Weight Management in Children
What is abnormal?
For children and adults, the terms overweight and obesity are based on body mass index (BMI). For children BMI is measured at every well visit and plotted on a growth chart. A child is overweight if their BMI is at or above the 85th percentile and obese if the BMI is at or above the 95th percentile.
Why should we pay attention to this?
Obesity can influence many aspects of a child’s health and cause problems later in life. Children that are obese in childhood are more likely to have severe obesity in adulthood. Genetics may play a role, but because of the rapid rise of obesity we know that it has been influenced by lifestyle and society. Obesity can cause high cholesterol, high blood pressure, diabetes, heart disease, gallbladder disease, obstructive sleep apnea, arthritis, depression, polycystic ovarian syndrome, endometrial cancer, breast cancer and colon cancer
How does it happen?
Extra weight is like a math problem, it is caused by a positive difference in energy in the body. Excessive calorie intake and low levels of energy expenditure can cause weight gain. Changes can be made to help balance this equation. Family influence and food choices are important parts of changing a child’s weight.
The most common periods for developing obesity are at age 5-6 years old and adolescence. Adolescent girls are more likely to remain obese in adulthood than boys.
Certain patterns can increase the risk of obesity. These include skipping breakfast, eating fried food and drinking carbonated beverages. Overeating can also interfere with body regulation and over time can cause a decrease sensation of feeling full.
What should you do?
For all children, BMI will be checked at every well visit and discussed if it is abnormal. Certain screening tests may be done to check for high cholesterol and diabetes. For older children and teenagers, ask them questions to see if they are ready to address their weight
- How concerned are you about your weight?
- Do you think that you can improve your body fitness?
- Do you think that you can change eating and physical activity patterns?
Lifestyle changes and prevention
Changes can be made today! Feeding habits are learned early on and are well established by age 2-3 years old.
Things you can do to help
- Introduction of complementary healthy foods at 6 months of age
- 2 hrs or less screen time per day
- 5 servings fruits and vegetables
- 1 hr of activity per day
- No sugary drinks, just water or milk
- Don’t use food as a reward
- Don’t make children finish food from their plate
- Establish daily family meal times, snack times and physically active family time
- Offer only healthy food
- Remove snack food in the home
- Be a good role model and be consistent!
AAP Textbook of Pediatric Care-Obesity and Metabolic Syndrome. Helen Chiehyu Wang, MD; Sheila Gahagan, MD, MPH
10 minute exercises: http://www.nationwidechildrens.org/time-for-10-videos
Food choices chart https://www.nhlbi.nih.gov/health/educational/wecan/downloads/go-slow-whoa.pdf
Food choices flash cards https://www.nhlbi.nih.gov/health/educational/wecan/downloads/gswflashcards.pdf
Parent Handbook https://www.nhlbi.nih.gov/sites/www.nhlbi.nih.gov/files/parent_hb_en.pdf
Calorie counting website and app http://www.calorieking.com/
Programs and toolkits for obesity prevention http://www.letsgo.org/