Article Summary 

A child's obesity is a long-lasting illness that affects millions of kids across the globe. It develops from the interaction of genetic, environmental, behavioural, and social factors. It should never be blamed solely on the child being lazy or lacking willpower. It is an issue that will significantly impact a child's future risk of serious health issues, including diabetes, cardiovascular disease, and depression. The good news is that, with proper support, both families and healthcare professionals can work together to help improve a child's health and quality of life.

What is Childhood Obesity?

Childhood obesity is a long-lasting health problem where a child gains too much weight, which can put them at risk for future health problems. Childhood obesity is determined medically by measuring the body mass index (BMI) at or above the 95th percentile for age and gender in children two years old and greater. Since children's bodies are constantly changing as they grow, BMI in children is always measured using age- and gender-specific growth charts instead of adult standards. A high BMI measures extra body mass; however, it does not directly measure percent body fat. Therefore, it simply means that there needs to be additional evaluation. 

Child Obesity Facts You Should Know

Childhood obesity is one of the biggest public health issues facing us today. In fact, according to the World Health Organization (WHO), the number of children and young people aged 5-19 years who were obese grew by over 10 times in just 40 years. From 11 million in 1975 to 124 million in 2016. The importance of understanding how family life influences these behaviours is crucial to turning back the clock on this epidemic. 

One of the leading predictors of a child's weight is the environment they live in. Children growing up in homes where high amounts of processed foods, sugary drinks, and large portions are available are much more likely to develop an unhealthy weight. Parents/caregivers set examples for what they expect their children to do when it comes to eating and being physically active. And if parents eat healthy and engage in regular physical activities, their children are going to be much more inclined to follow suit.

  • Children who drink sugar-sweetened beverages regularly have a much greater risk of gaining excess weight compared to those who don't. 
  • Excessive screen use (including TV, smartphones, and gaming devices) has been directly connected to childhood obesity due to both the inactive behaviour of excessive screen time and exposure to advertisements promoting unhealthy food choices. 
  • Poor sleep habits contribute to a child developing an unhealthy weight because poor quality sleep disrupts the hormone balance responsible for regulating a person's feelings of hunger and fullness. 
  • Eating meals together as a family contributes to making healthier food choices, reduces the amount of food consumed, and decreases the likelihood of your child becoming overweight/obese. 
  • Regularly consuming breakfast contributes to a child maintaining a balanced diet and having less body fat than skipping breakfast altogether. 
  • Physical inactivity is a significant contributor to childhood obesity. The WHO recommends at least 1 hour per day of moderate to vigorous physical activity for children ages 5-17. 

Common Reasons for Child Obesity

Obesity occurs when a child consistently takes in more calories than their body burns off, leading to the storage of excess calories as body fat. Although the reasons why this happens are rarely straightforward. 

Genetics and epigenetics greatly influence obesity development. Children with parents or siblings who have obesity have a greater chance of becoming obese. Trauma or violence experienced by a child can affect how their genes operate, thereby affecting their child's metabolism and immune response. Women pregnant with gestational diabetes, men whose partner had pre-pregnancy obesity, women gaining excessive amounts of weight during pregnancy and excessive prenatal weight gain all increase a child's risk for obesity. 

Environmental influences include consuming sugary sweetened beverages, consuming large portions of food, frequently snacking on processed foods, eating away from home frequently, spending extended periods watching screens, engaging in minimal physical activity and getting inadequate sleep. 

Other social and community factors influencing obesity development are limited accessibility to relatively inexpensive sources of healthy food options, close proximity to fast-food locations, fewer safe outdoor recreation areas, poorly connected transportation networks, and advertising for unhealthy food products targeted towards children; these are just a few examples. 

There are instances where other medical conditions (such as hypothyroidism or Cushing syndrome) or genetic disorders (like Prader-Willi syndrome) or taking certain medications (corticosteroids or certain psychiatric medicines) will increase a child's risk for obesity. 

Signs and Health Risks of Childhood Obesity

Although childhood obesity sometimes does not show obvious signs beyond an overweight status, the potential for serious health consequences is very high. Possible complications include:

  • Hypertension 
  • Dyslipidaemia 
  • Insulin resistance and type 2 diabetes 
  • Fatty liver disease 
  • Asthma and obstructive sleep apnoea (OSA) 
  • Painful joints and Blount's disease 
  • Mental health problems, including depression and low self-esteem 
  • Social isolation and bullying 

Youngsters suffering from obesity are at an increased risk of maintaining their weight into adulthood and subsequently experiencing an even greater number of chronic illnesses later in life.

