Many children face challenges with healthy weight management. A report by the World Health Organization (WHO) showed that more than 340 million children and adolescents aged 5-19 were overweight or obese. And this figure continues to rise.
Excessive weight gain in children can lead to a cascade of health problems, which can affect their physical, emotional, and social well-being.
Understanding the causes and developing detailed prevention and treatment plans are essential to address this epidemic and nurture a generation of healthy kids.
Let’s explore childhood obesity, its causes, symptoms, treatment, and prevention.
What is Childhood Obesity?
Childhood obesity is a serious condition where a child’s weight falls above the healthy range for their age and height. According to the Centers for Disease Control and Prevention (CDC), childhood obesity is when a child has a Body Mass Index (BMI) of 30 or higher. This condition is prevalent among children, with 18% of girls and 19% of boys being overweight.
You can determine your child’s body mass index by dividing weight in kilograms by height in meters squared (kg/m2), and a high BMI indicates potential excess body fat. For example, if your 14-year-old kid weighs 91 kg and has a height of 1.75 m. Their resulting BMI is 30 kg/m2, categorizing them into a category of obese.
Signs and Symptoms of Childhood Obesity
Besides excessive body weight, common signs and symptoms of childhood obesity include:
- Early puberty in girls
- Delayed puberty in boys
- Accumulation of fat tissue in the breast area (posing a particular challenge for boys)
- Shortness of breath
- Gastroesophageal reflux (commonly known as acid reflux)
- Increased sweating
- Sleep apnea and snoring
- Joint pain
- Dislocated hips
- Flat feet and knock knees
- Skin rashes and irritation
- Stretch marks on hips, abdomen, and back (although they may also occur in non-obese children)
Acanthosis nigricans, characterized by dark, velvety skin around the neck and other areas
What Causes Childhood Obesity?
Childhood obesity often arises from a combination of various factors that elevate the risk of excessive weight gain in children. The following factors contribute to the causes of childhood obesity:
The Lifestyle Behaviors:
These include behaviors such as:
- High-calorie, low-nutrient food intake (fast food, snacks, candy, sodas).
- Overeating and excessive food consumption.
- Prolonged sedentary activities (TV, electronic devices).
- Inadequate physical activity. The Centers for Disease Control and Prevention advise kids and teenagers between the ages of 6 and 17 to participate in moderate-to-intense physical activity for at least 60 minutes per day.
Environmental factors include:
- Limited access to healthy food.
- Regular consumption of high-calorie, low-nutrient meals.
- Few opportunities for physical activity.
- Lack of safe outdoor spaces for activities.
- Limited social connections for physical engagement.
- Exposure to targeted advertising promoting sedentary lifestyles and unhealthy diets.
According to a study, children who have obese parents are at considerably increased risk of obesity than children of normal-weight parents.
Various rare genetic syndromes can contribute to obesity in kids, including:
- Prader-Willi syndrome
- Pro-opiomelanocortin deficiency
- Leptin receptor deficiency
- Bardet-Biedl syndrome (BBS)
These genetic disorders alter a child’s body’s fat distribution or make them constantly hungry, which encourages overindulgence in food.
Children often develop a tendency to overeat as a coping mechanism for emotions such as loneliness, sadness, stress, or boredom.
Studies indicate that lower-income communities often lack access to fresh produce and reside in “food deserts” where fast food and processed options are prevalent.
Financial constraints may make calorie-rich but nutrient-poor choices more affordable, which further limits access to good nutrition.
Additionally, limited safe spaces for exercise and constrained time and energy for physical activities are common in lower-income neighborhoods.
Obesity in children may occur due to underlying medical issues, especially those impacting the endocrine system (a complex network of glands and organs that uses hormones to control your bodily functions). Examples include:
- Hypothyroidism (an underactive thyroid) is a condition where insufficient thyroid hormone secretion leads to a slower metabolic rate and weight gain.
- Cushing’s syndrome, also known as Cushing’s disease, is characterized by elevated cortisol levels. This condition contributes to weight gain in the upper body, face, and shoulders and can cause obesity.
Certain medications can contribute to weight gain and lead to obesity, including:
- Diabetes medications (insulin, sulfonylureas, thiazolidinediones)
- Anti-seizure medications (carbamazepine, valproate)
Effects of Childhood Obesity
Childhood obesity has become a major public health concern in India. According to the National Institutes of Health (NIH), more than 14.4 million children in the country grapple with obesity.
