Over the last few decades, childhood obesity has developed into a major health problem for families in the United States. The current estimate is that 1 in 5 children have been affected by obesity. This number takes into account children who have other health issues or are at greater risk for obesity. Even considering these issues, obesity has become a widespread problem for all children.
A variety of issues contribute to the development of obesity, these include: behavior, genetics, and some medications. Aspects of our society may contribute to this problem, such as child care and school, accessibility to healthy foods, and safe park areas for recreation.[1]
Childhood obesity affects the child and adolescent in a variety of areas: psychological, cardiac health, and their basic health status. In order to truly improve on the problem of obesity, the subject of healthy living requiring attention, include: diet, exercise, physiological aspects, and psychological issues. The main area to fight childhood obesity is prevention by educating the child and family. This is done by encouraging healthy behavior such as foods to choose from, and increasing the activity of the family as a whole. One of the best places to begin with education, is to sit down with a Dietician that the healthcare provider can suggest, and learn about the healthy food options and vital aspects of nutrition for the child and family. The main aspect requires the reduction of unhealthy behavior so that it will not affect the individual throughout life.[2]
Healthy People 2030, which is a federal program that monitors a set of objectives designed to improve health, has listed overweight and obesity as a social issue to address. The Covid-19 pandemic has raised the need to monitor childhood health. The direct effects of the pandemic on children, which includes - infection, hospitalization, and deaths - and indirect effects which affect the family, such as economic problems, impacts the family by leading to less physical activity and more screen time.[3]
There are a variety of health concerns related to childhood obesity: genetics plays a large role, environmental factors, metabolism, lifestyle of the child and family, and eating habits. [4]
Some childhood diseases can predispose the individual to develop obesity, and as such require individualized management. Obese children are also more likely to be bullied, feel isolated, have low self-esteem, and develop depression.
Racial predisposition in descending order, include:
Hispanic children
non-Hispanic Black children
non-Hispanic white children
non-Hispanic Asian children [5]
Symptoms and Causes of Childhood Obesity
Contrary to popular belief, obesity is not due to laziness or a lack of will power. Growing children require a certain amount of calories in order to maintain their growth and development, however when excess calories are taken in, it will be stored as fat in the body and as a result the child will gain excess weight. Children and adults both tend to gain weight for similar reasons:
Behavior: The family tends to share poor eating habits and lack of activity. A busy family will tend to eat fast foods and as such consume more foods high in fat.
Genetics: When a child has a parent or sibling who is obese, they are at an increased risk of becoming obese.
Socioeconomic and community: Access to healthy foods may be limited due to cost. The food intake at daycare and school may not always be healthy. There is also a lack of physical activity due to daycare and school attendance.
Other socioeconomic: The cost and accessibility to healthy foods; lack of a social support system; limited access to recreational facilities such as playgrounds, basketball courts, bike paths, or parks.
Cultural: Advertisements for fast food chains can affect the family's eating behaviors. Fast foods tend to be high in fats, as well as large in portion.[5]
Diagnosing Obesity in a Child
During a well-child exam the health care provider will plot the child's height and weight according to their age. This plot is used to calculate the Body Mass Index(BMI). The Center for Disease Control and Prevention(CDC) has determined a classification of percentiles, as follows:
BMI of 85th to 94th percentile is overweight
BMI of 95th percentile and over is obesity
BMI of 99th percentile and above is severe obesity
With the BMI included, parts of the health history need to be taken into account: Is there a family history of obesity and weight-related illnesses; Does the child experience depression and sleep problems; how are the child's eating habits, and level of activity; does the child have any health conditions; does the child experience feelings of isolation or has been bullied.
Blood tests may be performed to check for hormonal issues or other conditions which the child could develop due to obesity.[6]
Management and Treatment of Obesity
The main objective is to focus on healthy eating habits and an increased activity level. The child should never feel that this is their fault. Parents need to provide support to their child in order to address a weight problem.
When addressing an eating problem it is beneficial for the parents to involve the entire family. Healthy meal options need to be provided and an increase in physical activity that would be appropriate for the entire family would benefit all members. Limiting screen time to two hours per day is sufficient, this is when play time could be encouraged.
It is important that the whole family learn about healthy eating habits. Guiding the family to select healthy foods will increase the willingness to eat them. Encourage children to be part of the food selection and preparation. Usually when one member of the family eats rapidly, it becomes a behavior for all. Teach the importance of eating slowly to improve digestion and develop the ability to recognize fullness vs hunger. Eating meals as a family does not only help to establish good eating behaviors, it is also a good time to catch up on one another's day. Designating a place for eating meals and snacks, instead of in front of the television would be helpful. Obtaining a menu from the school for lunch meals will aid in planning healthy lunches. When possible pack a lunch of healthy foods instead of eating what is served at school.[5]
In summary, the incidence of childhood obesity has reached epidemic proportions. Illnesses that would normally be seen in older adults are now developing in childhood. Establishing healthy eating habits and increased activity are vital to addressing this problem. The family will benefit from choosing healthy foods, planning a menu for the week, and eating together with a pleasant atmosphere of positive conversation. These various aspects will help to reduce the burden of society. Addressing the obesity issue will aid in preventing illnesses that will last into adulthood, and also prevent long-term health issues that would place a burden on an already stressed healthcare system.
Sources:
1.Overweight and Obesity
2. Childhood and Adolescent
Obesity in the United States:A Public Health Concern
3. Five-Year Trends in US Children's Health and Well-being, 2016-2020
4. Obesity in Children
5. Childhood Obesity
6. Childhood Obesity
Assessed and Endorsed by the MedReport Medical Review Board