Childhood obesity

Diagnosis

BMI-for-age growth charts is often utilized to assess the size and growth trends in children. A heightened BMI could indicate an increased level of body fat, although BMI itself does not directly measure body fat. However, it serves as a signal to healthcare providers that additional tests may be necessary to determine if excessive fat poses a concern for the child.

As BMI does not account for factors like muscle mass or having a larger-than-average body frame and considering the significant variability in growth patterns among children, healthcare providers also consider the child’s individual growth and development.

BMI percentile cutoffs establish a threshold beyond which a child might be at a higher risk of developing health issues related to weight:

• Overweight, if BMI is between the 85th and 94th percentiles
• Obesity, if BMI is 95th percentile or higher
• Severe obesity, a BMI of 99th percentile or above

So, if the child is in the 80th percentile, it signifies that 80% of children of the same sex and age have a lower BMI. The growth chart assesses the child’s percentile, indicating their comparison with peers of the same sex and age.

Apart from assessing BMI and tracking weight on growth charts, various factors are also considered, including the family’s history of obesity and weight-related issues, the child’s eating habits, activity level, other health conditions, and psychosocial history. This includes incidents of depression, sleep disturbances, feelings of sadness, and whether the child experiences isolation, loneliness, or bullying.

Blood tests
For certain blood tests, it is necessary for the child to abstain from food and liquids before to the exam. Blood tests that may be required include blood sugar test, cholesterol test, and tests to look for illnesses linked to obesity or hormone imbalances.

Treatment

The primary focus in addressing childhood obesity should be on enhancing overall well-being rather than solely concentrating on weight. It is vital to offer supportive measures to children as they work towards better health. Treatment typically involves adjustments to diet and exercise, and in certain instances, may include medications or bariatric surgery. The specific approach to addressing childhood obesity is determined by factors such as the child’s age and any accompanying medical conditions.

• Treatment for children whose weight falls into the overweight category: A weight-maintenance program that aims to decelerate the pace of weight gain, enabling the child to gain height without adding pounds, is suggested for children aged 2 and older who are classified as overweight.
• Treatment for children whose weight falls into the obesity category: Regardless of whether the goal is weight maintenance or weight loss, the strategy remains unchanged: advocating for a nutritious diet in terms of food choices and portion sizes, combined with elevated physical activity levels. In the case of older children and adolescents dealing with obesity or severe obesity, the objective might involve aiming for a more significant weight reduction of up to 2 pounds per week through dietary adjustments. For children aged 6 to 11 categorized as obese, it is recommended to pursue gradual weight loss of about 1 pound per month by promoting alterations in eating habits.
• Healthy eating: Modest adjustments in choosing what food to prepare for children can benefit the child’s health. It is also beneficial to ensure that one’s home has a diverse range of nutritious foods accessible.
  • Prioritize fruits and vegetables: A way to initiate the teaching of healthy eating habits is by offering a diverse range of fruits and vegetables to the family, creating a colorful array in every meal, including snacks.
  • Limit drinks with added sugar: It is advisable to steer clear of sugary beverages such as soda, sweet tea, lemonade, and sports drinks, as these can contribute to an excess of more than 120 calories per day in a child’s diet.
  • Avoid fast food: The food options on their menu are generally heavy in calories and fat.
  • Eat meals together as a family: Strive to create enjoyable mealtimes centered around conversation and sharing rather than criticism or conflict. Unpleasant mealtimes may prompt the child to eat quickly to leave the table swiftly, potentially associating eating with stress.

Discourage eating in front of screens like TV, computers, or video games, as this can lead to rapid consumption and reduced awareness of the quantity consumed.

• • Provide sensible serving sizes: Encourage the child to eat until they feel satisfied, even if it means leaving food on the plate. Begin with a modest portion, and if the child is still hungry, they can request more. Kids usually require less food compared to adults.
• Physical activity: Active kids are more likely to grow up to be fit adults, and effective weight management in young people is facilitated by good habits formed in childhood. Physical activity is essential to reaching and maintaining a healthy weight. In addition to helping kids sleep better at night and remain awake throughout the day, it burns calories and improves bones and muscles.

To improve physical activity:

• • Set time limits for TV: There should be absolutely no screen time for kids under the age of two. For kids older than two, recreational screen time should be restricted to no more than two hours per day.
  • Emphasize activity, not exercise: Organize activities that ensure everyone in the family gets exercise, such as engaging in walks, bike rides, or swimming. Playing games like jump rope, tag, or hide-and-seek can be excellent for increasing physical fitness and burning calories. Kids should be active for at least an hour a day, ranging from mild to strenuous.
  • Determine what is enjoyable to the child: Assist children in discovering physical activities they find enjoyable and not overly challenging. If the kids enjoy climbing, take them to the closest climbing wall or jungle gym in the area.
  • Medications: As part of a comprehensive weight-loss plan, some children and adolescents may be prescribed medication.
  • Weight-loss surgery: Weight loss surgery is not a cure-all solution. It cannot replace the necessity for a balanced diet and regular physical activity. However, in cases where the health risks associated with a child’s weight outweigh the potential dangers of surgery, healthcare providers may recommend this intervention. If lifestyle changes prove ineffective in assisting teenagers with severe obesity in losing weight, weight-loss surgery may be considered. Nevertheless, it does not guarantee that adolescents will shed additional pounds or sustain weight loss over the long term. It’s essential to also consider the risk of potential complications associated with such procedures.