Furthermore, children with obesity are more likely to carry the condition into adulthood, increasing their risk of developing chronic diseases such as:
- Type 2 diabetes
- Sleep apnea
- High blood pressure (hypertension)
- High cholesterol
- Heartburn, reflux, and other digestive issues
- Heart disease
- Musculoskeletal disorders like osteoarthritis
- Nonalcoholic fatty liver disease (NAFLD)
- Kidney disease
- Reproductive issues, including irregular menstruation and hormonal imbalances
- Certain cancers, such as colon cancer and breast cancer
Beyond the physical health implications, children dealing with obesity are more prone to social and psychological challenges:
- Social isolation
- Low self-esteem
- An increased likelihood of experiencing anxiety and depression
How to Tackle Childhood Obesity?
If you are worried about your child’s weight, consulting a healthcare provider about your child’s obesity diagnosis, treatment, and prevention is advisable. Here’s a detailed look at how you can tackle your child’s obesity.
Childhood Obesity Diagnosis
Your child’s healthcare provider can assess whether your child is experiencing obesity by utilizing a BMI growth chart to determine their weight status. Furthermore, they may consider additional factors like your child’s activity level, diet, family health history, and medical history.
Should the healthcare provider diagnose obesity in your child, they will help you develop a tailored and health-focused weight loss plan, which may include:
- Discussions about nutritious food choices
- Establishing an appropriate level of physical activity
- Suggesting enrollment in a weight management program to address your child’s specific needs.
Childhood Obesity Treatment
Here are some childhood obesity treatment options:
To promote a healthy lifestyle for your child and address obesity:
- Ensure your child gets 150-300 minutes of weekly physical activity. Try including fun activities for them to engage more.
- Serve whole foods, focusing on fruits, vegetables, whole grains, and lean proteins and limiting processed foods.
- Restrict sweetened beverages and opt for water, seltzer, milk, or diluted fruit juice.
- Minimize takeout and restaurant meals, as they often contain excessive sodium and fat.
- Have family meals without distractions, model mindful eating, and provide the same nutritious meals for everyone.
- Avoid forcing your child to finish their plate; let them eat until full and respect their satiety cues.
- Prioritize good-quality sleep to prevent weight gain and hormonal imbalances.
- Introduce stress-relieving practices like yoga, breathing exercises, or meditation.
- Be consistent with healthy habits, but allow occasional treats or breaks from exercise.
- Limit screen time to two hours a day for children older than two; younger children should have none.
- Use positive messaging, focusing on overall health and healthy behaviors rather than weight.
If diet and lifestyle changes are insufficient for addressing obesity in children, the American Academy of Pediatrics recommends considering prescription weight loss medications for those aged 12 and older, alongside behavioral and lifestyle treatments. These approved drugs include:
According to the 2023 AAP guidelines, surgery may be considered for adolescents aged 13 and older with severe obesity. Common procedures include:
- Gastric bypass
- Gastric banding
- Gastric sleeve (sleeve gastrectomy)
Childhood Obesity Prevention
To prevent excessive weight gain in your child, you can do the following things:
- Set a Positive Example: Make healthy eating and regular physical activity a family practice. This fosters a supportive environment where everyone participates.
- Provide Healthy Snack Options: Keep nutritious snacks readily available. Options include roasted chickpeas, masala oats, sprout chaat, fruit chaat, poha, khakra with hummus, makhana snacks, and vegetable sticks with mint yogurt dip.
- Introduce New Foods Gradually: Offer new foods multiple times. Remember, patience is key – It often takes multiple attempts for acceptance.
- Avoid Food Rewards: Choose nonfood rewards to promote positive behavior. Stay away from giving candies or sweets as rewards.
- Prioritize Sufficient Sleep: Ensure your child gets enough sleep, as inadequate sleep may disrupt hormonal balance and increase appetite, contributing to weight gain.
Furthermore, visit your child’s healthcare provider at least once a year for comprehensive health check-ups and monitoring.
Remember, proactive healthcare measures and consistent family efforts create a solid foundation for your child’s overall well-being and healthy development.