Overweight and Obese Children

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KEY POINTS

• Children who are overweight or obese weigh more than what is healthy for their body type. Overweight and obesity increase your child’s risk for diabetes, asthma, sleep disorders, and other health problems.
• Treatment for overweight or obesity will include lifestyle changes, such as a healthy diet and regular exercise. If your child has trouble with stress, depression, or anxiety, your child’s healthcare provider may refer your child to a therapist. If hormone imbalances are contributing to excess weight, your child’s provider may prescribe medicine to treat the imbalance.
• Support and encourage your child. Work with your child's healthcare provider, dietitian, or therapist to find the right plan for a healthy weight for your child.

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What is overweight and obesity?

Overweight or obesity is having too much body fat. Children who are overweight or obese weigh more than what is healthy for their body type.

Overweight or obesity increases your child’s risk of poor health and major illness, including:

• Diabetes
• High cholesterol
• High blood pressure
• Gallbladder disease
• Sleep disorders
• Asthma

Being overweight or obese can also cause your child to be self-conscious about his or her looks or to be teased or bullied. Overweight or obese children are at increased risk for depression and substance abuse. Sometimes the pressure from parents and other adults to lose weight causes children to react too strongly. They may think too much about weight and set the stage for an eating disorder.

Another problem is that overweight or obese children often become overweight adults.

What is the cause?

Several things can cause overweight or obesity.

• Eating more food than the body uses. Your child gets energy (calories) from the food he eats. Eating more calories than the body uses means that the extra energy is stored as fat.
• Not getting enough exercise. Watching television, working, or playing on the computer for hours every day and not exercising regularly contribute to weight gain. Children who are overweight or obese may burn fewer calories than children who are not because it is harder to be physically active.
• Metabolism. Overweight or obese children may use less energy when they are at rest than people who are not overweight or obese.
• Family history. Inherited genes can affect your child's weight. Children of overweight or obese parents are 10 times more likely to become overweight or obese than children whose parents are not. Unhealthy family eating habits may also be a reason several members of a family are overweight or obese.
• Emotions. Depression, anger, anxiety, and stress are emotional problems that can lead to eating more and exercising less.
• Hormone imbalances. Having an underactive thyroid gland can lead to weight gain and can make losing weight difficult.
• Medicines. Some medicines such as birth control pills or medicines to treat depression can cause weight gain.

What are the symptoms?

Putting on too much weight is the first sign that your child may be at risk for overweight or obesity. You may notice that your child's clothing is getting too tight. As your child gains weight, he or she may have symptoms caused by overweight or obesity. These symptoms include:

• Shortness of breath when he or she is active
• Trouble sleeping, including sleep apnea. If your child has sleep apnea, he or she stops breathing for a short time during sleep. These problems can make your child tired during the day.
• Pain in the joints and muscles, especially the back, knees, and ankles
• Rashes that develop where the skin rubs together and traps moisture
• Irregular periods in girls

Overweight or obesity increases the risk that your child will have health problems as an adult, such as gallbladder, heart, or liver disease.

How is it diagnosed?

Your child’s healthcare provider will ask about your child’s symptoms and examine your child. Your child’s provider will ask about your child’s medical history, eating habits, and exercise habits. Your child may have blood tests to check for hormone problems.

Your child’s healthcare provider will check your child's height and weight against the standard growth charts. The body mass index, or BMI, for children is used for ages 2 through 20. These growth charts, one for boys and one for girls, help to check weight through the growing years. BMI most accurately shows whether your child is underweight, normal, or overweight. Your child's BMI is compared with that of thousands of children of the same age. This comparison will show what percentile of BMI your child is in.

Overweight is greater than the 85% of BMI for your child's age.

Obese is usually defined as greater than 95% of BMI for your child's age.

Growth charts are only one part of a larger picture that takes into account your child's medical history and current health. Your child’s healthcare provider can tell you if your child has an increased risk of health problems because of weight. Your child’s provider can also help find a healthy weight program that works for your child.

How is it treated?

Treatment for overweight or obesity will include lifestyle changes. Dietitians and healthcare providers can help you design a safe, healthy, effective program for your child to have a healthy weight.

