Childhood Obesity: Know The Facts

May 9, 2012 at 8:01 pm Leave a comment

By Christina Payne, MD

Healthy eating habits should be established early with children to prevent obesity.

It’s time for your son’s 9 year-old check-up. He appears healthy,

but needs a physical form signed for camp. He isn’t due for shots and

hasn’t contracted anything more than a cold in the last year, so the

entire appointment seems unnecessary. As your doctor visits with you,

he expresses concern that your son is obese and discusses a nutrition

and exercise regimen to help the condition. He also suggests blood

work to evaluate cholesterol and blood sugar levels, which seems

premature to you given he is only 9. Although always appearing a

little “pudgy”, he has never given cause for alarm. He goes to P.E. three

days a week and plays outside on a regular basis. Lunch is eaten from

the school cafeteria and dinner often involves fast foods due to a busy

family schedule.


Childhood obesity is defined as a body mass index (BMI) greater

than the 95 percentile for age and gender. BMI is calculated as weight

(in kilograms) divided by height in meters squared. An overweight or

at-risk child has a BMI greater than the 85 percentile. Most physicians

calculate the BMI with their electronic charting systems at check-ups

for children over 3. Almost one in five children in the United States

is overweight or obese, this amount tripling over the past 30 years.

Therefore, obesity prevention and diagnosis is fast becoming a regular

part of health maintenance. Obviously, appropriate nutrition leads the

list of interventions to maintain healthy weight children. Guidelines

can be found online at AHA nutrition guidelines.

Good nutrition along with regular exercise must be enforced to help

prevent obesity and its associated diseases.


Obese children have increased medical care usage when

compared to healthy weight children. They begin developing adult type

illnesses at a young age, often requiring medications still unapproved

for children. Type 2 diabetes, hyperlipidemia (elevated cholesterol),

hypertension, asthma, and fatty liver disease are the main medical

issues increased in obese children. Obstructive sleep apnea is 5 times

more likely in obese children compared to those at a healthy weight.

Orthopedic conditions and sports related injuries are significantly

higher in these children as well. Once present, most of these issues tend

to worsen into adulthood. Fortunately, weight reduction and a modified

lifestyle help reverse these problems. Obesity is definitely a major

problem to be treated by the medical community, but also a serious

public health issue as well.


Treatment of the obese child involves interventions in almost all

areas of life. Busy families may have good intentions but have difficulty

putting a physician’s recommendations into practice. The goal of

weight reduction therapy is to allow younger children to maintain their

weight as they grow taller, and older children to undergo slow weight

loss (around one or two pounds per month). Successful dietary plans

enforce portion control and food selection. One such plan called We

Can!, is sponsored by the NIH ( More rapid

weight loss or complicated cases should involve a nutritionist. The

American Academy of Pediatrics Sports Medicine and Fitness

recommends 60 minutes of physical activity a day. To get this amount

of exercise definitely requires more time than school programs allow.

The entire family must be involved in the change, from the type of foods

kept at home to family time afterschool and on weekends. Studies have

shown that if just one parent is present for a sit down meal with the

family in the evening, those children are more likely to maintain a

healthy weight.


In conclusion, the topic of weight management and obesity in

children is a very sensitive topic, but its treatment is essential for a

healthy childhood. Patients like the boy mentioned at the beginning of

this article are rapidly increasing. As pediatricians, our goal is to

encourage healthy changes without making a child feel insecure or

develop other unhealthy eating disorders. Steady lifestyle modification

with progressive small changes in diet and exercise over time remains

the mainstay of treatment.


Nutrition Guideline for a healthy weight

  • Exclusive breastfeeding for 6 months and continued breastfeeding until at least 12 months
  • Limit dining out for meals
  • Limit sugared beverages
  • Eat breakfast daily
  • Eat a diet rich in calcium
  • Try to eat whole grains when possible
  • Consume recommended daily intake of fruits and vegetables
  • Allow a child to self regulate the quantity of food he eats within
  • the appropriate portion size
  • Have at least five family meals at home per week



Entry filed under: Pediatrics. Tags: , , , .

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