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Obesity in children and adolescents is a serious issue with many
health and social consequences that often continue into
adulthood. Implementing prevention programs and getting a better
understanding of treatment for youngsters is important to
controlling the obesity epidemic.
Many parents are rightly 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
the science is a lot less precise than we would like. Are kids
too concerned about their weight? What are the best strategies
for prevention? What treatments work over a long time?
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 out the best possible
advice.
Note: The term "childhood obesity" may refer to both children
and adolescents. In general, we use the word, "children" to
refer to 6 to 11 years of age, and "adolescents" to 12 to 17
years of age.
Prevalence of childhood obesity
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 past two decades is
dramatic.
A
measurement called percentile of Body Mass Index (BMI) is used
to identify overweight and obesity in children and adolescents.
The Centers for Disease Control (CDC), the supplier of national
growth charts and prevalence data, avoids using the word
"obesity" for children and adolescents. Instead, they suggest
two levels of overweight: 1) the 85th percentile, an "at risk"
level, and 2) the 95th percentile, the more severe level.
The American Obesity Association uses the 85th percentile of BMI
as a reference point for overweight and the 95th percentile for
obesity.
Causes of childhood obesity
There are many factors that contribute to causing child and
adolescent obesity - some are modifiable and others are not.
Modifiable causes include:
Physical Activity - Lack of regular exercise.
Sedentary behavior - High frequency of television viewing,
computer usage, and similar behavior that takes up time that can
be used for physical activity.
Socioeconomic Status - Low family incomes and non-working
parents.
Eating Habits - Over-consumption of high-calorie foods. Some
eating patterns that have been associated with this behavior are
eating when not hungry, eating while watching TV or doing
homework.
Environment - Some factors are over-exposure to advertising
of foods that promote high-calorie foods and lack of
recreational facilities.
Non-changeable causes include:
Genetics - Greater risk of obesity has been found in
children of obese and overweight parents.
Prevention
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 of
preventing obesity in children and adolescents. Families and
schools are the two most critical links in providing the
foundation for those behaviors.
Families
Parents are the most important role models for children. Results
from an American Obesity Association survey show that:
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The majority of
parents in the U.S. (78 percent) believe that physical
education or recess should not be reduced or replaced with
academic classes.
Almost 30 percent of parents said that they are "somewhat"
or "very" concerned about their children's weight.
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12 percent of
parents considered their child overweight.
Comparing their own childhood health habits to their
children's, 27 percent of parents said their children eat
less nutritiously, and 24 percent said their children are
less physically active.
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35 percent of
parents rated their children's school programs for teaching
good patterns of eating and physical activity to prevent
obesity as "poor," "non-existent," or "don't know."
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Among six choices
of what they believed to be the greatest risk to their
children's long-term health and quality of life, 5.6 percent
of parents chose "being overweight or obese." More parents
selected other choices as the greatest risk: alcohol (6.1
percent), sexually transmitted disease (10 percent), smoking
(13.3 percent), violence (20.3 percent), and illegal drugs
(24 percent).
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In terms of their
own behavior, 61 percent of parents said that it would be
either "not very difficult" or "not at all difficult" to
change their eating and/or physical activity patterns if it
would help prevent obesity in any of their children.
Parents appear to underestimate the health risk of excess weight
to their children, and the difficulty in achieving and
maintaining behavioral changes associated with obesity
prevention. Additional studies are needed to develop appropriate
public health programs to better educate parents in identifying
and understanding changes in their children's weight, to
incorporate the family in prevention efforts, and to improve
school-based obesity prevention programs that include increasing
physical education classes.
Create an active environment:
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Make time for the
entire family to participate in regular physical activities
that everyone enjoys. Try walking, bicycling or
rollerblading.
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Plan special
active family-outings such as a hiking or ski trip.
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Start an active
neighborhood program. Join together with other families for
group activities like touch-football, basketball, tag or
hide-and-seek.
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Assign active
chores to every family member such as vacuuming, washing the
car or mowing the lawn. Rotate the schedule of chores to
avoid boredom from routine.
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Enroll your child
in a structured activity that he or she enjoys, such as
tennis, gymnastics, martial arts, etc.
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Instill an
interest in your child to try a new sport by joining a team
at school or in your community.
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Limit the amount
of TV watching.
Create a Healthy Eating Environment:
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Implement the same
healthy diet (rich in fruits, vegetables and grains) for
your entire family, not just for select individuals.
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Plan times when
you prepare foods together. Children enjoy participating and
can learn about healthy cooking and food preparation.
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Eat meals together
at the dinner table at regular times.
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Avoid rushing to
finish meals. Eating too quickly does not allow enough time
to digest and to feel a sense of fullness.
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Avoid other
activities during mealtimes such as watching TV.
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Avoid foods that
are high in calories, fat or sugar.
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Have snack foods
available that are low-calorie and nutritious. Fruit,
vegetables and yogurt are some examples.
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Avoid serving
portions that are too large.
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Avoid forcing your
child to eat if he/she is not hungry. If your child shows
atypical signs of not eating, consult a healthcare
professional.
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Limit the
frequency of fast-food eating to no more than once per week.
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Avoid using food
as a reward or the lack of food as punishment.
Methods of Weight Loss:
Exercise
More female
students (67 percent) reported the use of exercise for
weight loss or maintenance than male students (49 percent).
More white female students (70 percent) reported the use of
exercise for weight loss or maintenance than black female
students (59 percent).
Change of Eating Behaviors
More female
students (56 percent) reported that they ate less food,
fewer calories, or foods low in fat than male students (25
percent) to lose weight or to avoid gaining weight.
More white
students (42 percent) reported that they ate less food,
fewer calories, or foods low in fat than black students (34
percent) to lose weight or to avoid gaining weight.
More white female
students (60 percent) reported that they ate less food,
fewer calories, or foods low in fat than Hispanic female
students (51 percent) and black female students (43 percent)
to lose weight or to avoid gaining weight.
Fasting
13 percent of
students reported fasting ("without eating for 24 hours or
more" ) to lose weight or to avoid gaining weight.
More female
students (19 percent) reported fasting than male students (6
percent) to lose weight or to avoid gaining weight
Use of Dietary Supplements
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8 percent of
students reported taking diet pills, powders, or liquids
without a doctor's advice to lose weight or to avoid gaining
weight.
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More female
students (11 percent) reported taking diet pills, powders,
or liquids without a doctor's advice than male students (4
percent) to lose weight or to avoid gaining weight.
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More white female
students (12 percent) reported taking diet pills, powders,
or liquids without a doctor's advice than black female
students (6.9 percent) to lose weight or to avoid gaining
weight.
Purging / Laxative Use
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5 percent of
students reported vomiting or taking laxatives to lose
weight or to avoid gaining weight.
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More female
students (7 percent) reported vomiting or taking laxatives
than male students (2 percent) to lose weight or to avoid
gaining weight.
Creating a Healthy Eating Environment in Schools
Recommended daily servings of fruits and vegetables are not
being met by today's youth. According to the Centers for Disease
Control and Prevention, "51 percent of children and adolescents
eat less than one serving a day of fruit, and 29 percent eat
less than one serving a day of vegetables that are not fried."
Children today drink less milk
and more carbonated soft drinks. The consumption of
non-citrus juices such as grape and apple mixtures increased by
280 percent.
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