Healthy diet

In general, a healthy eating plan for a healthy weight is one that:

• Includes a lot of fruits, vegetables, whole grains, and beans
• Includes fat-free or low-fat milk products
• Includes lean meats, poultry, fish, eggs or egg whites, nuts, seeds, and soy foods
• Is low in saturated fats, trans fats, cholesterol, salt, and added sugars

Exercise

Exercise is a very important part of a successful program for a healthy weight. Almost any activity that involves mild to moderate exertion is good. Your child may choose to walk, jog, swim, cycle, or do aerobics. Walking is a great way for almost everyone to get more exercise. Using a pedometer can be fun and motivating. A pedometer is a device that attaches to clothing and tracks how many steps your child takes in a day.

Strength training will make your child’s muscles stronger and able to work longer without getting tired. Strength training, or weight training, means doing exercises that build muscle strength. To build muscle, your child can lift free weights, use weight machines, use resistance bands, or use his bodyweight, such as doing push-ups, pull-ups, or sit-ups. Check with your child's healthcare provider before your child starts a strength training program.

Ask your child’s healthcare provider what kinds and amounts of exercise might be right for your child.

Emotions

Some children eat as a way to cope with emotional problems. If your child has trouble with stress, depression, or anxiety, your child’s healthcare provider may refer your child to a therapist. Your child needs to learn how to deal with emotional problems to succeed with a healthy weight program.

Medicines

If hormone imbalances are contributing to excess weight, your child’s provider may prescribe medicine to treat the imbalance.

Claims have been made that certain herbal and dietary products help with weight loss. Many of these claims are not true. Some supplements can have serious side effects. Talk to your child’s healthcare provider before you allow your child to use herbal and dietary supplements.

How can I help my child?

Parents often do not think that their child is overweight or obese. Even if they know their child is heavier than other children, parents may think that the child will simply grow out of it. However, if a child is overweight or obese, it is often due to unhealthy eating and exercise habits. Those habits are not likely to change unless parents take action.

If several people in your family have diabetes or weight problems, your child is at higher risk. Making healthy lifestyle changes as a family helps everyone. Make one or two changes at a time and let children adjust. Making big changes in diet or lifestyle is not easy. Sometimes just eliminating sweetened drinks and starting an exercise program will be enough to help your child have a healthy weight.

Some tips to help your child:

• Use the Choose My Plate style of eating to help control portion sizes. See https://www.choosemyplate.gov/ for details.
• Make sure your child eats a healthy breakfast every day. Skipping breakfast can leave your child hungry, tired, and likely to eat unhealthy foods and bigger amounts of food later in the day.
• Let your child help plan meals and shop for groceries. Show your child how to read a nutrition label. This helps your child learn and make his or her own decisions about new foods to try. Buy and serve more fruits and vegetables and fewer soft drinks and snack foods.
• Serve water and non-fat milk instead of sugary drinks. Sugary drinks can add an extra 500 or more calories per day.
• Keep healthy snacks on hand. Snacks like chips, cookies, and candy are high in fat and calories.
• Don't use food as a reward or withhold food as punishment.
• Your child should not be put on a strict diet unless under the care of a healthcare provider or dietitian. A diet that is too strict can interfere with normal growth.
• Plan activities with your child that include exercise, such as skating, biking, running, or walking. Give your child active chores, such as washing the car, vacuuming, or cleaning windows.
• It’s hard to be active when sitting in front of a screen (TV, computer, DVD, video games). Try to keep screen time to 2 hours or less per day, not including what your child needs to do for school.
• Most children like learning on the computer. Although too much computer time is not good, there are kid friendly web sites and programs that provide fun ideas to get kids moving and eating healthier.
• Support and encourage your child. Children know when they are overweight or obese and don't want to be nagged about it. It's important for your child to know that you love and accept him or her at any weight. Look for weight-loss support groups in your community. Support from other children can help motivate your child.
• BAM! Body and Mind https://www.cdc.gov/bam/ gives kids 9 to 13 years old the information they need to make healthy lifestyle choices.
• Keep your appointments with your child’s healthcare provider, dietitian, or therapist. They can guide you and help keep your child motivated.