What is the rate of obesity in children and adolescents in the United States?
According to the Centers for Disease Control and Prevention (CDC), 9% of children age 2 to 5 years, 21% of children age 6 to 11 years, and 17% of children age 12 to 19 years are obese. Overall, 17% of children, or 12.7 million children in the United States, are considered obese.
Obesity in children and adolescents has tripled over the past 30 years. Overweight children are more likely to become overweight adults. This increases their risk to develop diseases such as heart disease and diabetes later in life.
Symptoms and Causes
What causes children to become overweight?
Children become overweight for many different reasons. The most common causes are lack of physical activity, unhealthy eating patterns, genetic factors ("runs in the family"), or a combination of these factors. Only in rare cases is being overweight caused by a medical condition such as a hormone disorder. A physical exam and some blood tests will rule out the possibility of a medical condition.
Although weight problems run in families, not all children with a family history of obesity will be overweight. Children whose parents or brothers or sisters are overweight may be at an increased risk of becoming overweight themselves, but this can be related to shared family behaviors such as eating and activity habits. Genetic factors can increase the likelihood that a child will be overweight.
A child's diet and activity level play an important role in determining a child's weight. Today, many children spend a lot time being inactive. For example, the average child spends approximately 24 hours each week watching television. As computers, video games, tablets and smartphones continue to grow in popularity, the number of hours of inactivity may only increase.
Diagnosis and Tests
How do I know if my child is overweight?
The best person to determine whether or not a child is overweight is the child's health care provider. If you think that your child is overweight, arrange an appointment with the child's health care team. Your child will have his/her weight and height measured to determine if his or her weight is within a healthy range.
Management and Treatment
If my child is overweight, how can I help?
For overweight or obese children, it is very important to be supported in their journey towards health. Children's feelings about themselves often are based on their parents' feelings about them; if you accept your children at any weight, they will be more likely to feel good about themselves.
It is also important to talk to your children about their weight in a nonjudgmental way, allowing them to share their concerns with you. You can help you child by gradually changing your family's physical activity and eating habits so that the entire family can benefit from new healthy behaviors.
There are many ways to involve the entire family, but increasing physical activity is especially important. Some ways to accomplish this include the following:
- Lead by example. If your children see that you are physically active and having fun, they are more likely to be active and stay active for the rest of their lives.
- Plan family activities that provide everyone with exercise, like walking, biking or swimming.
- Be sensitive to your child's needs. It is important to help your child find physical activities that he or she enjoys and that aren't too difficult.
- Make an effort to reduce the amount of time you and your family spend in sedentary (stationary) activities, such as watching TV or playing video games.
Make the most of the opportunities that you and your family have to be healthier and more active.
How can I teach my child healthy eating habits?
The eating habits your children pick up when they are young will help them maintain a healthy lifestyle when they are adults. If you are unsure about how to select and prepare a variety of foods for your family, ask your healthcare provider or registered dietitian for nutrition counseling.
Do not place your child on a restrictive diet. Children should never be placed on a restrictive diet to lose weight, unless a doctor supervises one for medical reasons.
One way to begin teaching healthy eating habit is to serve a variety of fruits and vegetables to your family. Provide a “rainbow” of fruits and vegetables with meals and as snacks. Avoid sugary drinks like soda pop, fruit-flavored drinks, sweet tea, lemonade and sugary sports drinks. The average child takes in more than 120 calories per day from sugary drinks alone.
Other approaches you can take in helping your overweight child include the following:
- Guide your family's choices rather than dictate foods. Make a wide variety of healthful foods available in the house. This practice will help your children learn how to make healthy food choices.
- Encourage your child to eat slowly. A child can detect hunger and fullness better when eating slowly.
- Eat meals together as a family as often as possible. Try to make mealtimes pleasant with conversation and sharing, not a time for scolding or arguing. If mealtimes are unpleasant, children may try to eat faster to leave the table as soon as possible. They then may learn to associate eating with stress.
- Involve children in food shopping and preparing meals. These activities offer parents hints about children's food preferences, teach children about nutrition, and provide children with a feeling of accomplishment. In addition, children may be more willing to eat or try foods that they help prepare.
- Plan for snacks. Continuous snacking may lead to overeating, but snacks that are planned at specific times during the day can be part of a nutritious diet, without spoiling a child's appetite at meal times. You should make snacks as nutritious as possible.
- Discourage eating meals or snacks while watching TV. Try to eat only in designated areas of your home, such as the dining room or kitchen. Eating in front of the TV may make it difficult to pay attention to feelings of fullness, and may lead to overeating.
- Try not to use food to punish or reward your child. Withholding food as a punishment may lead children to worry that they will not get enough food. For example, sending children to bed without any dinner may cause them to worry that they will go hungry. As a result, children may try to eat whenever they get a chance. Similarly, when foods, such as sweets, are used as a reward, children may assume that these foods are better or more valuable than other foods. For example, telling children that they will get dessert if they eat all of their vegetables sends the wrong message about vegetables.
- Make sure your child's meals outside the home are balanced. Find out more about your school lunch program, or pack your child's lunch to include a variety of foods. Also, select healthier items when dining at restaurants. Be mindful of large portion sizes when eating out. Be a good example for your children and take half of the meal home for a second meal.
Should I enroll my child in a weight-loss program?
If your efforts at home don’t help your child reach a healthy weight, and your child’s healthcare provider determines that your child's health is at risk unless he or she loses weight steadily, you may want to consider a formal treatment program.
Look for the following characteristics when choosing a weight-control program for your child. The program should:
- Be staffed with a variety of health professionals. The best programs may include registered dietitians, exercise physiologists, pediatricians, family physicians, nurse practitioners, psychiatrists or psychologists.
- Perform a medical evaluation of the child. Before being enrolled in a program, your child's weight, growth and health should be reviewed by a healthcare provider. During enrollment, your child's weight, height, growth, and health should be monitored by a health professional at regular intervals.
- Focus on the whole family, not just the overweight child.
- Be adapted to the specific age and capabilities of the child. Programs for 4-year-olds are different from those for children 8 or 12 years old in terms of the responsibilities of the child and parents.
- Focus on behavioral changes.
- Teach the child how to select a variety of foods in appropriate portions.
- Encourage daily activity and limit sedentary activity, such as watching TV.
- Include a maintenance program and other support and referral resources to reinforce the new behaviors and to deal with underlying issues that contributed to the child becoming overweight.