Obesity—Children and Teens
(Obesity—Pediatric and Adolescent; Overweight—Children and Teens; Overweight—Pediatric and Adolescent; Pediatric and Adolescent Overweight; Children and Teens Overweight; Pediatric and Adolescent Obesity; Children and Teens Obesity)
Being overweight or obese means your weight is above an ideal weight range. Appropriate weight ranges are calculated using the body mass index (BMI). For anyone under 20 years of age, these scales are based on height, weight, sex, and date of birth. Child and teen BMI results differ from adult BMI. This is because they are compared to the results of other children and teens in the same age range. This extra step takes into account that children and teens are still growing. BMI levels for anyone under age 20 are as follows:
- Underweight —BMI at or below the 5th percentile for the age group
- Desired weight —BMI between the 5th-84th percentiles for the age group
- Overweight —BMI between the 85th-94th percentiles for the age group
- Obese —BMI at or above the 95th percentile for the age group
Calories are taken into your body through food and drink. They are used for:
- Physical activity
- Basic body functions
Excess weight gain occurs when this balance of calories taken in and calories used is not kept in place. If this happens regularly, it will lead to obesity. Some things that can cause children and teens to take in more calories than they use are:
- Poor eating habits
- Sedentary lifestyle (inactive)
- Overeating or binging
- Taking certain medicines
- Having an illness or condition
These factors increase your child’s chance of being overweight or obese:
- Poor sleeping habits
- Large birth weight
- Lack of exercise
- Lack of sleep
- Sedentary activities (eg, watching TV, playing on the computer, playing video games)
- High levels of fast food in diet
- Stressful life events or change
- Family and peer problems
- Low self-esteem
- Depression]]> and other emotional problems
- Family history
- Genetic factors
Symptoms of obesity include:
- Increased weight
- Thickness around midsection
- Obvious areas of fat deposits
Complications of Untreated Obesity
Excess weight increases the chance of a child developing:
- High blood pressure]]>
- ]]>High cholesterol]]>
- ]]>Type 2 diabetes]]>
- Bone and joint problems
- Sleep problems (eg, ]]>sleep apnea]]> )
- Liver and gallbladder disease
- Unhealthy eating habits, including eating disorders
- Substance abuse problems
- Problems during adulthood (more likely to develop heart disease as adults, shortened life expectancy in adulthood)
The doctor will:
- Ask about your child’s symptoms and medical history.
- Do a physical exam.
Tests may include the following:
- BMI—Height and weight will be measured. This information, as well as birth date, will be used to calculate ideal weight ranges.
- Waist circumference, sagittal diameter, and waist-to-hip ratio—These are used to estimate the amount of fat deposited in the skin and inside the abdominal cavity.
- Skinfold caliper—This test measures fat just beneath the skin. It cannot measure fat inside the abdomen.
- Electrical measurements—These are tests that calculate the percentage of body fat. This measures the difference between the electrical characteristics of fat and other tissues in your body.
- Blood tests—These tests rule out other conditions that may cause excess body weight.
Obesity can be difficult to treat. Success requires that parents and caretakers play an active role. Medical professionals may also be needed to assist in weight loss, such as a:
- Dietitian—A dietician can help assess your child’s current food intake and recommend new options so that your child has a well-balanced diet.
- Behavioral therapist—A therapist can help change habits related to overeating or binging. This therapy may also be done in a group setting with peers. Getting the whole family involved in behavioral classes may also be beneficial.
The doctor or medical specialist may recommend:
Have your child follow basic healthy eating habits, such as:
- Eat five fruits and vegetables every day.
- Limit sugar-sweetened beverages, including juices.
- Eat breakfast every day.
- Switch to low-fat dairy products.
- Eat a diet rich in calcium.
- Eat a high-fiber diet.
Other steps you can take include:
- Pay attention to how food is prepared. This can make a big difference.
- Limit fast food, take-out, and eating in restaurants. These give you little control over how the food is prepared.
- Set a good example. Prepare healthy meals at home.
- Eat together as a family.
In more severe cases, your child may have to follow a meal plan.
Encourage your child to:
- Participate in physical activity. This is a healthier choice for your child than watching TV or playing on the computer.
- Get involved in family activities. This will help him learn how to add activity into his day.
The American Academy of Pediatrics offers these general guidelines for your child:
- Get at least one hour daily of physical activity.
- Limit time in front of a TV, game, or computer screen to 1-2 hours per day. If your child is under two years old, avoid screen time.
In more severe cases, your doctor may provide a specific activity plan.
Some children who are obese may already have serious conditions due to their weight, such as:
- Lung or heart problems
- Bone and joint problems
Other children may have a hard time losing weight despite following guidelines. For these children, other options may be considered, such as:
- Certain medicines (eg, orlistat]]> ), when added to lifestyle changes, may help teens lose weight. But teens need to be closely monitored for side effects.
- Bariatric surgery may also be an option for some obese children and teens. This option is generally only considered if all other options have failed.
To help reduce your child’s chance of being overweight or obese:
- Encourage at least five servings of fruits and vegetables every day.
- Choose lean meats, poultry, and fish.
- Serve reasonable portions, and eat healthy meals together as a family.
- Limit sugar-sweetened drinks. Encourage your child to drink water.
- If your child is over two years of age, encourage him to get at least 60 minutes of moderate to vigorous activity most days of the week.
- Limit screen time to two hours a day maximum.
- Make sure your child is getting enough sleep.
- Set a good example for your children. Choose healthy food options. Be physically active.
American Academy of Pediatrics
American Heart Association
Dietitians of Canada
American Academy of Child and Adolescent Psychiatry. Childhood obesity. American Academy of Child and Adolescent Psychiatry website. Available at: http://www.aacap.org/cs/root/facts_for_families/obesity_in_children_and_teens . Accessed March 18, 2010.
American Academy of Pediatrics. Prevention and treatment of childhood overweight and obesity. American Academy of Pediatrics website. Available at: http://www.aap.org/obesity/index.html . Accessed March 18, 2010.
American Heart Association. Overweight in children. American Heart Association website. Available at: http://www.americanheart.org/presenter.jhtml?identifier=4670 . Accessed March 18, 2010.
Carson-Dewitt R. Obesity. EBSCO Health Library website. Available at: http://www.ebscohost.com/thisTopic.php?marketID=15topicID=81 . Accessed March 18, 2010.
Centers for Disease Control and Prevention. Children's BMI tool for school. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/healthyweight/assessing/bmi/childrens_bmi/tool_for_schools.html . Accessed March 19, 2010.
Centers for Disease Control and Prevention. Tips for parents: ideas to help children maintain a healthy weight. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/healthyweight/children/index.html. Accessed 3/19/2010 . Accessed March 18, 2010.
DynaMed Editors. Obesity in children and adolescents. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Accessed March 18, 2010.
Kids Health Nemours. Overweight and obesity. Kids Health Nemours website. Available at: http://kidshealth.org/parent/general/body/overweight_obesity.html . Accessed March 18, 2010.
4/16/2010 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Díaz RG, Esparza-Romero J, Moya-Camarena SY, Robles-Sardín AE, Valencia ME. Lifestyle intervention in primary care settings improves obesity parameters among Mexican youth. J Am Diet Assoc. 2010;110(2):285-290.
10/15/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: US Food and Drug Administration. Meridia (sibutramine): market withdrawal due to risk of serious cardiovascular events. US Food and Drug Administration website. Available at: http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm228830.htm. Published October 8, 2010. Accessed October 15, 2010.
Last reviewed April 2010 by ]]>Kari Kassir, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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