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5% of U.S. Kids 'Severely Obese,' Experts Warn

New and better treatments needed for this newly defined disease, researchers say

WebMD News from HealthDay

By Steven Reinberg

HealthDay Reporter

MONDAY, Sept. 9 (HealthDay News) -- While the rate of obesity among U.S. children seems to have leveled off, the number who are "severely obese" continues to rise, according to the American Heart Association.

Some 5 percent of children and teens now fall into this category, putting them at high risk for premature heart disease and type 2 diabetes, the researchers report in an American Heart Association scientific statement published in the Sept. 9 online edition of Circulation.

"We are defining a new class of pediatric obesity called 'severe' obesity," said lead researcher Aaron Kelly, an associate professor of pediatrics at the University of Minnesota Medical School in Minneapolis.

"This type of obesity is different than traditional obesity and overweight in children," he said. "It is an extreme form of obesity."

Children are considered severely obese if they have a body mass index (BMI) above the 95th percentile for their sex and age, or a BMI of 35 or higher. BMI is a measure of weight in relation to height, and a child in the 95th percentile weighs more than 95 percent of other children the same sex and age.

For example, Kelly said, a 7-year-old girl of average height who weighs 75 pounds, or a 13-year-old boy of average height who weighs 160 pounds, would both be considered severely obese.

And those excess pounds have "both immediate and long-term health consequences," Kelly said. Severely obese kids face heightened risks of high blood pressure, type 2 diabetes, high cholesterol and early signs of narrowing in the arteries -- all risk factors for heart disease.

Cardiologist Dr. Valentin Fuster, director of Mount Sinai Heart at the Mount Sinai Medical Center in New York City, warns that in addition to heart problems, obesity can cause children to develop asthma, sleep apnea, strained bones and joints, and it can lead to low self-esteem.

And, Kelly pointed out, "if you are a child or adolescent who is severely obese, the likelihood of you being an adult with morbid obesity is very high."

The steps to treating severely obese children range from lifestyle changes -- such as diet and exercise -- to more intensive tactics, including weight-loss drugs and, in some cases, surgery to reduce the size of the stomach.

Unfortunately, Kelly said, diet and exercise do not work all that well for these kids. And drugs and surgery are limited in their reach; surgery isn't appropriate for, or available to, all severely obese children, and the most effective weight-loss drugs aren't approved for use in children, Kelly noted.

More research into effective therapies is key, as is the recognition of severe obesity as a chronic disease, he explained.

"Pediatricians need other options besides just lifestyle therapy to treat this disease," Kelly said.

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