From the Cleveland Clinic: Obesity in Children

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Almost one out of every five children in the U. S. is overweight, and this number is continuing to grow. Children have fewer weight-related health and medical problems than adults. However, overweight children are at high risk of becoming overweight adolescents and adults, placing them at risk of developing chronic diseases such as heart disease and diabetes later in life. They are also more prone to develop stress, sadness and low self esteem.

What Causes Obesity in Children?

Children become overweight for a variety of reasons. The most common causes are genetic factors, lack of physical activity, unhealthy eating patterns, or a combination of these factors. Only in rare cases is being overweight caused by a medical condition such as a hormonal problem. A physical exam and some blood tests can rule out the possibility of a medical condition.

Although weight problems run in families, not all children with a family history of obesity will be overweight. Children whose parents or brothers or sisters are overweight may be at an increased risk of becoming overweight themselves, but this can be linked to shared family behaviors such as eating and activity habits.

A child's total diet and activity level play an important role in determining a child's weight. Today, many children spend a lot time being inactive. For example, the average child spends approximately 4 hours each day watching television. As computers and video games become increasingly popular, the number of hours of inactivity may only increase.

What Diseases Are Obese Children at Risk For?

Obese children are at risk for a number of conditions, including:

• High cholesterol
• High blood pressure
• Early heart disease
• Diabetes
• Bone problems
• Skin conditions such as heat rash, fungal infections and acne

How Do I Know if My Child Is Overweight?

The best person to determine whether or not your child is overweight is your child's doctor. In determining whether or not your child is overweight, the doctor will measure your child's weight and height. The doctor will also consider your child's age and growth patterns. Assessing obesity in children can be difficult because children can grow in unpredictable spurts. For example, it is not unusual for boys to appear overweight, but they may grow taller and "grow into the weight" a few years later.

How Can I Help My Overweight Child?

If your child is overweight, it is very important that you allow him or her to know that you will be supportive. Children's feelings about themselves often are based on their parents' feelings about them and if you accept your children at any weight, they will be more likely to feel good about themselves. It is also important to talk to your children about their weight, allowing them to share their concerns with you.

It is not recommended that parents set children apart because of their weight. Instead, parents should focus on gradually changing their family's physical activity and eating habits. By involving the entire family, everyone is taught healthful habits and the overweight child does not feel singled out.

How Can I Involve My Family in Healthful Habits?

There are many ways to involve the entire family in healthy habits, but increasing the family's physical activity is especially important. Some ways to accomplish this include:

• Lead by example. If your children see that you are physically active and having fun, they are more likely to be active and stay active for the rest of their lives.
• Plan family activities that provide everyone with exercise, like walking, biking, or swimming.
• Be sensitive to your child's needs. Overweight children may feel uncomfortable about participating in certain activities. It is important to help your child find physical activities that they enjoy and that aren't embarrassing or too difficult.
• Make an effort to reduce the amount of time you and your family spend in sedentary activities, such as watching TV or playing video games.

Whatever approach parents choose to take, the purpose is not to make physical activity and following a healthy diet a chore, but to make the most of the opportunities you and your family have to be active and healthy.

Reviewed by the Department of Nutrition Therapy at The Cleveland Clinic.

Edited by Tracy Shuman, MD, WebMD, October 2005.

The Centers for Disease Control The National Institute of Diabetes and Digestive and Kidney Diseases