Childhood Obesity:

An Overview on Why, and What to Do

Childhood obesity is on the rise. Nearly 20 percent of U.S. children are obese. Three decades ago, that number was only about 7 percent.

Obesity is defined as having a body mass index (BMI) above the 95th percentile for age, sex and race, or any BMI above 30. BMI is a measurement determined by dividing a person's body weight (in kilograms) by the square of his or her height (in meters).

The increase in childhood obesity can be tied to youngsters' getting too little exercise and eating too many foods that are high in calories and fat. Also, schools have reduced their emphasis on physical fitness, while allowing less healthy food choices in lunchrooms and vending machines.

Genetics and race also play a role. Children of overweight parents are at a greater risk for obesity themselves, and recent studies have found nearly two-thirds of American adults are overweight. African American, Hispanic and American Indian children are more at risk for obesity than are children of other racial backgrounds.

Up to 70 percent of adolescents who are obese remain overweight as adults. And the health effects of obesity begin long before adulthood. Many children who are obese already have high cholesterol, insulin resistance and high blood pressure, all of which increase a child's risk for heart disease and diabetes.

Sleep apnea can be a serious problem for obese children. Sleep apnea is a sleep disorder in which a person's breathing is interrupted many times during the night. Sleep apnea can cause learning and memory problems in children.

Obese children also are at risk for liver problems, hypertension, endocrine imbalance, gallbladder disease and joint disease. Obese girls also are more likely to have asthma.

Besides the physical health problems associated with obesity, emotional problems also are common. Obese children and teens are more likely to be teased by other children; they are more likely to have poor self-image and self-esteem, and to feel socially isolated. Obesity in children and teens also increases the risk for depression and suicide.

If a child or teen is overweight -- with a BMI in the 85th to 95th percentile for age, sex and race -- he or she should be screened by a health care provider. The health care provider will look at family history of weight problems and personal history of weight gain and concerns about weight, plus blood pressure and cholesterol levels. If a child or teen is obese -- with a BMI of at least 30 -- he or she should be seen by a health care provider for a complete medical evaluation.

Self-Care

• Encourage your child to increase his or her physical activity. Sign your child up for team sports such as soccer, basketball and swimming, so that he or she is active year-round. Children need at least one hour of physical activity every day, but this hour can be spread throughout the day.

• Get the entire family involved in regular physical outings that include walking and biking. Plan family vacations that focus on physical activities such as hiking or biking.

• Prepare nutritious, low-fat, lower-calorie meals for your family. Avoid serving desserts, candy and other fattening foods or treats.

• If your child has a weight problem, be supportive rather than critical. Encourage appropriate eating habits and provide proper nutrition.

• Limit the amount of time your child can watch television or play video games to no more than 30 minutes a day. Enforce that limit.

• Mealtime should be spent around the table, not in front of the television. Make meals an enjoyable, unhurried time with the family.

• Food should never be used as a reward or punishment.

• If you believe that your child should be on a diet, discuss it with your child's doctor and nutritionist. Diets emphasizing weight loss may not be appropriate for growing children at some ages; better nutrition may be more appropriate. Your child's health care provider can help you decide.

• Offer only healthful snacks, including fruits and vegetables; low-fat cheese or plain yogurt; and cookies such as fig bars, graham crackers, gingersnaps or vanilla wafers.

• Limit beverage choices to water, skim or 1 percent milk, and sugar-free drinks. Instead of serving juice, provide fresh fruits and vegetables. (Even 100 percent juices like orange juice still contain a lot of sugar.)

• Avoid fast-food restaurants. These places serve mostly high-fat, high-calorie foods.

Decision Guide for Childhood Obesity
Symptoms/Signs	Action
Child gets less than 30 minutes of physical activity each day	Use self-care
Child eats fast-food meals more than once a week	Use self-care
Child's diet includes junk food, desserts and snacks	Use self-care
Child views more than one hour of television daily	Use self-care
Child is overweight or obese (BMI at least 85th percentile for age, sex and race, or BMI 30 or above)	See provider
Adolescent is overweight (BMI at least 85th percentile but less than 95th percentile for age, sex and race)	See provider
Adolescent is obese (BMI at least 95th percentile for age, sex and race, or BMI 30 or above)	See provider
Child or teen is worried about his or her weight, getting teased, has social issues, appears depressed	See provider