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The problem
of childhood obesity in the United States has grown considerably
in recent years. Between 16 and 33 percent of children and
adolescents are obese. Obesity is among the easiest medical
conditions to recognize but most difficult to treat. Unhealthy
weight gain due to poor diet and lack of exercise is responsible
for over 300,000 deaths each year. The annual cost to society
for obesity is estimated at nearly $100 billion. Overweight
children are much more likely to become overweight adults
unless they adopt and maintain healthier patterns of eating
and exercise.
What
is obesity?
A few extra pounds do not suggest obesity. However they may
indicate a tendency to gain weight easily and a need for changes
in diet and/or exercise. Generally, a child is not considered
obese until the weight is at least 10 percent higher than
what is recommended for the height and body type. Obesity
most commonly begins in childhood between the ages of 5 and
6, and during adolescence. Studies have shown that a child
who is obese between the ages of 10 and 13 has an 80 percent
chance of becoming an obese adult.
What
causes obesity?
The causes of obesity are complex and include genetic, biological,
behavioral and cultural factors. Basically, obesity occurs
when a person eats more calories than the body burns up. If
one parent is obese, there is a 50 percent chance that the
children will also be obese. However, when both parents are
obese, the children have an 80 percent chance of being obese.
Although certain medical disorders can cause obesity, less
than 1 percent of all obesity is caused by physical problems.
Obesity in childhood and adolescence can be related to:
- poor
eating habits
- overeating
or binging
- lack
of exercise (i.e., couch potato kids)
- family
history of obesity
- medical
illnesses (endocrine, neurological problems)
- medications
(steroids, some psychiatric medications)
- stressful
life events or changes (separations, divorce, moves, deaths,
abuse)
- family
and peer problems
- low
self-esteem
- depression
or other emotional problems
What
are risks and complications of obesity?
There are many risks and complications with obesity. Physical
consequences include:
- increased
risk of heart disease
- high
blood pressure
- diabetes
- breathing
problems
- trouble
sleeping
Child and
adolescent obesity is also associated with increased risk of
emotional problems. Teens with weight problems tend to have
much lower self-esteem and be less popular with their peers.
Depression, anxiety, and obsessive compulsive disorder can also
occur.
How
can obesity be managed and treated?
Obese children need a thorough medical evaluation by a pediatrician
or family physician to consider the possibility of a physical
cause. In the absence of a physical disorder, the only way
to lose weight is to reduce the number of calories being eaten
and to increase the child's or adolescent's level of physical
activity. Lasting weight loss can only occur when there is
self-motivation. Since obesity often affects more than one
family member, making healthy eating and regular exercise
a family activity can improve the chances of successful weight
control for the child or adolescent.
Ways
to manage obesity in children and adolescents include:
- start
a weight-management program
- change
eating habits (eat slowly, develop a routine)
- plan
meals and make better food selections (eat less fatty foods,
avoid junk and fast foods)
- control
portions and consume less calories
- increase
physical activity (especially walking) and have a more active
lifestyle
- know
what your child eats at school
- eat
meals as a family instead of while watching television or
at the computer
- do
not use food as a reward
- limit
snacking
- attend
a support group (e.g., Weight Watchers, Overeaters Anonymous)
Obesity frequently
becomes a lifelong issue. The reason most obese adolescents
gain back their lost pounds is that after they have reached
their goal, they go back to their old habits of eating and exercising.
An obese adolescent must therefore learn to eat and enjoy healthy
foods in moderate amounts and to exercise regularly to maintain
the desired weight. Parents of an obese child can improve their
child's self esteem by emphasizing the child's strengths and
positive qualities rather than just focusing on their weight
problem.
When a
child or adolescent with obesity also has emotional problems,
a child and adolescent psychiatrist can work with the child's
family physician to develop a comprehensive treatment plan.
Such a plan would include reasonable weight loss goals, dietary
and physical activity management, behavior modification, and
family involvement.
For more
information see Facts for Families:
#02: Teenagers with Eating Disorders
#04: The Depressed Child
#54: Children and Watching TV
#61: Children and Sports
#66: Helping Teenagers with Stress
See also: Your Child (1998 Harper Collins)/Your
Adolescent (1999 Harper collins) and Good Grief (1996
Jessica Kingsley).
Article
#79 Updated 01/01
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All
Family Resources wishes to thank the (AACAP) for giving
us permission to use this article.
The
American Academy of Child and Adolescent Psychiatry (AACAP)
represents over 6,900 child and adolescent psychiatrists
who are physicians with at least five years of additional
training beyond medical school in general (adult) and child
and adolescent psychiatry.
Facts
for Families© is developed and distributed by the American
Academy of Child and Adolescent Psychiatry (AACAP).
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make a tax deductible contribution to the AACAP Special
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