Obesity in children

Causes

When children eat more than they need, their bodies store the extra calories in fat cells to use for energy later. If this pattern continues over time, and their bodies do not need this stored energy, they develop more fat cells and may develop obesity.

Infants and young children are very good at listening to their bodies’ signals of hunger and fullness. They will stop eating as soon as their bodies tell them they have had enough.

But sometimes a well-meaning parent tells them they have to finish everything on their plate. This forces them to ignore their fullness and eat everything that is served to them.

Some people may use food to reward good behavior or seek comfort when sad.

These learned habits lead to eating no matter if we are hungry or full. Many people have a very hard time breaking these habits.

The family, friends, schools, and community resources in a child’s environment reinforce lifestyle habits regarding diet and activity.

Children are surrounded by many things that make it easy to overeat and harder to be active. Watching television, gaming, texting, and playing on the computer are activities that require very little energy. They can take up a lot of time and replace physical activity. And, when children watch television, they often crave the unhealthy high-calorie snacks they see on commercials. See also: Screen time and children

The term eating disorders refers to a group of medical conditions that have an unhealthy focus on eating, dieting, losing or gaining weight, and body image. Obesity and eating disorders often occur at the same time in teenage girls and young-adult women who may be unhappy with their body image.

Certain medical conditions, such as hormone disorders or low thyroid function, and certain medications, such as steroids or anti-seizure medications, can increase a child’s appetite. Over time this increases their risk for obesity.

Exams and Tests

The health care provider will perform a physical exam and ask questions about your child's medical history, eating habits, and exercise routine.

Blood tests may be done to look for thyroid or endocrine problems, which could lead to weight gain.

Child health experts recommend that children be screened for obesity at age 6. Your child's body mass index (BMI) is calculated using height and weight. A health care provider can use BMI to estimate how much body fat your child has.

However, measuring body fat and diagnosing obesity in children is different than measuring these things in adults.

Treatment

SUPPORTING YOUR CHILD

The first step in helping your child get to a healthy weight is to consult with their doctor. The doctor can help to set healthy goals for weight-loss and help with monitoring and support.

Try to get the whole family to join a weight-loss plan, even if weight loss is not the goal for everyone. Weight-loss plans for children focus on healthy lifestyle habits. A healthy lifestyle is good for everyone.

Having support from friends and family may also help your child lose weight. See also: Supporting a child with weight loss

CHANGING YOUR CHILD'S LIFESTYLE

Eating a balanced diet means you child consumes the right types and amounts of foods and drinks to keep their body healthy.

• Know what size portions are child should eat to meet your body’s needs for nutrients, without getting too much of some and not enough of others.
• Stock your pantry and refrigerator with healthy foods. See also: Healthy grocery shopping
• Choose a variety of healthy foods from each of the food groups and eat foods from each group at every meal.
• Learn more about eating healthy and eating out.

Choosing healthy snacks and drinks for your children is important, but can be a challenge. See also: Snacks and sweetened drinks - children

• Fruits and vegetables are good choices for healthy snacks. They are full of vitamins and low in calories and fat. Some crackers and cheeses also make good snacks.
• Avoid junk-food snacks like chips, candy, cake, cookies, and ice cream. The best way to keep kids from eating junk food or other unhealthy snacks is to not have these foods in your house.
• Avoid sodas, sport drinks, and flavored waters, especially ones made with sugar or corn syrup. These drinks are full of calories and can lead to weight gain, even in active children. If needed, choose beverages with artificial (manmade) sweeteners.

Children should not watch more than 2 hours of TV a day. This can be difficult because watching TV is part of their daily routine. See also: Screen time and children

Children should have many chances to play, run, bike, and play sports during the day. Experts recommend they get 60 minutes of moderate activity every day. Moderate activity means you breathe and your heart beats faster than normal. If your child is not athletic, find ways to motivate your child to be more active. See also: Exercise and activity - children

WHAT ELSE TO THINK ABOUT

You may see ads for supplements and herbal remedies that claim they will help with weight loss. But many of these claims are not true, and some of these supplements can have serious side effects. Talk to your health care provider before giving them to your child.

Weight loss drugs are not recommended for children.

Bariatric surgery is currently being performed for some children, but only after they've stopped growing. See also: Weight-loss surgery in children

Possible Complications

A child who is overweight or obese is more likely to be overweight or obese as an adult. Obese children are now developing health problems that used to be seen only in adults. When these problems begin in childhood, they often become more severe when the child becomes an adult.

Children with obesity are at risk for developing these health problems:

• High blood glucose (sugar) or diabetes
• High blood pressure (hypertension)
• High blood cholesterol and triglycerides (dyslipidemia or high blood fats)
• Heart attacks due to coronary heart disease, congestive heart failure, and stroke later in life
• Bone and joint problems -- more weight puts pressure on the bones and joints. This can lead to osteoarthritis, a disease that causes joint pain and stiffness.
• Stopping breathing during sleep (sleep apnea). This can cause daytime fatigue or sleepiness, poor attention, and problems at work.

Obese girls are more likely not to have regular menstrual periods.

Obese children often have low self-esteem. They are more likely to be teased or bullied, and they may have a hard time making friends.

Alternative Names

Weight - loss - children; Obese - children

References

United States Department of Agriculture. Dietary Guidelines for Americans, 2010. National Academy Press, Washington, DC, 2000.

Seagle HM, Strain GW, Makris A, Reeves RS; American Dietetic Association. Position of the American Dietetic Association: weight management. J Am Diet Assoc. 2009;109:330-346.

Pratt JS, Lenders CM, Dionne EA, Hoppin AG, Hsu GL, Inge TH, Lawlor DF, MarinoMF, Meyers AF, Rosenblum JL, Sanchez VM. Best practice updates for pediatric/adolescent weight loss surgery. Obesity (Silver Spring). 2009 May;17(5):901-10.

Update Date: 9/21/2011

Updated by: David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.; and Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine.