Childhood Obesity: Know the Facts
by Christina Payne, MD
It’s time for your son’s nine-year-old check-up. He appears healthy, but needs a physical form signed for camp. He isn’t due for shots and hasn’t contracted anything more than a cold in the last year, so the entire appointment seems unnecessary.
As your doctor visits with you, he expresses concern that your son is obese and discusses a nutrition and exercise regimen to help the condition. He also suggests blood work to evaluate cholesterol and blood sugar levels, which seems premature to you given that your son is only nine. Although always appearing a little “pudgy”, he has never given cause for alarm. He goes to physical education three days a week and plays outside on a regular basis. Lunch is eaten from the school cafeteria and dinner often involves fast foods due to a busy family schedule.
Childhood obesity is defined as a body mass index (BMI) greater than the 95th percentile for age and gender. BMI is calculated as weight (in kilograms) divided by height in meters squared. An overweight or at-risk child has a BMI greater than the 85th percentile. Most physicians calculate the BMI with their electronic charting systems at check-ups for children over 3.
Almost one in five children in the United States is overweight or obese, this statistic tripling over the past 30 years. Therefore, obesity prevention and diagnosis is fast becoming a regular part of health maintenance.
Obviously, appropriate nutrition leads the list of interventions to maintain healthy weight children. Good nutrition along with regular exercise must be enforced to help prevent obesity and its associated diseases.
Obese children have increased medical care usage when compared to healthy weight children. They begin developing adult-type illnesses at a young age, often requiring medications still unapproved for children. Type 2 diabetes, hyperlipidemia (elevated cholesterol), hypertension, asthma, and fatty liver disease are the main medical issues increased in obese children.
Obstructive sleep apnea is five times more likely in obese children compared to those at a healthy weight. Orthopedic conditions and sports-related injuries are significantly higher in these children as well. Once present, most of these issues tend to worsen into adulthood.
Fortunately, weight reduction and a modified lifestyle help reverse these problems. Obesity is definitely a major problem to be treated by the medical community, but also a serious public health issue as well. Treatment of the obese child involves interventions in almost all areas of life.
Busy families may have good intentions, but can encounter difficulty putting a physician’s recommendations into practice. The goal of weight reduction therapy is to allow younger children to maintain their weight as they grow taller, and older children to undergo slow weight loss (around one or two pounds per month).
Successful dietary plans enforce portion control and food selection. One such plan called We Can!, is sponsored by the National Institute of Health . More rapid weight loss or complicated cases should involve a nutritionist.
The American Academy of Pediatrics Sports Medicine and Fitness recommends 60 minutes of physical activity a day. To get this amount of exercise definitely requires more time than school programs allow. The entire family must be involved in the change, from the type of foods kept at home to family time after school and on weekends. Studies have shown that if just one parent is present for a sit-down meal with the family in the evening, those children are more likely to maintain a healthy weight.
In conclusion, the topic of weight management and obesity in children is a very sensitive topic, but its treatment is essential for a healthy childhood. Patients like the boy mentioned at the beginning of this article are rapidly increasing.
As pediatricians, our goal is to encourage healthy changes without making a child feel insecure or develop other unhealthy eating disorders. Steady lifestyle modification with progressive small changes in diet and exercise over time remains the mainstay of treatment.
Christina Payne has a degree in chemistry from Baylor University and graduated from the University of Texas Southwestern Medical School. She did her pediatric residency at Columbus Childrens Hospital and Ohio State University in Columbus, Ohio. After moving to Texarkana in 2001, Dr. Payne practiced as a general pediatrician with Southern Clinic before joining Collom and Carney. She has a son and daughter and enjoys spending time traveling, running and shopping for antiques.
