Childhood Obesity

What is it?

Obesity is the state of being extremely overweight according to standard growth charts.

Who gets it?

Obesity is one of the most common nutritional problems in the United States. Both infants and children can be obese. Infants with obese parents, however, have an 80 percent chance of developing obesity.

What causes it?

Obesity occurs when an infant or child takes in more calories than the body can use. Obesity can have many causes, ranging from diet and lifestyle to, in rare cases, hormonal disorders. Causes include overfeeding; providing only high calorie beverages to satisfy thirst; using food to solve problems, relieve stress, or as a reward; and not providing enough opportunities for exercise. Studies have also shown that children who struggle over food when young tend to have more weight problems when they are older. Other factors that contribute to obesity include a family history of obesity, abnormal eating patterns such as binge eating, and the use of corticosterioid drugs.

What are the symptoms?

The symptom of obesity is being grossly overweight according to standard growth charts. Complications of obesity include heart disease, hypertension, and some cancers.

How is it diagnosed?

At regular physical exams, your doctor will check your child's height and weight and plot them on a growth chart. A growth chart shows how your child's growth compares to other children of the same age and is plotted in percentiles. For example, if an infant is in the 20th percentile for weight on a growth chart, that means that 20 percent of infants weigh less than that child and 80 percent weigh more. Infants and toddlers naturally have chubby bodies. However, an infant or toddler is considered obese when his or her weight gain is far out of proportion to his or her growth in height. An overweight baby will look fat, not just chubby. An older child is considered obese when there is a drastic change in the growth curve on the chart. For example, if your child has been at the 30th percentile level and suddenly jumps to the 75th over a six-month time period, there is probably a weight problem. An adolescent's height and weight are converted to body mass index, which is weight in kilograms divided by height in meters squared. An adolescent is considered mildly obese when his or her body mass index is higher than 27. The doctor will recommend a treatment plan when the body mass index is 30 or higher.

What is the treatment?

While a child is still growing, treatment for obesity is to slow the rate of weight gain. However, never reduce your child’s food intake to promote weight loss without first consulting a doctor. The most important treatment for obesity is prevention through healthy eating habits. With an infant, avoid overfeeding. According to the American Academy of Pediatrics, breastfed newborns should be nursed whenever they show signs of hunger. Newborns should be nursed approximately 8 to 12 times every 24 hours, usually 10 to 15 minutes on each breast. If you are bottle feeding, don't allow your child to have the bottle readily available day and night. Most infants need to be fed every two hours from birth to around two months of age, then every three hours from two to six months of age. By six months, most babies are satisfied with three meals a day and two snacks. Don't rush your infant at feeding times. It generally takes 15 to 20 minutes for a baby to feel comfortably full. If your baby stops feeding before the bottle is empty, don't insist that he or she finish it. Your baby knows how much he or she needs. Solid foods can be introduced around six months of age. Again, children on solid foods will let you know when they are full, usually by turning their heads away or holding their mouths closed.

Children also should not receive sweets until after 12 months. With a child of any age, it is extremely important not to use food as a reward or to control behavior. These children learn to use food as a stress reliever. Balance and moderation are important. Underfeeding a child is actually more harmful than overfeeding. Teach your children the basic food groups and provide the recommended number of servings per day. It's been said many times, but we'll say it again “breakfast is the most important meal of the day.” Children who skip breakfast have more difficulty performing in school and tend to snack and eat heavier meals later in the day. When your child does snack, provide healthy snacks, such as fruits, vegetables, and grains. Don't deprive your child of all sweets, but provide them in moderation. Children who feel deprived are more likely to associate negative feelings with food and suffer from eating disorders later in life. Follow your doctor's recommendations for diet carefully. Because your child is still growing, it is important to make sure you provide the right amounts of nutrients and calories for growth.

Obese adolescents usually benefit from the same types of behavior modification programs used with adults. This involves reducing the amount of calories they take in by following a well-balanced diet and making permanent changes to their eating habits, combined with a regular program of physical activity, such as bike riding, swimming, or walking. Obese adolescents often have a poor self-image and become isolated socially. These children may also need counseling to help deal with their problems.

Self-care tips

You can help your child avoid obesity by providing the right kinds of foods in the right amounts. If you're not sure of the guidelines for a healthy diet, ask your doctor. He or she can give you nutritional information that is appropriate for your child's age. Also keep in mind that chubbiness is normal at certain ages, and that many children gain weight when going through a normal growth spurt. Never change your child's diet to promote weight loss without consulting with your doctor.

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This information has been designed as a comprehensive and quick reference guide written by our health care reviewers. The health information written by our authors is intended to be a supplement to the care provided by your physician. It is not intended nor implied to be a substitute for professional medical advice.