Obesity in Children and Teens

Obesity is when a person has too much body fat. Without treatment, obesity can become a serious, long-term disease.

In many ways, childhood obesity is a puzzling disease. Doctors do not fully understand how the body controls weight and body fat. On one hand, the cause seems simple. If a person takes in more calories than they use for energy, then they will gain weight.

But a child or teen's obesity can be caused by a combination of things. It can be linked to:

• Genes
• Socioeconomic issues
• How the body turns food into energy (metabolism)
• Not getting enough sleep
• Not getting enough exercise
• Lifestyle choices
• Emotional issues
• Too much screen time and sedentary behaviors

Some endocrine disorders, diseases, and medicines may also have a strong effect on a child’s weight.

Things that may put your teen at risk for obesity are:

• Genes. Obesity may be passed down through families. Having even one obese parent may raise a child’s risk for it. Experts are looking at the link between genes, the ever-changing environment, and obesity.
• Metabolism. Each person’s body uses energy differently. Metabolism and hormones don’t affect everyone the same way. They may play a role in weight gain in children and teens.
• Socioeconomic factors. There is a strong tie between economic status and obesity. Obesity is more common among low-income people. In some places, people may have limited access to affordable healthy foods. Or they may not have a safe place to exercise.
• Lifestyle choices. Overeating and an inactive lifestyle both contribute to obesity. A diet full of sugary, high-fat, and refined foods can lead to weight gain. So can a lack of regular exercise and lack of sleep. In children, watching TV and sitting at a computer can play a part.

Too much body fat is the main symptom of obesity. But it’s hard to directly measure body fat. A guideline called the body mass index (BMI) is used to estimate it. The BMI uses a teen’s weight and height to come up with a result. The result is then compared with standards for children of the same gender between the ages of 2 and 19.

A teen who is overweight has a BMI between the 85th and 95th percentile for age and gender. They are obese if the BMI is at or greater than the 95th percentile for age and gender.

Obesity is diagnosed by a healthcare provider. BMI is often used to define obesity. For adults, BMI is a weight status category that does not depend on sex or age. But because children have changes in weight, height, and body fat as they age, BMI levels among children and teens are expressed relative to other children and teens of the same sex and age. There are 3 categories of obesity in children and teens:

• Severe obesity. BMI greater than or equal to 120% of the 95th percentile for age and sex.
• Obesity. BMI at the 95th percentile or more for age and sex..
• Overweight. BMI between the 85th and 95th percentile for age and sex..

The results above mean the child should be evaluated with a health history, a physical exam, and tests.

Treatment depends on your child's symptoms, age, and health. It also depends on how severe the condition is.

Treatment for obesity may include:

• Nutrition counseling
• Changes to portion sizes and snack habits n
• More physical activity or an exercise program
• More sleep and a regular sleep routine
• Behavior changes
• Individual, group, or family therapy that focuses on changing behaviors and facing feelings linked to weight and normal developmental issues
• Support and encouragement for making changes and following recommended treatments
• Medicine
• Weight-loss surgery
• Treatment for other obesity-related conditions

Treatment often involves the help of a nutritionist, mental health professionals, an exercise specialist, and other healthcare professionals. The goal of obesity treatment should be better health. This may differ for each child. Goals can include good self-esteem, being more physically active, improved weight, or better cholesterol levels.

Ask your child's healthcare provider about enrolling in an intensive health behavior and lifestyle treatment (IHBLT) program. This may also be called intensive behavioral intervention or family healthy weight programs. IHBLT is a safe and effective treatment for childhood obesity. It's a family-centered program that focuses on nutrition, physical activity, and behavior change strategies that are for your family. If there are no IHBLT programs nearby, you can work together with your child's healthcare provider to address different lifestyle and behavior topics.

Obesity can affect your teen’s health in a number of ways. These include:

• High blood pressure and high cholesterol. These are risk factors for heart disease.
• Diabetes. Obesity is the major cause of type 2 diabetes. It can cause resistance to insulin, the hormone that controls blood sugar. When obesity causes insulin resistance, blood sugar becomes higher than normal.
• Joint problems, such as osteoarthritis. Obesity can affect the knees and hips because of the stress placed on the joints by extra weight.
• Sleep apnea and breathing problems. Sleep apnea causes people to stop breathing for brief periods. It interrupts sleep throughout the night and causes sleepiness during the day. It also causes heavy snoring. The risk for other breathing problems, such as asthma, is higher in an obese child.
• Psychosocial effects. Modern culture often sees overly thin people as the ideal in body size. Because of this, people who are overweight or obese often suffer disadvantages. They may be blamed for their condition. They may be seen as lazy or weak-willed. Obese children can have low self-esteem that affects their social life and emotional health.

Young people often become overweight or obese because they have poor eating habits and aren’t active enough. Genes also play a role.

Here are some tips to help your teen stay at a healthy weight:

• Focus on the whole family. Slowly work to change your family’s eating habits and activity levels. Don’t focus on a child’s weight. Instead, focus on their overall health.
• Be a role model. Parents who eat healthy foods and are physically active set an example. Their child is more likely to do the same.
• Encourage physical activity. Children ages 3 to 5 should be active throughout the day. Children and teens ages 6 to 17 should get at least 60 minutes of physical activity each day.
• Limit screen time. For children ages 2 to 5, the American Academy of Pediatrics (AAP) advises no more than 1 hour of screen time per day. For older children, the AAP advises creating a family media plan. Create your family’s plan at HealthyChildren.org/MediaUsePlan.
• Have healthy snacks on hand. Keep the refrigerator stocked with fat-free or low-fat milk instead of soft drinks. Offer fresh fruit and vegetables instead of snacks high in sugar and fat.
• Encourage nutritious foods. These include a variety of vegetables and fruits, whole grains, lean protein foods, and low-fat and fat-free dairy products.
• Drink more water. Encourage children and teens to have water instead of drinks with added sugar. Limit your child’s intake of soft drinks, sports drinks, and fruit juice drinks.
• Get enough sleep. Encourage children and teens to get more sleep every night. Follow a regular bedtime routine. Earlier bedtimes have been found to decrease rates of obesity.

• Obesity is a long-term disease. It’s when a teen has too much body fat.
• Many things can lead to childhood obesity. These include genes and lifestyle choices.
• Body mass index (BMI) is used to diagnose obesity. It’s based on a child’s age, weight, height and sex.
• Treatment may include nutrition counseling, exercise, therapy, and support.
• Obesity can lead to many other health problems. Some of these are heart disease, type 2 diabetes, and joint problems.
• Obesity can be prevented with healthy lifestyle choices like being more physically active and eating more fruits and vegetables.

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.
• Before your visit, write down questions you want answered.
• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
• Ask if your child’s condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if your child does not take the medicine or have the test or procedure.
• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.