OBESITY IN CHILDREN
If a child is overweight or obese, this means that they are carrying excess body fat. If nothing is done about this, the extra weight that they are carrying may cause problems for their health.
What are the health risks for your child of being overweight or obese?
Children who are overweight or obese can develop health problems during childhood because of their weight. Health problems can include
- Type 2 diabetes
- High blood pressure
- High cholesterol levels
- Fatty liver disease
- Heart disease
These health problems have traditionally been problems just affecting adults, with overweight and obese adults having an increased risk of developing them. But because of the rise in the levels of childhood obesity, these obesity-related health problems are now affecting younger people.
A child who is overweight or obese also has an increased risk of:
- Joint problems. Obese children are also more likely to develop bow legs and are more likely to have fractures of bones.
- Going through puberty early.
- Breathing problems, including worsening of asthma, difficulties with your child’s breathing whilst they are asleep (obstructive sleep apnoea) and feeling out of breath easily when they are exercising.
- Developing iron deficiency and vitamin D deficiency.
- Being overweight or obese as an adult (more than half of children who are obese will grow up to be obese as adults).
- Developing heart problems as an adult.
Being overweight or obese as a child or teenager can also have psychological effects for some. It can lead to low self-esteem and a lack of confidence. A child may be subject to bullying because of their weight. They may become withdrawn and avoid social contact. It may lead to low mood and, in severe cases, depression.
If overweight and obesity are recognised and treated in childhood and the teenage years, some of these health problems may be reversed, or even prevented. The child is also more likely to grow into an adult who has a healthy weight.
What is the cause of being overweight or obese in children?
For anyone (including children), weight depends on how much energy is consumed (the calories in food and drink) and how much energy is used up by the body. If more calories are eaten than used, weight increases. The excess energy is converted into fat and stored in your body.
The reasons why energy taken in may not balance energy used up and may lead to weight gain in children, include the following:
How much a child eats and drinks
Many children are overweight or obese simply because they eat and drink more than their body needs. Having too many foods that are sugary or fatty is a common problem. Sugary drinks also are often part of the problem.
A lack of physical activity
A child may be eating the right type and the right amount of food but, if they are not doing enough physical activity, they may put on weight. Long periods without exercise also contribute – for example, spending many hours watching television or playing video games. Having parents who are inactive can also increase a child’s risk of being overweight or obese.
Being overweight or obese does run in families. It is thought that 5 out of 10 children who have one parent who is obese will become obese themselves. And 8 out of 10 children who have two parents who are obese will also become obese themselves. This may partly be due to learning bad eating habits from parents as children. But, some people actually inherit a tendency in their genes that makes them prone to overeating and being overweight. Research has also shown that children who are born to mothers who are overweight, or mothers who develop diabetes during their pregnancy, are more likely to be overweight or obese themselves.
Lack of sleep
Not getting enough sleep has been suggested as another possible risk factor for obesity in children. There seems to be a trend of children going to bed later but, also, too little physical exercise can lead to poor sleep.
Two hormones called leptin and ghrelin may be important here. Leptin is released by fat cells to tell the brain that fat stores are sufficient. Ghrelin is released by the stomach as a signal of hunger. In someone who does not have enough sleep, leptin levels are low and ghrelin levels are high. These changes in hormone levels may encourage a child to eat more.
Rarely, a child has a medical cause for being overweight or obese. For example, there are some rare genetic diseases that can cause overweight and obesity in children. Conditions such as an underactive thyroid gland (hypothyroidism) or other hormone problems may also be a cause. Some medicines can also make children more likely to put on weight. However, in general, a medical cause for being overweight or obese is unusual.
What can be done if a child is overweight or obese?
Parents worried that their child may be overweight or obese, can discuss this with their doctor. The doctors may be able to suggest ways to help or refer them to other professionals who may be able to help. However, many overweight children do not need to be referred for specialist care.
Doctors, nurses and other healthcare professionals can look to see whether a child is overweight or obese by calculating their body mass index (BMI). BMI is a measurement of the child’s weight in relation to their height. BMI is calculated by dividing the child’s weight in kg by their height in metres squared (weight (kg)/ height m2). However, it is important to know that a child’s BMI is not interpreted in the same way as an adult’s BMI. Instead, their BMI is charted on special growth charts. These charts can show how a child’s BMI compares with the normal range for children of a similar age, sex and ethnic background. A doctor will check the child’s BMI against these standardised charts to determine if they are overweight or obese.
How much weight should a child lose if they are overweight or obese?
In general, rapid weight loss or strict dieting is not recommended for children who are still growing, unless this has been specifically advised by a specialist. For most children, the aim is usually to keep the weight at the same level rather than weight loss. As they grow and their height increases, the child should either not gain any weight as well or their weight gain should be slower than their height gain. Sometimes, if teenagers have stopped growing, weight loss of around 0.5 kg per week may be appropriate. A child’s healthcare professional will be able to advise what is best for them.
What is the treatment for a child who is overweight or obese?
The main way to treat a child who is overweight or obese is to look at changes that can be made to their lifestyle. Changes that involve the whole family are best. Other family members who are overweight may also benefit at the same time. Parents act as an important role model for children and can help them to stay healthy.
The two main lifestyle changes that are advised are for your child to eat more healthily and do plenty of physical activity. Small, gradual changes may be best. This enables the child to stick to these changes in the long term. Parents should be involved as much as possible in helping their child make these changes. A child should be praised and encouraged at every opportunity, in what they are doing.
Eating more healthily
Overweight children should be encouraged to eat more healthily and to reduce the total number of calories that they eat
Some suggestions that may be helpful include:
- A balanced and varied diet should be designed for the whole family.
- The child should eat meals at regular times and avoid snacking as much as possible.
- Meals should be eaten in a sociable atmosphere as a family, without distractions. For example, meals should not be eaten in front of the television.
- If snacks are eaten, they should be healthy snacks, for example, fruit instead of sweets, chocolates, chips, nuts, biscuits and cakes.
- Sugary drinks should be avoided (water is best).
- Snacks or food should not be used as a reward.
- The child should eat foods high in fibre. Foods rich in fibre include wholegrain bread, brown rice and pasta, oats, peas, lentils, grain, beans, fruit, vegetables and seeds. Amongst other things, foods high in fibre will help to fill the child up.
- Children need some fat in their diets but it is better that food should be grilled, boiled and baked rather than fried.
Doing plenty of physical activity
It is recommended that all children should do at least 60 minutes of moderate physical activity every day. Some suggest that children who are overweight or obese should even do more than this. This 60 minutes does not have to be done all at once and can be broken up into 10- or 15-minute blocks. If parents involved children in activities they enjoy, they are more likely to continue with it. Also, children should be encourages to become generally less inactive (sedentary). The amount of time spent on edentary activities, such as watching television, using a computer, or playing video games, should be less than two hours each day.
As mentioned above, being overweight or obese as a child may lead to psychological problems for some children. Counselling or specialist help to increase confidence and self-esteem and to help develop coping strategies for teasing or bullying is sometimes needed.