Leadership, Education & Training Program (LET)

Childhood Obesity: Assessment, Prevention & Treatment

Childhood Obesity: Overview

Obesity is a widespread public health concern that affects adults and children alike.
Childhood obesity has been linked to increased risk for diseases such as:

  • cardiovascular disease
  • diabetes
  • stroke
  • certain cancers later in life
  • Child and adolescent obesity also increases the risk of:
  • social stigmatization
  • depression among youth

 

With increasing numbers of children becoming overweight, health professionals need to search for effective methods of treatment and prevention to combat further increases in childhood overweight.

Childhood Obesity Prevalence

In the past thirty years, childhood obesity has more than doubled in children and tripled in adolescents.

Among children aged 6-11 years, rates of obesity climbed from 7% in 1980 to 18% in 2010. This same trend is seen among 12-19 year olds where obesity rates rose from 5% to 18% during the same time period.

Obesity Assessment

Obesity is defined as having excess body fat. This can be determined by the use of BMI percentile categories using growth charts.

  • 85th-95th percentile are classified as overweight
  • 95th percentile are classified as obese

 

Growth charts can be used to monitor growth over time. These charts are divided by percentile curves to demonstrate the distribution of body measurements. Growth charts are provided by the Centers for Disease Control and Prevention and can be found here.

Contributing Factors

There are many factors that contribute to childhood obesity. These can be divided into genetic, behavioral and environmental factors.

Genetic Factors
Genetic characteristics may increase an individual's likelihood of being overweight. However, it is likely that this works in conjunction with environmental and behavioral factors.

Behavioral Factors
Many factors contribute to increased energy intake among children.

  • High-energy-dense foods and sugar drinks are readily available for children. Sugar sweetened beverages are a large source of this in children's diet and has been associated with obesity. These drinks are high in added sugar and calories and low in nutrient value.
  • Advertising of less healthy foods is common and influences children's ability to make healthy food choices. The foods most commonly advertised are high in total calories, sugars, salt, and fat. Healthy food advertisements are much less often seen
    Lack of physical activity also contributes to obesity.
  • Many children live in communities where there may not be a safe place for them to be active. Getting to a safe park or recreation center may be difficult depending on the families' access to transportation.
  • Children also spend a great amount of time using media such as cell phones, television, computers or video games. On average, children 8-18 years of age spend 7.5 hours a day using these. Time spent on these activities means that children are not taking part in more active play.

 

Environmental Factors
The home, child care, school and community environments all play an important role in a child's development and maintenance of healthy diet and physical activity habits. A majority of young children are enrolled in schools providing an optimum environment to reinforce health eating and physical activity behaviors. When not in school, experiences in a child care or home setting continue to shape dietary and physical activity behaviors. The communities that children live in play an important role in providing physical activity opportunities and access to affordable and healthful food.

Health Effects

Obese children are more likely to be obese in adulthood than healthy-weight children. This places them at increased risk for adult health problems such as heart disease, type 2 diabetes, stroke, multiple types of cancer and osteoarthritis.

In addition to the long-term health effects, obese children are more likely to have cardiovascular risk factors such as high cholesterol or high blood pressure. Obese children are also more likely to have prediabetes, placing them at an increased risk for development of diabetes.

Social problems such as stigmatization and poor self-esteem are also apparent with childhood obesity.

Prevention

Maintaining a healthy diet and physical activity levels are important for preventing obesity and consequent diseases.

Many aspects influence the dietary and physical activity of children and adolescents. Communities, schools, child care settings, faith-based institutions, government agencies, families and the media all impact these behaviors of children. In addition, the food and beverage industries play an increasingly important role in the dietary and physical activity behaviors of children.

Recognizing the influential role the food and beverage industry has on dietary habits of children, the United States Better Business Bureau established the Children's Food and Beverage Advertising Initiative. This initiative is a voluntary self-regulated program that includes many of the largest food and beverage companies in the United States. The goal of this imitative is to encourage healthier dietary choices and healthy lifestyle among children by shifting the types of food and beverages advertised to children under the age of 12.

Schools also play an important role in establishing an environment that supports healthful lifestyle habits. Policies within schools can be established to encourage health eating and regular physical activity. Schools have the opportunity to both educate students about these behaviors and provide opportunities for them to be practiced. In effort to increase the number of fruits and vegetables served in schools, programs such as Let's Move! Salad Bars 2 Schools and the National Farm to School Network.

In response to the childhood obesity epidemic, the Let's Move! Campaign was established by Michelle Obama, the First Lady.

Treatment

Treatment for childhood obesity depends on the child's age and existing medical conditions. For most, treatment includes changes to the child's diet and physical activity.

The goal for obesity treatment is most over for weight maintenance rather than weight loss. As a child grows, they add inches in height but not in pounds, causing BMI-for-age to drop over time into a healthier range.

Depending on a child's existing health complications, treatment may include a multidisciplinary team including the family physician, dietitian, counselor or physical therapist. Specific plans for diet and physical activity may be developed if general guidance is ineffective. In extreme cases, drugs or very-low-calorie diets may be used.


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