Childhood obesity is of increasing concern as a public health problem in the United States. Some surveys have found the total obesity rate among children and adolescents to be between 21% and 24%. During the same time, 32.2% of adults were obese. Overweight is caused by taking in more calories than the body uses (energy gap). On average, American children consumed between 110 and 165 extra calories than they use up every day; over a 10-year period, these extra calories would add 10 lbs to their weight. Already overweight teens took in an average of 700-1,000 extra calories every day, resulting in an average of 58 extra pounds.
Overweight and obesity are defined using the Body Mass Index (BMI). Children between the ages of 2 and 19 are assigned a percentile based on their BMI number. The percentile tells how their weight compares to that of other children who are their same age and gender. For example, if a boy is in the 75th percentile for his age group, 75 of every 100 children who are his age weigh less than he does and 25 of every 100 weigh more than he does. Adult BMI is interpreted differently.
The BMI weight categories for children are:
• Below the 5th percentile: Underweight
• 5th percentile to less than the 85th percentile: Healthy weight
• 85th percentile to less than the 95th percentile: At risk of overweight
• 95th percentile and above: Overweight
The reasons why the energy gap exists are related to both increased food intake and decreased energy use. Food intake reasons include:
• Increased consumption of sugary beverages
• Tendency to super-size portions
• More meals eaten away from home
• Increased snacking between meals
• Heavy advertising of high-sugar foods
• Decrease in children carrying their lunch to school from home
• Poor eating habits such as skipping breakfast and later snacking on high fat, sugary foods, etc.
Inadequate energy use reasons include:
• More time spent watching television or using the computer
• Fewer physical education requirements at school
• Fewer children walking to school
• Limitation of outdoor activities of children
• Teen access to cars has increased, etc.
Other factors that affect childhood obesity include an inherited tendency toward weight gain, mental illness, binge eating disorder, eating in response to stress, poor sleeping habits. In rare cases, medical or genetic disorders can cause obesity, or certain medications also can cause weight gain.
Children who are overweight are at increased risk of type II diabetes, high blood pressure, fatty liver, sleep apnea, early puberty, joint pain, increased anxiety and stress, low self-worth. Diagnosis is usually made on the basis of the child’s BMI.
Overweight children and their parents have to be referred to a registered dietician who can help them develop a diet plan for increasing the amount of nutrient-rich, low-calorie foods in their diets. Nutrition education usually involves the entire family. Typically, children are encouraged to increase their level of exercise rather than to drastically reduce calories. Drug therapy and weight-loss surgery are very rarely used in children, except in the most extreme cases of health-threatening obesity when other methods of weight control have failed. Children who are overweight often have psychological and social problems that can be helped with psychotherapy in addition to nutritional counseling.
The younger the child is the better the chance that the weight control strategies will help maintain a normal weight. Children may grow into a normal weight as they become taller. But children who remain overweight have a much greater likelihood of being overweight adults. The greater the degree of overweight, the higher the likelihood that overweight will continue into adulthood.