Today’s youth are considered the most inactive generation in history caused in part by reductions in physical education programs at school and unreachable or unsafe recreational community facilities. In the United States, only the state of Illinois requires daily physical education for students in grades K through 12. Many adverse health effects associated with being overweight are seen in children and adolescents. Overweight during childhood and particularly adolescence is related to the increasing morbidity and mortality in recent life.
Many parents are correctly concerned about their child’s weight and how it affects them. They look for specific answers for prevention and treatment options. Unfortunately, the state of science is much less accurate than we would like. Are the boys concerned about their weight? What are the best strategies for prevention? What treatments work on a long term term?Researchers are trying to answer those and many other questions. In many cases, common sense works well.
In situations where there are serious health, psychological or social problems, parents should seek the best advice possible.
Obesity in children and adolescents is a serious issue with many health and social consequences that often continue into adulthood. Implementing prevention programs and gaining a better understanding of treatment for young people is important in controlling the epidemic of obesity.
The percentage of overweight and obese children and adolescents is now higher than ever. Poor dietary habits and inactivity are reported to contribute to increased obesity in youth.
Causes of Morbid Obesity in Children
There are many factors that contribute to causing child and adolescent obesity – some are modifiable and some are not.
Modifiable causes include:
- Physical activity – lack of regular exercise.
- Sedentary behavior – high frequency in watching TV, computer use, and similar behaviors that take time that can be used for physical activity.
- Socioeconomic status – low family income and non-working parents.
- Eating habits – excessive consumption of foods high in calories.
- Some eating patterns that have been associated with this behavior are eating when they are not hungry, eating while watching TV or doing homework
- Environment – Some factors are overexposure to food advertising that promote high calorie meals and lack of recreational facilities.
Non-modifiable causes include:
- Genetics – The greatest risk of obesity has been found in children of obese and overweight parents.
Predominance and identification
About 15.5 percent of adolescents (ages 12 to 19) and 15.3 percent of children (ages 6 to 11) are obese. The increase in obesity among American youth over the last two decades is dramatic, as shown in the tables below.
Predominance of obese children
(Ages 6 to 11) in the 95th percentile of the body mass index (BMI) 1999 to 2000 15.3% 1988 to 1994 11% 1976 to 1980
Prevalence of obese adolescents (ages 12 to 19) in the 95th
Percentage of body mass index (BMI)
1999 to 2000 15.5% 1988 to 1994 11% 1976 to 1980 5%
A measure called percent body mass index (BMI) is used to identify overweight and obesity in children and adolescents.Centers for Disease Control (CDC), the supplier of national growth charts and prevalence data, avoid using the word “obesity” for children and adolescents. Instead, they suggest two levels of excess weight: 1) the 85%, “at a risk level” and 2) the 95%, the most severe level.
The American Obesity Association uses the 85 percent BMI as a benchmark for overweight and 95 percent for obesity.
Prevention of morbid obesity in children
Teaching healthy behaviors at a young age is important since change becomes more difficult with age. Behaviors involving physical activity and nutrition are the cornerstone for preventing obesity in children and adolescents. Families and schools are the two most critical links in providing the foundation for such behaviors.
Families Coping with Morbid Obesity in Children
Parents are the most important role models for children. The results of an American Obesity Association survey show that:
- Most parents in the US. (78 percent) believe that physical education or recess? Should not be reduced or replaced by academic classes.
- Almost 30 percent of parents said they were “somewhat” or “very” worried about their children’s weight.
- 12 percent of parents considered their children overweight.
- Comparing their own health habits in childhood with those of their children, 27 percent of parents said that their children eat less nutritious, and 24 percent said their children are less physically active.
- 35 percent of parents rated their children’s school programs to teach good eating patterns and physical activity to prevent obesity as “poor,” “non-existent,” or “do not know.”
