Obesity, Pediatric

Obesity is the condition of having too much total body fat. Being obese means that the child's weight is greater than what is considered healthy compared to other children of the same age, gender, and height. Obesity is determined by a measurement called BMI (body mass index). BMI is an estimate of body fat and is calculated from height and weight. For children, a BMI that is greater than 95 percent of boys or girls of the same age is considered obese.

• Diseases such as asthma, type 2 diabetes, and nonalcoholic fatty liver disease.
• High blood pressure.
• Abnormal blood lipid levels.
• Sleep problems.

What are the causes?

• Eating daily meals that are high in calories, sugar, and fat.
• Drinking sugar-sweetened beverages, such as soft drinks.
• Being born with genes that may make the child more likely to become obese.
• Having a medical condition that causes obesity, including:
  • Hypothyroidism.
  • Polycystic ovarian syndrome (PCOS).
  • Binge-eating disorder.
  • Cushing syndrome.
• Taking certain medicines, such as steroids, antidepressants, and seizure medicines.
• Not getting enough exercise (sedentary lifestyle).

What increases the risk?

• Having a family history of obesity.
• Having a BMI between the 85th and 95th percentile (overweight).
• Receiving formula instead of breast milk as an infant, or having exclusive breastfeeding for less than six months.
• Living in an area with limited access to:
  • Parks, recreation centers, or sidewalks.
  • Healthy food choices, such as grocery stores and farmers' markets.

What are the signs or symptoms?

The main sign of this condition is having too much body fat.

How is this diagnosed?

• BMI. This is a measure that describes your child's weight in relation to his or her height.
• Waist circumference. This measures the distance around your child's waistline.
• Skinfold thickness. Your child's health care provider may gently pinch a fold of your child's skin and measure it.

Your child may have other tests to check for underlying conditions.

How is this treated?

• Dietary changes. This may include developing a healthy meal plan.
• Regular physical activity. This may include activity that causes your child's heart to beat faster (aerobic exercise) or muscle-strengthening play or sports.
  • Work with your child's health care provider to design an exercise program that works for your child.
• Behavioral therapy that includes problem solving and stress management strategies.
• Treating conditions that cause the obesity (underlying conditions).
• In some cases, children over 12 years of age may be treated with medicines.

Follow these instructions at home:

Eating and drinking

• Limit these foods:
  • Fast food, sweets, and processed snack foods.
  • Sugary drinks, such as soda, fruit juice, sweetened iced tea, and flavored milks.
• Give low-fat or fat-free options, such as low-fat milk instead of whole milk.
• Offer your child at least 5 servings of fruits or vegetables every day.
• Eat at home more often. This gives you more control over what your child eats.
• Set a healthy eating example for your child. This includes choosing healthy options for yourself at home or when eating out.
• Make healthy snacks available to your child, such as fresh fruit or low-fat yogurt.
• Other healthful choices include:
  • Learn to read food labels. This will help you to understand how much food is considered one serving.
  • Learn what a healthy serving size is. Serving sizes may be different depending on the age of your child.
  • Include your child in the planning and cooking of healthy meals.
• Talk with your child's health care provider or a dietitian if you have any questions about your child's meal plan.

Physical activity

• Encourage your child to be active for at least 60 minutes every day of the week.
• Make exercise fun. Find activities that your child enjoys.
• Be active as a family. Take walks together or bike around the neighborhood.
• Talk with your child's daycare or after-school program leader about increasing physical activity.

Lifestyle

• Limit the time your child spends in front of screens to less than 2 hours a day. Avoid having electronic devices in your child's bedroom.
• Help your child get regular quality sleep. Ask your health care provider how much sleep your child needs.
• Help your child find healthy ways to manage stress.

General instructions

• Have your child keep a journal to track food and exercise.
• Give over-the-counter and prescription medicines only as told by your child's health care provider.
• Consider joining a support group. Find one that includes other families with obese children who are trying to make healthy changes. Ask your child's health care provider for suggestions.
• Do not call your child names based on weight or tease your child about weight. Discourage other family members and friends from mentioning your child's weight.
• Pay attention to your child's mental health as obesity can lead to depression or self esteem issues.
• Keep all follow-up visits. This is important.

Contact a health care provider if:

• Your child has emotional, behavioral, or social problems.
• You child has trouble sleeping.
• You child has joint pain.
• Your child has trouble breathing.
• Your child has been making the recommended changes but is not losing weight.
• Your child avoids eating with you, family, or friends.

Summary

• Obesity is the condition of having too much total body fat.
• Being obese means that the child's weight is greater than what is considered healthy compared to other children of the same age, gender, and height.
• Talk with your child's health care provider or a dietitian if you have any questions about your child's meal plan.
• Have your child keep a journal to track food and exercise.