Childhood obesity is a serious medical condition that affects children and adolescents. Childhood obesity is particularly troubling because the extra kilograms often start children on the path to health problems that were once considered adult problems: diabetes, high blood pressure and high cholesterol. According to the World Health Organisation (WHO) in 2016 the number of overweight children under the age of five was estimated to be over 41 million. In the WHO African Region, the number of overweight or obese infants and young children (aged 0 to 5 years) increased from 4 to 9 million between 1990 and 2016. Now, almost half of all overweight children under 5 lives in Asia and one quarter lives in Africa.
The treatment for childhood obesity is no different from many other ‘lifestyle’ diseases: determine the cause(s) and control or eradicate it (them). Obese children are above the normal weight for their age and height. The vast majority of these children consume too many calories relative to their energy expenditure. Simply – they eat more than they burn off.
Body mass index (BMI) was developed to describe and identify obesity. Essentially BMI asks whether the weight of the subject in excess of what is healthy for a given height? BMI is the ratio between an individual's weight to their height relative to their gender and age. A person is overweight when their BMI is between 25.0 and 29.9. Obesity is defined as a BMI greater than 30.0. BMI is not used for children under 2 years of age, and instead growth charts should be used to identify any weight issues. With the exception of very rare bone diseases, the idea of an individual's excessive weight due to being "big boned" is an urban myth.
Causes of Childhood Obesity
The WHO reports that the fundamental causes behind the rising levels of childhood obesity are a shift in diet towards increased intake of energy-dense foods that are high in fat and sugar but low in vitamins, minerals and other healthy micronutrients, and a trend towards decreased levels of physical activity. Most obesity is caused by consuming more calories than are burnt off.
Body weight is a reflection of genetics, diet, exercise and activity, psychological factors, and socioeconomic factors.
Diet is the main culprit in childhood obesity. Regularly eating high-calorie foods (fast food, pies, muffins) and food high in sugar (fruit juice, cold drinks, donuts) can cause weight gain, particularly when coupled with lack of exercise.
Lack of exercise and activity has become almost the norm with children, who are spending increased amounts of time in sedentary activities like watching television, playing games on tablets and mobile devices or playing video games. Children who don't exercise much are more likely to gain weight because they don't burn as many calories as they consume.
Psychological factors like stress, boredom and depression can increase a child's risk of obesity. Some children overeat to cope with problems at home or school. Their parents might have similar tendencies which is where the children pick up the behaviour and mimic the ‘coping mechanism’.
Socioeconomic factors affect access to resources, supermarkets and healthy, fresh foods. Researchers know that family income is a big factor in childhood obesity. As poverty rises, so does the rate of obesity among children, according to the University of Michigan. In low-income communities, places to play and supermarkets may be scare, which can promote consumption of low nutrition and fast food and little to no physical activity. For every 1% increase in low-income status, there’s a 1.17% increase in rates of overweight/obese children, says the study.
For many people buying convenience foods that don't spoil quickly is the only option (or so they believe). In addition, many people feel that the only acceptable exercise is in a gym. Gym memberships are expensive. Our role as health care providers and nutritionists is to teach clients healthy alternatives and how to shop for the healthiest choices.
Physical and Psychological Consequences
One out of five children is overweight or obese, and the latest numbers indicate that rates of childhood obesity show no signs of waning. Beyond vanity and social anxiety, being overweight or obese during childhood increases the risks of developing long-term complications that can impact health for a lifetime. Physical complications include Type 2 diabetes, high cholesterol, high blood pressure, asthma, and sleep disorders like obstructive sleep apnea.
On the psychological side, overweight and obese children tend to have more anxiety and poorer social skills than normal-weight children do. This can result in children acting out and becoming disruptive at school, or withdrawing. Children often tease or bully their overweight peers, who suffer a loss of self-esteem and an increased risk of depression as a result.
Reining in the Obesity Epidemic
It has become more and more the ‘trend’ to keep children busy throughout the day. Parents rush them from school to social activities and then home to do homework and gulp down dinner before bed. All of that running around is not only stressful, but it also leaves little time for food preparation, exercise and mindfulness. It is no wonder that when children have some ‘time-out’ they tune in to online activities.
Benjamin Franklin's famous dictum "an ounce of prevention is worth a pound of cure" is ironically the perfect approach to childhood obesity. The CDC has recently stated that if the alarming increase in childhood obesity not be reversed, this generation of children will be the first not to exceed the life span of their parents.
Childhood obesity must be tackled before the teen years. Twenty percent of overweight and obese 4-year-old children will grow up to become obese adults; 80% of obese teens will continue their obesity into adulthood. All of the above-reviewed consequences of paediatric obesity are brought forward into the adult years.
Whether your child is at risk of becoming overweight or is currently overweight or obese, you can take measures to get things on the right track. The best strategies to reduce childhood obesity is to improve the eating and exercise habits of the child and their family. Obesity prevention will require both a personal and cultural change in lifestyle, and families who want to change the food culture in their household to be healthier need to be intentional about it.
James Baldwin said: “Children have never been very good at listening to their elders, but they have never failed to imitate them.” That is as true today as it was when he lived.
Children learn about eating healthy, exercising and making the right nutritional choices ay home. The biggest influence on the choices kids make when selecting food and choosing to be active is what they saw their parents do.
As health care professionals, you can guide parents to make good nutrition choices for their children:
- Provide easily accessible fruits and vegetables
- Eat meals as a family as often as possible
- Adjust portion sizes appropriately for your child’s age
- Do not allow children to watch TV while eating
- Be sure your child gets enough sleep