Risk Factors for Childhood Obesity

While there are numerous causes of childhood obesity outlined previously, the following are specific risk factors that enhance a child's risk of developing obesity:

  • History of obesity in first-degree relatives (parents/siblings)
  • Low family income
  • Turning down opportunities to engage in recreational activities due to a lack of green space
  • Exposure to second-hand tobacco smoke
  • Previous adverse childhood experiences (ACEs)
  • Large amount of screen time for prolonged periods
  • Inconsistent sleep patterns

Many of the factors causing childhood obesity cannot be controlled by families or children.

How is Childhood Obesity Diagnosed?

Childhood obesity is generally discovered during regular "well-child" visits with paediatricians. Paediatricians compare a child's height and weight against established BMI-for-age growth charts to determine whether the child weighs appropriately for their age and sex. If the child's BMI appears to be elevated, the physician completes a complete physical exam and gathers information regarding the child's health background, dietary habits, levels of physical activity, and the characteristics of their home environment. In addition to a physical exam, blood testing and/or imaging may be required to identify any possible contributing factors to obesity as well as to screen for potential comorbidities (e.g., hypercholesterolaemia or impaired glucose tolerance).

Early Adiposity Rebound

Screening childhood obesity before 5 years is important. Early adiposity rebound occurs when a child's BMI bottoms out and begins to rise again before the age of 5. Normally, this natural increase begins around 5 and 6 years of age. An early rebound is a strong clinical indicator of a higher risk for overweight or obesity later in life.

Child Obesity Solutions

The most effective way to address childhood obesity is through a multi-faceted treatment strategy that includes everyone involved in the child's care, paediatricians, registered nutritionists, exercise physiologists, psychologists/family therapists, etc. The best evidence-based recommendation for treating childhood obesity is intensive health behaviour and lifestyle treatment (IHBLT). IHBLT provides families with at least 26 hours of face-to-face therapy sessions spanning anywhere from 3 to 12 months, focusing on nutrition education, physical activity, and behavioural modifications with the entire family. Goals for the treatment programme do not focus solely on reducing body weight but also on enhancing the family's total health status, their self-concept/image, and overall quality of life. 

If a child requires additional assistance beyond IHBLT programmes to manage their weight loss journey, then weight loss drugs may be considered. For example, metabolic or bariatric surgery may be prescribed when appropriate. 

The most essential factor is tailoring treatment based upon each unique individual's needs while avoiding stigmatising language/support throughout the process. 

How to Prevent Child Obesity?

Preventing childhood obesity is a partnership requiring active participation from families, schools, communities, and government agencies. Steps families can take to prevent childhood obesity include:

  1. Breastfeeding exclusively until approximately six months of age. 
  2. Encourage at least sixty minutes of moderate-intensity physical activity daily. 
  3. Limit children's screen time to no more than ninety minutes daily. 
  4. Limit consumption of sugar-sweetened beverages and limit fruit juices to special occasions. 
  5. Prepare meals at home as often as possible; encourage children to participate in meal preparation. 
  6. Eat meals together as a family as frequently as possible.  
  7. Establish consistent bedtime routines; remove electronic devices from bedrooms. 
  8. Provide guidance for food selection while refraining from rewarding children with food items.

By establishing positive habits early on in their lives, children provide themselves with the basis they need to make healthy decisions throughout their lifetime.

When Should You Seek Medical Help for Childhood Obesity?

Talk to a paediatrician immediately if you have concerns regarding your child's weight and or if your child shows some of the common symptoms of obesity-related health issues (e.g., fatigue, trouble breathing while active, chronic knee, hip, or joint pain). Attend every single one of your child's scheduled "well-child" check-ups; at each appointment, weight & growth will be evaluated. Attend all of your child's scheduled follow-up visits after an obesity diagnosis so that their doctor can assess how effective their treatment plan is and make adjustments as necessary. Don't delay in seeking help. Early intervention is much more beneficial than waiting.

Find a Paediatrician Near You

If you are concerned about your child's weight, growth, or overall health, you can consult a paediatrician at an NMC Healthcare location near you. Explore paediatric care services across the UAE:

Conclusion

Childhood obesity is a serious yet treatable medical problem that needs compassion and understanding instead of criticism. Childhood obesity is caused by a combination of factors, including genetics and environment. While many of these contributing factors cannot be controlled by parents or families, there are ways for both the entire family and individual members to develop healthy lifestyles. Your child's risk of developing long-term obesity-related problems can be significantly reduced by using appropriate and timely interventions. If you are worried about your child's weight, talk to their doctor. There is help available, and it works.