Being Overweight or Obese
More and more children in the United States are overweight and even obese (very overweight). This happens when a person eats more calories (energy) than he uses up each day. Although it may seem that being obese can be easily detected, it is not diagnosed simply by looking at someone. In fact, parents often do not even know that they or their children are obese. How can that be? Different people have different standards for their "ideal" body image, and each of us (children and adults alike) has a unique body shape, which carries our weight in a special way. With this in mind, objective (impartial or unbiased) standards have been developed for defining and measuring obesity, regardless of shape, age or race.
Obesity in children is defined as too much (excess) body fat in relation to lean body mass and is best measured by a term called body mass index (BMI). BMI is calculated by using a person's weight and height and gives an estimate of the amount of body fat. Since total body fat normally changes with a child's age, BMI is then compared with age- and sex-specific percentile standards based on large national surveys of children as old as age 20. Based on the current recommendations of expert committees, children with BMI values greater than or equal to the 85th percentile and less than the 95th percentile are considered overweight, while those children at or above the 95th percentile of the sex-specific BMI growth charts are considered obese.
Information collected in a recent national study in 2009 shows that around 16% of children between the ages of 6 and 19 years are overweight. Unfortunately, these numbers have gone up during the past years. The data for adolescents (12 to 19 years old) are particularly worrisome, because overweight adolescents are at the highest risk of becoming overweight adults. This means they are more likely to develop obesity-related health conditions.
Many factors are felt to contribute to the increased number of children with obesity in the United States. Although there is some evidence to suggest that genetic (passed down from mother and father to their child) factors play a role in which foods and how much a child wants to eat, the most important causes likely may be more related to personal behavior and dietary habits.
There is no question that children are consuming more calories, and in particular, more fat.
- Children now eat many convenience foods, which are typically high in fat and calories (for example, granola bars, frozen pizzas, breaded chicken pieces).
- Children also frequently eat in fast-food restaurants and tend to order high-fat items such as French fries, hamburgers, cheeseburgers, fried chicken and milk shakes.
- Portion sizes continue to increase in restaurants, and children often eat adult-sized portions, even when ordering from a "children's" menu.
- Children can find vending machines all over, including schools and public places. Access to food is good since children need to eat often, but unfortunately, these vending machines tend to have mostly high-fat and high-calorie snacks.
- Although changes are being made to ensure that school lunch programs follow national recommendations for heart-healthy diets, most school lunches still offer high-fat items.
- Many children drink several glasses of soda and juice each day, adding unnecessary sugar and calories to their diets.
Children also are getting less exercise and therefore, burning off fewer calories.
- Children spend many hours each day watching television, using the computer and playing video games. These activities require very little energy or movement compared to more physical activities such as bike riding, running, swimming and climbing trees. In fact, studies have shown a direct relationship between television watching and obesity (so-called "couch potatoes").
- Many physical-education programs (gym classes) in schools have been limited by budget cutbacks in our schools.
- Unfortunately, many children live in neighborhoods where it is not safe to play outside.
- Children who are home alone after school may be instructed to stay inside. Therefore, they do not get enough exercise and have easy access to high-calorie snack foods.
Obesity is a risk factor for lots of health problems in childhood and later in life. Just being overweight puts children at risk of orthopedic problems, sleep disturbances, gallstones, menstrual irregularities, diabetes and kidney problems. Some researchers even think there is a relationship between asthma and obesity. In addition, children who are overweight or obese are more likely to develop high blood pressure, high cholesterol and heart disease as adults. Long-term obesity also increases the risk of arthritis, heart disease, diabetes and certain kinds of cancer.
If you think your child may be overweight, talk with your child's pediatrician. First, your child's height and weight will need to be measured to calculate his BMI and compare it with the national growth charts. Knowing your child's sex, age and body type, the pediatrician may use these charts to suggest a target weight range for your child. In most cases, middle-school-aged children should not try to lose weight by dieting. It is a more healthy approach for them to just try to maintain their current weight as they grow taller.
Fortunately, there are things that parents can do to help their children prevent (and treat) being overweight or obese. In general, it involves the entire family getting regular exercise and eating a sensible, heart-healthy diet.
- Encourage exercise every day, for at least 1 hour.
- Plan family activities that involve exercise, such as bicycling, walking, hiking and swimming.
- Limit television, computer and video-game time to an average of one to two hours per day.
- Eat meals together as a family whenever possible, and do not allow television watching while eating.
- Switch to low-fat or nonfat milk (except for children younger than 2 years old), and reduced-fat cheeses and yogurts.
- Drink water instead of soda or juice.
- Limit how much fried and high-fat foods are eaten.
- Use low-fat cooking methods such as baking, steaming, boiling, grilling and broiling, and use nonstick pans and cooking spray instead of oil when frying.
- Try to eat at least five servings each day of fruits and vegetables.
- Always have a wide variety of fruits and vegetables on hand, and serve them as snacks instead of cookies, chips, ice cream or other high-fat foods.
- Trim visible fat from meat and remove skin from poultry before cooking.
- Avoid using high-fat sauces, salad dressings and spreads (for example, butter, margarine, mayonnaise).
- Limit how often your family eats in restaurants.
- When eating out, choose lower-fat items, such as a grilled chicken sandwich instead of a fried burger, a salad instead of fries, or pasta with tomato sauce instead of pepperoni pizza.
Never severely restrict (cut back) your child's calories; children who are overweight still need three well-balanced meals and one or two nutritious snacks each day, in order to have enough energy to learn, play and grow to their full potential. In addition, children should not follow fad diets because these may not have important nutrients children need and therefore may make children sick.
Your pediatrician can give you general information on nutrition, being overweight, and preventing or treating obesity. Sometimes a child may need to be referred to a nutritionist or registered dietician for more specific help and information, especially if changing his eating habits doesn't seem to be working.