Childhood overweight and obesity rates have been rising at an alarming rate over the past 3 decades. According to the CDC, the percentage of children in the United States classified as being obese has increased from 6.5% in 1976-1980 to 17.4% in 2013-2014, and the percentage of adolescents who are obese has increased from 5.0% to 20.6%.1,2 Childhood obesity has progressively developed into a sweeping epidemic that has now even achieved the status of a public health crisis by the World Health Organization (WHO). The WHO projects that if this trend continues at its current rate, the number of obese infants and young children could rise to 70 million by 2025.3For these reasons, childhood obesity has been deemed one of the most serious health challenges of the 21stcentury.4

 

Classifying Overweight and Obesity in Children

There is no international consensus on clinically significant cutoffs for the classification of overweight and obese children. The American Medical Association Expert Committee recommendations published in 2017 suggests that a BMI that is equal or greater than the 85thpercentile but less than the 95thpercentile for sex and age should be considered overweight. A BMI equal to or greater than the 95thpercentile for sex and age should be considered obese.5

 

Physical and Psychosocial Impacts of Childhood Obesity

Childhood obesity has many detrimental effects and associated comorbidities that can lead to long-lasting, serious health conditions in adulthood that are costly to treat and difficult to control. Although obesity in childhood does not necessarily guarantee that the person will be obese in adulthood, childhood obesity often produces a metabolic syndrome that greatly increases the risk for an individual to remain obese into adolescence and adulthood.6

Metabolic syndrome is a combination of high insulin levels, obesity, high blood pressure, and abnormal lipid levels.6This combination of factors ultimately increases the child’s likelihood for having cardiovascular disease and diabetes. This likely helps explain why serious diseases previously seen only in adults such type 2 diabetes, liver disease, and cardiovascular disease are now being diagnosed in children of younger ages.4

The psychosocial impact of childhood obesity must also be considered when evaluating this issue. Research has shown that childhood obesity is associated with poor body image, low self-esteem, social isolation, recurrent anger, early forms of eating disorders, clinical depression, and negatively acting out in school and other social settings.6

 

Treatment Strategies for Parents

Prevention is the most effective treatment for childhood obesity. Up until adolescence the majority of children do not have a significant role in choosing the food and drink they consume. It is thus often up to the parents to thoughtfully select food and beverage items for their children. Experts suggest that making available a variety of healthy choices, as well as having an awareness and respect for the child’s personal food preferences can help motivate children to eat a healthier diet. Actively encouraging decreased sitting time and promoting “free play”, where the child may engage in activity of their own selection, has been shown to be more effective than ordering the child to exercise or decrease their food intake.6

 

Barriers to Health Professionals

According to the results of a study surveying health professionals on the topic of childhood obesity, many clinicians reported a lack of confidence sensitively discussing the issue of weight management with families.7Many factors exist that may contribute to this lack of confidence in the realm of childhood obesity. These barriers to health professionals, as well as barriers that families and schools are facing, will be discussed in further detail in next week’s blog post.

 

Eating and activity habits, including food preferences, are typically developed early in life. Unfortunately, childhood obesity is often a problem of adults’ mishandling of providing adequate healthy food options and opportunities for activity rather than a problem of the child’s own diet and activity choices. Healthcare providers and parents can both make significant contributions to promote lifetime wellness for children in their care through fostering healthy habits and creating a health-oriented environment.

 

References:

 

  1. “Childhood Obesity Facts.” Centers for Disease Control and Prevention, US Dept. of Health and Human Services, 22 Dec. 2016, www.cdc.gov/obesity/data/childhood.html. Accessed February 28, 2019.
  2. Fryar, Cheryl D., et al. “Prevalence of Overweight and Obesity among Children and Adolescents Aged 2–19 Years: United States, 1963–1965 through 2013–2014.” Health E-Stats, National Center for Health Statistics, Centers for Disease Control and Prevention, 18 July 2016. www.cdc.gov/nchs/data/hestat/obesity‗child‗13‗14/obesity‗child‗13‗14.htm. Accessed February 28, 2019.
  3. “Facts and Figures on Childhood Obesity.” World Health Organization, 29 Oct. 2014, www.who.int/end-childhood-obesity/facts/en/. Accessed February 28, 2019.
  4. Vittrup B, McClure D. Barriers to childhood obesity prevention: parental knowledge and attitudes. Pediatr Nurs. 2018;44(2):81-87.
  5. Rao G. Childhood obesity: Highlights of AMA expert committee recommendations.

Am Fam Physician. 2008 Jul 1;78(1):56-63.

  1. Moglia P PhD, Dill K MD. Childhood obesity. In: Magill’s Medical Guide (Online Edition). Salem Press; 2017.
  2. Bouch AB. Childhood obesity: an overview of the existing barriers to the health practitioner’s role in providing effective intervention. Communitypractioner.co.uk. https://www.communitypractitioner.co.uk/resources/2017/07/childhood-obesity-overview-existing-barriers-health-practitioner’s-role-providing. Published July 26, 2017. Accessed February 28, 2019.