Childhood Obesity
Signs and Symptoms
The causes of obesity are complex, including genetic, biological, behavioral, nutritional and cultural factors. Obesity occurs when a person eats more calories than the body burns up. The root causes of obesity are excess consumption of food, a lack of physical activity or both.
If one parent is obese, there's a 50 percent chance that his or her children will be obese. When both parents are obese, their children have an 80 percent chance of obesity.
Many genetic and environmental factors contribute to the number of calories people eat and burn up, which is why weight loss and weight gain varies for different people.
Related Illnesses
Obesity increases the risk of many serious health problems. Obesity is associated with more than 30 medical conditions. Scientific evidence has established a strong relationship with at least 15 of those conditions, some of which include:
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Diagnosis
A child's weight is evaluated by his or her primary care pediatrician during regular check-ups and office visits. Weight issues rarely sprout rapidly but rather develop over time. If you think your child has a weight problem, make an appointment with his or her pediatrician or primary care doctor.
There are two main tools doctors use to assess a child's weight:
Growth Charts -- These charts are used throughout a child's development to assess growth, both height and weight, as compared to other children the same age and to watch how a child's body changes over time. Almost every doctor uses the same growth charts from the Centers for Disease Control and Prevention (CDC), based on the measurements of thousands of children.
Body Mass Index (BMI) for Age Charts -- This index uses height, weight, gender and age to assess a child's weight. A formula is used to calculate a child's BMI:
BMI = weight in kilograms / (height in meters) ²
The number is plotted on a growth chart -- greater than the 95 percentile is considered overweight or obese. A child who falls between the 85 percentile and 95 percentile is considered at risk for becoming overweight.
Note that this is higher than the cutoffs for adults. An adult with a BMI between 25 and 30 is considered overweight, while an adult with a BMI over 30 is considered obese.
If you have questions about your child's weight, ask to see his or her growth chart. It can be helpful to look at your child's measurements over time. Children also may like to see their chart.
If your child is overweight or at risk, your doctor or a nutritionist may do a 24-hour food recall with you and your child. This is a tool for gathering information about meal patterns, the consumption of sugared-beverages and snacking routines. You and your child may be asked about his or her level of physical activity.
Children determined to be overweight or at risk should be referred by their pediatrician to a registered dietitian and possibly a comprehensive obesity program, such as the UCSF Weight Assessment for Teen and Child Health (WATCH) Clinic.
Treatment
For some children, especially if they are still growing taller, it's more important to stabilize weight and allow them to grow into their weight. Overweight children who are still growing do not necessarily need to lose weight but simply maintain so that they can grow into their weight. The earlier a child is identified as being overweight or at risk the easier it is to treat. Because it's hard to permanently change dietary and exercise habits, it's essential to do something sooner rather than later.
Obese children need a thorough medical evaluation by a pediatrician or family doctor to assess their family history as well as their diet and exercise routines. First, the doctor will check for genetic and biochemical disorders related to obesity, such as Prader-Willi Syndrome and other genetic disorders, and hypothyroidism, and other hormonal disorders.
Diet and Activity Changes
The main way to treat obesity in children is to help them eat a healthy diet and encourage them to be physically active. In some instances, medication and even surgery may be considered depending on how overweight a child is and how much the weight is impacting his or her health.
Since losing weight is so difficult, it is very important that parents support their child while he or she makes difficult lifestyle changes. Lasting weight loss only occurs when the whole family participates.
Surgery
UCSF Children's Hospital has begun to evaluate the use of bariatric surgery to treat teens with severe weight problems.
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