Is Your Child Obese?
Body mass index (BMI) uses height and weight measurements to estimate how much body fat a person has. To calculate BMI, divide weight in kg by height in meters squared; for pounds and inches, divide weight by height squared and multiply the result by the conversion factor 703.
An easier way to measure BMI is to use a BMI calculator. Once you know your child's BMI, it can be plotted on a standard BMI chart. Kids fall into one of four categories:
1. Underweight: BMI below the 5th percentile
2. Normal weight: BMI at the 5th and less than the 85th percentile
3. Overweight: BMI at the 85th and below 95th percentiles
4. Obese: BMI at or above 95th percentile
BMI is not a perfect measure of body fat and can be misleading in some situations. For example, a muscular person may have a high BMI without being overweight (because extra muscle adds to a body weight — but not fatness). In addition, BMI may be difficult to interpret during puberty when kids are experiencing periods of rapid growth. It's important to remember that BMI is usually a good indicator — but is not a direct measurement — of body fat.
If you're worried that your child or teen may be overweight, make an appointment with your doctor, who can assess eating and activity habits and make suggestions on how to make positive changes. The doctor may also decide to screen for some of the medical conditions that can be associated with obesity.
Depending on your child's BMI, age, and health, the doctor may refer you to a registered dietitian for additional advice and, possibly, may recommend a comprehensive weight management program.
The Effects of Obesity
Obesity increases the risk for serious health conditions like type 2 diabetes, high blood pressure, and high cholesterol — all once considered exclusively adult diseases. Obese kids also may be prone to low self-esteem that stems from being teased, bullied, or rejected by peers.
Kids who are unhappy with their weight may be more likely than average-weight kids to:
•develop unhealthy dieting habits and eating disorders, such as anorexia nervosa and bulimia
•be more prone to depression
•be at risk for substance abuse
Overweight and obese kids are at risk for developing medical problems that affect their present and future health and quality of life, including:
•high blood pressure, high cholesterol and abnormal blood lipid levels, insulin resistance, and type 2 diabetes
•bone and joint problems
•shortness of breath that makes exercise, sports, or any physical activity more difficult and may aggravate the symptoms or increase the chances of developing asthma
•restless or disordered sleep patterns, such as obstructive sleep apnea
•tendency to mature earlier (overweight kids may be taller and more sexually mature than their peers, raising expectations that they should act as old as they look, not as old as they are; overweight girls may have irregular menstrual cycles and fertility problems in adulthood)
•liver and gall bladder disease
•depression
Cardiovascular risk factors present in childhood (including high blood pressure, high cholesterol, and diabetes) can lead to serious medical problems like heart disease, heart failure, and stroke as adults. Preventing or treating overweight and obesity in kids may reduce the risk of developing cardiovascular disease as they get older.
Causes of Overweight
A number of factors contribute to becoming overweight. Genetics, lifestyle habits, or a combination of both may be involved. In some instances, endocrine problems, genetic syndromes, and medications can be associated with excessive weight gain.
Much of what we eat is quick and easy — from fat-laden fast food to microwave and prepackaged meals. Daily schedules are so jam-packed that there's little time to prepare healthier meals or to squeeze in some exercise. Portion sizes, in the home and out, have grown greatly.
Plus, now more than ever life is sedentary — kids spend more time playing with electronic devices, from computers to handheld video game systems, than actively playing outside. Television is a major culprit.
Kids younger than 6 spend an average of 2 hours a day in front of a screen, mostly watching TV, DVDs, or videos. Older kids and teens average 4.5 hours a day watching TV, DVDs, or videos. When computer use and video games are included, time spent in front of a screen increases to over 7 hours a day! Kids who watch more than 4 hours a day are more likely to be overweight compared with kids who watch 2 hours or less.
The American Academy of Pediatrics (AAP) currently recommends limiting the time kids over 2 years of age spend in front of a screen to no more than 1-2 hours. The AAP also discourages any screen time for children younger than 2 years.
Many kids don't get enough physical activity. Although physical education (PE) in schools can help kids get up and moving, more and more schools are eliminating PE programs or cutting down the time spent on fitness-building activities. One study showed that gym classes offered third-graders just 25 minutes of vigorous activity each week.
Current guidelines recommend that kids over 2 years of age get at least 60 minutes of moderate to vigorous physical activity on most, preferably all, days of the week.
Genetics also play a role — genes help determine body type and how your body stores and burns fat just like they help determine other traits. Genes alone, however, cannot explain the current obesity crisis. Because both genes and habits can be passed down from one generation to the next, multiple members of a family may struggle with weight.
Preventing Overweight and Obesity
The key to keeping kids of all ages at a healthy weight is taking a whole-family approach. It's the "practice what you preach" mentality. Make healthy eating and exercise a family affair. Get your kids involved by letting them help you plan and prepare healthy meals, and take them along when you go grocery shopping so they can learn how to make good food choices.
And avoid falling into these common food/eating behavior traps:
•Don't reward kids for good behavior or try to stop bad behavior with sweets or treats. Come up with other solutions to modify their behavior.
•Don't maintain a clean-plate policy. Be aware of kids' hunger cues. Even babies who turn away from the bottle or breast send signals that they're full. If kids are satisfied, don't force them to continue eating. Reinforce the idea that they should only eat when they're hungry.
•Don't talk about "bad foods" or completely eliminate all sweets and favorite snacks from kids' diets. Kids may rebel and overeat these forbidden foods outside the home or sneak them in on their own
People in the same family tend to have similar eating patterns, maintain the same levels of physical activity, and adopt the same attitudes toward being overweight. Studies have shown that a child's risk of obesity greatly increases if one or more parent is overweight or obese.
New Research-Overeating When Not Hungry Is Common In Obese Kids
Children who are overweight and obese eat 34% more calories from snack foods even after eating a meal, compared to their siblings of average weight. Indulging in that much more food, if continued over time, can lead to excess weight gain, according a study from the University of Pennsylvania School of Nursing in The American Journal of Clinical Nutrition. Bodyweight has increasingly become a huge health issue in the United States. Just over one third of Americans are of normal weight, while 35.8% are overweight and 27.6% are obese. In the study, consisting of 47 same-sex sibling pairs, results showed that overweight and obese kids were more susceptible than their normal-weight siblings to overeating when shown tasty snacks after eating meals they had enjoyed until they felt full.When given a calorie-dense appetizer before dinner time, the average-weight siblings ate less of their dinner than their overweight brother or sister. Meanwhile, the obese and overweight siblings did not lessen the amount of food they consumed at dinner enough to offset the extra calories they picked up from the appetizer.
Tanja Kral, Ph.D., head author and an assistant professor at Penn Nursing explained,The overweight and obese siblings showed an impaired ability to adjust for calorie differences and consumed more snacks even when satiated. These findings suggest some children are less responsive to their internal cues of hunger and fullness and will continue eating even when full.Dr. Kral pointed out that this inability might be hereditary, and then made worse by an environment that serves big portions of unhealthy foods. Since the full siblings had more similar eating patterns than the half-siblings, the expert suggests that genetics is playing a role.
The subjects were analyzed for three weeks, while once a week they were given a pasta dinner with tomato sauce, broccoli, unsweetened applesauce, and two percent milk. The overweight and obese kids ate an average of 93 calories more than their normal-weight siblings when given the option to eat delectable snacks after their meal. Over time, this additional calorie intake is actually enough to cause excess weight gain.
Dr. Kral concluded,These findings may represent a behavioral inclination for obesity in children. Future studies should test whether teaching children to focus on internal satiety cues and structuring the home food environment in a healthy way may prevent at-risk children from overeating.
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