In 2010, the U.S. Centers for Disease Control and Prevention reports that 34% of American adults and 17% of children are “obese.” Even more staggering is that the number of adults considered “overweight” is 64% and that nearly one-third of children are at least overweight to obese.
At PL Pediatrics, like many practices around the country, we see a growing number of overweight and obese children every year. Below is an overview of obesity in children. Management of obesity, especially in children and even adolescents should be a parent-driven process. This article is meant to provide background information in order for parents to help make informed decisions which will help children attain a healthy lifestyle and body weight.
Risk factors for obesity in Children include:
- Having at least one obese parent
- Having a television in the bedroom
- Watching television for more than 2 hours per day
- Sedentary lifestyle
- Poor diet (diet high in fat, sugar and processed foods)
Health Consequences of Obesity include:
- High cholesterol
- Early onset of cardiovascular disease
- Type 2 diabetes mellitus
- Menstrual Irregularity with decreased fertility
- Obstructive Sleep Apnea
- Liver disease
- Musculoskeletal complaints
- Psychological Stress
Many of these problems were once thought of as medical issues of adulthood. However, as the obesity rate rises in the pediatric population we are seeing more children and adolescents with the same obesity-related complications. The incidence is difficult to estimate because many of these problems go undetected for years. For instance, type 2 diabetes, a problem almost exclusively related to obesity, can be detected only by blood work. This kind of testing may not be pursued for months or years if a child feels okay. Once a problem of people over age 40, type 2 diabetes is now diagnosed in children by pediatricians and pediatric subspecialists more than ever. Without proper diagnosis, management, and control (including weight loss), these children may face a shortened lifespan with numerous complications related to diabetes.
How to Diagnose Obesity:
Body Mass Index (BMI) is the ratio of weight (in kilograms) to the square of the height (in meters). The BMI is a way to determine the proportion of a person’s weight to their height. As opposed to adults, in children normal BMI varies by age. Because of this variation, the BMI is assigned a percentile score relative to other children of the same age and gender. At each well-child visit, a child’s weight and height are measured and the BMI is easily calculated and plotted on a standardized curve. This is generally calculated for children over the age of two years. Below is a graph from the Center for Disease Control and Prevention website. It explains how BMI is used in children.
- BMI < 5th percentile = Underweight
- BMI from 5th-85th percentile = Healthy weight
- BMI between 85th and 95th percentile = Overweight
- BMI > 95th percentile = Obese
A BMI calculator can determine if your child is overweight or obese. You will need to know your child’s gender, age, weight and height. The best online BMI calculator I have found is also on the CDC Website.
In our practice if you are a considered “Overweight” or “Obese” we may offer you our Wellness Workbook. Although this was designed with overweight children in mind, it can be used with all types of kids to encourage healthy lifestyle habits. Within that workbook is a Health Screening Questionnaire, which gives health care providers an idea of which lifestyle habits should be given priority. For instance, some families may serve nutritious foods, but they are serving too many sugar-sweetened beverages. Other families may serve nutritious foods and drinks but the portions are too large, resulting in too many calories.
The Body of the Wellness Workbook covers 4 main areas:
1) Eating a diet high in fruits and vegetables
2) Reducing sugar sweetened beverages
3) Increasing meal consistency and family meals
4) Increasing Physical Activity
At the end of the Wellness Workbook is a Food and Exercise Journal. This journal provides an place to keep track of food and activity over the course of the week. Bringing a completed journal and health habit questionnaire to a visit with your pediatrician is a great way to get feedback on how to improve your families diet and exercise habits.