child is a child whose weight is 10%-20% higher than the normal weight for that age and height, while obesity is when a child’s weight is more than 20% higher than the normal.
Obesity can have a range of adverse effects on children, including high blood pressure, breathing issues, and Type 2 diabetes. In addition to physical health issues, a child can also suffer from many mental health issues that stem from obesity, such as anxiety and depression.
Sadly, many of these children grow to become obese adults, especially if one or both parents also suffer from the same condition.
Furthermore, some studies have reported that children who are already obese are at risk of becoming more severely obese or morbidly obese. Morbid obesity is severe obesity that’s generally defined as a body mass index (BMI) greater than or equal to 40.
Diagnosing Childhood Obesity
Child BMI
Doctors often use the body mass index (BMI) to determine if a child has obesity. In short, BMI is a person’s weight divided by the square of height that indicates the amount of body fat a child has.
According to the Centers for Disease Control and Prevention, if a child’s BMI falls between the 85th and 95th percentiles, they are considered overweight and at risk for obesity.Â
In this case, a doctor may screen for the following:
- The child’s family history of cardiovascular disease, diabetes, parental obesity
- Blood pressure
- Emotional and psychological concerns
- Increases in BMI from year to year
If a child’s BMI is at or above the 95th percentile, they are considered obese.Â
In this case, a doctor may proceed with conducting a full physical exam and screen for and evaluate:
- High blood pressure
- Diabetes
- Fatty liver
- Abnormal blood lipids
- Menstrual issues in women
- Psychological problems
- Activity level
- Eating habits
Blood Tests
In addition to BMI, a doctor may also order blood tests if they believe a child suffers from obesity. Blood tests may include:
- Blood sugar test
- Cholesterol test
- Hormone imbalances test
- Vitamin D deficiency test
- Other blood tests to check for conditions associated with obesity
The Extent of the Problem
Childhood Obesity Facts
According to WHO:1
- Worldwide, obesity has nearly tripled since 1975. In 1975, only around 1% of children and adolescents aged 5-19 had obesity, compared to more than 124 million children and adolescents (6% of girls and 8% of boys) in 2016
- In 2019, an estimated 38 million children under the age of 5 were overweight or obese
- In 2016, over 340 million children and adolescents aged 5-19 were suffering from being overweight and obese
- The majority of children suffering from being overweight or obese live in developing countries, where the rate of increase is more than 30% higher than in developed countries
Obesity Facts in America
Childhood obesity is a serious issue in the United States, putting children at risk for poor health.
According to the CDC, for children and adolescents between the ages of 2 and 19:2
- Obesity affects about 13.7 million children and adolescents
- The prevalence of obesity is 13.9% in children ages 2 to 5, 18.4% in children ages 6 to 11, and 20.6% in 12- to 19-year-olds
- Obesity is more prevalent in people who are Hispanic (25.8%) and non-Hispanic black (22.0%)
- Non-Hispanic Asians (11.0%) have a lower obesity prevalence
Factors Contributing to Childhood Obesity
Childhood obesity is the sum of the little things that add up over time, including:
Children who are exposed to high-calorie foods, including fast foods, baked foods, and unhealthy vending machine snacks can end up gaining weight.Â
Other culprits contributing to childhood obesity are high-sugar foods such as candy, desserts, and sugary drinks.
Today, many children spend a lot of time in sedentary activities, such as watching TV and playing video games, which can play a critical part in weight gain.Â
According to reports, children spend 7.5 hours in front of a screen, on average. That’s 7.5 hours spent on a smartphone, on a video game, or watching a movie, instead of playing outside, exploring, and creating.
Environmental Resources
The lack of high-quality and nutritious food is another cause of obesity in children. Some communities with limited resources and limited access to supermarkets can have a higher percent of childhood obesity.Â
People in these communities may buy low-quality foods that don’t spoil quickly, such as frozen meals, cookies, and crackers, instead of nutrient-rich foods such as fruits and vegetables.Â
In addition, communities who lack access to a safe place to exercise may also suffer from higher obesity rates.
Parental Perception
Children whose parents tend to overeat to cope with problems or deal with emotions might have similar tendencies. Moreover, personal, parental, and family stress can also increase a child’s risk of obesity.
Genetics
Genetics are also a cause of obesity in children. Some children with a family history of obesity will grow to have the same condition. This is especially true in families where high-calorie foods are always available, and physical activity isn’t encouraged or practiced.
How to Treat Childhood Obesity?
Diet
The first step in fighting childhood obesity is establishing healthier eating habits and regular exercise.
Here are some recommended diet guidelines for parents:
- Opt for more fruits and vegetables when grocery shopping. Instead of buying a pack of M&M's, fruits such as dates and grapes can be a healthier alternative
- Have fewer sugary drinks as they provide little nutritional value. Opt for more water, tea, milk, or other unsweetened drinks
- Limit fast food and replace those high-calorie meals wit high-balanced dishes that will contain all macronutrients, including protein, carbohydrates, and healthy fats
- Don't encourage eating in front of a TV, computer, or while playing video games. Children who eat or snack in front of a screen are unaware of the amount of food they're consuming, leading to fast eating and weight gain
- Serve smaller portion sizes. Children don't need the same amount of food as adults
- Eat out less often and strive to eat more home-cooked meals that contain less sugar and processed foods
Exercise
Apart from a proper diet, regular exercise is another critical part of maintaining a healthy weight. Children who stay physically active burn calories faster, have stronger bones and muscles, and have improved self-esteem.