- Among six options of what they believed to be the greatest risks for their children’s long-term health and quality of life, 5.6 percent of parents chose to “be overweight or obese.” More parents selected other options such as the largest risk: alcohol (6.1 percent), sexually transmitted disease (10 percent), smoking (13.3 percent), violence (20.3 percent), and illegal drugs (24 percent).
- In terms of their own behavior, 61 percent of parents said that it would be “not too difficult” or “not at all difficult” to change their eating patterns and / or patterns of physical activity if it helped prevent obesity in any of their children.
Create an active environment
- Make time for the whole family to participate in the regular physical activities that everyone enjoys. Try walking, cycling or rollerblading.
- Plan special active trips such as hiking or a ski trip.
- Start an active program in the neighborhood. Join together with other families for group activities like contact football, basketball, ???? Or the hiding place.
- Assign active tasks to each member of the family such as vacuuming, washing the car or mowing the lawn.Rotate the work schedule to avoid boredom in the routine.
- Enlist your child in a structured activity he or she enjoys, such as tennis, gymnastics, martial arts, etc.
- Inculcate an interest in your child to try a new sport joined to a team at school or in your community.
- Limit the amount of watching the TV.
Create a healthy eating environment:
- Implement the same healthy diet (rich in fruits, vegetables and grains) for your entire family, not just for individual selections.
- Plan time when you prepare food together. Children enjoy participating and can learn about cooking and preparing healthy foods.
- Eat together at the dinner table at regular times.
- Avoid craving to finish meals. Eating quickly does not give you enough time to digest and feel fullness.
- Avoid other activities during meals such as watching TV.
- Avoid foods that are high in calories, fat or sugar.
- Have affordable snack foods that are low in calories and nutritious. Fruit, vegetables and yogurt are some examples.
- Avoid portions that are too large.
- Avoid forcing your child to eat if he / she is not hungry. If your child shows abnormal signs of not eating, consult a health professional.
- Limit the frequency of fast food eating to no more than once a week.
- Avoid using food as a reward or lack of food as punishment.
Health risks, diagnosis and treatment
Determining whether a child or adolescent has a weight problem can be challenging. How do you know if the excess weight your child has is part of the natural growth process, and your child will barely grow? “How do you know if your child’s weight can negatively affect his or her health?
Health Risks of Morbid Obesity
Along with growing childhood obesity, there has been an increase in the incidence and prevalence of medical conditions in children and adolescents who had been rare in the past. Pediatricians and childhood obesity researchers are reporting more frequent cases of obesity-related diseases such as type 2 diabetes, asthma and hypertension that were once considered adult conditions.
Diagnosing Morbid Obesity
- There are some signs that can help you determine if your child has or is at risk for childhood obesity, such as:
- Family history of obesity.
- Family history of health risks related to obesity such as early cardiovascular disease, high cholesterol, high blood pressure levels, type 2 diabetes.
- Family history of smoking and sedentary behavior.
- Signs on the child’s health risks related to obesity as assessed by a pediatrician including:
- Cardiac risk factors. Studies of obese children show higher than average blood pressure, heart rate, and heart volume when compared to non-obese children.
- Risk factors for type 2 diabetes. This implies levels of glucose intolerance and insulin levels that are higher than average.
- Orthopedic problems. Some symptoms include tension by weight in lower limb joints, tibial torsion and arched legs, and slipped capital femoral epiphysis (especially in boys).
- Disorders of the skin. Some are heat rash, intertrigo, monilial dermatitis and acanthosis nigricans.
- Psychological / psychiatric issues. Poor self-esteem, negative self-image, depression, and withdrawal of peers have been associated with obesity.
- Patterns of sedentary behavior (such as watching too much television) and low physical activity levels.
- A higher size – children with obesity are often over 50 percent in height.
- Initiation in smoking. Research shows that young people use smoking as a method of weight management. Parents, pediatricians, and schools must work together to discourage smoking as a weight-management behavior for three main reasons: a) Smoking is not a good choice for weight management, b) smoking is harmful in itself, and c) Smoking is associated with a decrease in healthy nutrition and physical activity patterns.