Here are a few tips to help your child to be more physically active:
Preschool-aged children (ages 3 through 5 years) need to stay active throughout the day, while school-aged children and adolescents need 60 minutes or more of physical activity each day.3Â
Free-play activities, such as jumping rope or playing hide-and-seek, can do the trick. The trick is to get your child to move, whether by playing hide-and-seek or riding a bicycle
Limit your child’s screen time to no more than 2 hours per day for children older than 2. If your child is younger than 2, experts recommend not allowing screen time at all
Do activities that you believe your child likes. For example, if they’re naturally curious, you can take them on a hike. If they like climbing, consider taking them to the nearby climbing wall or jungle gym. Even if your child is a fan of a sedentary activity like reading a book, a good idea is to walk to the library to rent a book
Coping and Support
In some cases, intensive treatment to help children cope with obesity can yield positive results. According to a 2015 study, children who received intensive treatment that involved a multidisciplinary approach experienced significant changes in their BMI.4
Intensive treatment can include some or all of the items below:
- Physical activity education
- Dietary education
- Therapy sessions with a psychologist
- Group coaching on behavioral management
- Weekly in-home coaching sessions
- Group physical activity sessions led by a physiotherapist
Medications
In some cases, a doctor may prescribe medications to some children as part of their weight-loss plan. Medication is sometimes prescribed when a child who suffers from obesity also suffers from obesity-related conditions such as diabetes. Medications in no way replace the need for a healthy diet and regular exercise.
Weight-Loss Surgery
Weight-loss surgery is recommended for adolescents whose weight poses a greater health risk to their long-term health than surgery.Â
However, it’s important to keep in mind that weight-loss surgery doesn’t guarantee that your child will lose all the excess weight and maintain a healthy weight in the long term.Â
The same with weight-loss medication, surgery can not solely replace the long-lasting benefits of a healthy diet and regular physical activity.
How to Prevent Childhood Obesity?
Promote a Healthy Lifestyle
Parents are in charge of setting the right example for their children. Kids are visual learners, and if they see that you’re eating a cake, they will want to do the same.Â
See what motivates your child to get out of the house and then do those things together, whether that is a hike, riding a bike, or playing hide-and-seek.
Nutritional Education
Each school year, children in the United States receive less than 8 hours of required nutrition education instead of the 40 to 50 hours needed to affect behavior change. The percentage of schools offering nutritional education has dropped from 84.5% in 2000 to 74.1% in 2014.5
As diet plays a pivotal role in preventing childhood obesity, schools should provide students with more hours of nutrition education instruction and engage teachers and parents in nutrition education activities.
Nutritional education should become a significant part of every school’s comprehensive health education program and involve:
- Serving healthy foods in the school meal programs
- Educating students about agriculture, food, health, and nutrition
- Teaching students about healthy nutrition through gardening, cooking lessons, or farm field trips
- Parent-teacher group meetings to ensure that students see and hear consistent information about healthy eating
Adequate Sleep
A large number of studies have examined the link between sleep and obesity in children. Many of them have found convincing proof that too little sleep can actually lead to increased weight.
For example, one study that followed more than 8,000 children from birth discovered that those children who slept less than 10 and a half hours at night at age 3 had a higher risk of becoming obese by age 7 than children who slept more than 12 hours every night.6
This evidence suggests that healthy sleeping habits should also be part of a weight-reduction program that has traditionally focused on diet and physical activity.
Reducing Screen Time
Screen time affects childhood obesity in multiple ways. Evidence suggests that screen time leads to obesity in children through increased eating while watching, replacing physical activity with a more sedentary lifestyle, and reducing sleep.Â
Children are also exposed to high-calorie, low-nutrient food, and beverage marketing that influences their preferences.
Some steps caretakers can take to prevent childhood obesity due to screen time include:
- Limiting the amount of time your child spends on the screen
- Offering healthier eating habits and food choices while on the screen
- Making sure your child gets enough sleep
- Setting a fine example by reducing your own screen time
If you are a parent or caregiver concerned with a loved one’s obesity in adolescence, know that J. Flowers Health Institute is here for support. We can provide the structure and guidance necessary for a healthy, happy, and sustainable lifestyle.
More Resources for Parents
Resources
- https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
- https://www.cdc.gov/obesity/data/childhood.html
- https://www.cdc.gov/physicalactivity/basics/children/index.htm
- https://www.academicpedsjnl.net/article/S1876-2859(15)00167-9/fulltext
- https://www.cdc.gov/healthyschools/nutrition/school_nutrition_education.htm
- https://www.hsph.harvard.edu/obesity-prevention-source/obesity-causes/sleep-and-obesity/
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