Childhood Obesity By Yasmine Ali, MD Childhood obesity has been on the rise in the United States for over a decade, and, according to the American Heart Association (AHA), approximately one in three children and teenagers is obese or overweight.As the AHA notes, this rate is nearly triple what it was in 1963. In fact, childhood obesity has become so alarmingly prevalent and such a threat to children’s health that the American Academy of Pediatrics (AAP) has an entire website dedicated to its prevention and treatment. But hope is not lost. Parents everywhere will be happy to know that a variety of organizations, in addition to the AHA and the AAP, and including the World Health Organization (WHO), have joined in the fight to end childhood obesity.Engaging in the fight against childhood obesity requires understanding its definitions, causes, treatments, and opportunities for prevention.How Is Obesity in Children Defined?For children who are aged two to 19 years, obesity is defined using body mass index (BMI). Article Ending Childhood Obesity: Is It Possible? Article A Healthier Child in Just 10 Days A BMI at or above the 95th percentile for children of the same age and sex is classified as obese. A BMI at or above the 85th percentile but lower than the 95th percentile is considered to fall into the overweight category.For children who are younger than two years of age, there is currently no nationally recommended and agreed-upon definition for obesity.What Are the Health Risks of Childhood Obesity?There are numerous and serious health risks associated with obesity in children, both short-term and long term. Children who are obese are more likely to have high blood pressure (hypertension) and high blood cholesterol, both of which are risk factors for future cardiovascular disease (disease of the heart and blood vessels, including the blood vessels that supply the brain). In one study, for instance, as many as 70 percent of obese children were found to have at least one risk factor for cardiovascular disease.Children who are obese are also at a much greater risk of developing type 2 diabetes. In fact, the rise of type 2 diabetes in children has engendered great concern among the medical community, as “diabetes of childhood” used to be seen as only the rarer type 1 diabetes.Now, with the rise of childhood obesity, there has been a veritable explosion in cases of type 2 diabetes in children. Given that diabetes is also a strong risk factor for cardiovascular disease, this is another malady with grave long-term ramifications.Additionally, children with obesity are more likely to have breathing problems, such as asthma and obstructive sleep apnea. These children are also more likely to have joint problems and fatty liver disease which has been associated with cirrhosis and liver cancer over time.Finally, as many experts have noted, obesity or overweight in childhood often leads to obesity in adulthood. Article Does Going to Bed Too Late Cause Weight Gain? Article Obesity and Bullying: A Vicious Cycle What Causes Childhood Obesity?It is impossible to point to one single cause of the childhood obesity epidemic. Rather, a variety and combination of factors are at play.A number of studies have investigated the reasons for elevated rates of childhood obesity—with more studies ongoing. A more sedentary lifestyle has certainly been found to be prevalent in many studies. And studies have shown that children who watch television for longer than one hour per day tend to have a higher body mass index (BMI) as well as higher blood pressure. Researchers have suggested that more time spent in front of the television is associated with poor food choices that lead to overweight and obesity and, in turn, increased cardiovascular risk.The decline in physical education programs and the time allotted for physical activity during the average school day has also been implicated in the rise in childhood and adolescent obesity. In addition to obesity itself, there are many reasons that this decline in physical activity is of serious concern; lower levels of physical fitness tend to increase risk for heart disease. Poor nutrition choices of calorie-dense foods have also been linked to childhood obesity. Many studies have found a relationship between certain dietary behaviors—such as consuming sugary beverages—and obesity. The intake of sweetened beverages has received a lot of attention and research has overwhelmingly pointed to an association between their intake and obesity, both in children and adults. In addition, many clinicians note that when obese and overweight children follow their recommendations for reducing or avoiding sugary beverage intake, they reliably lose weight.Keep in mind that the category of sugary beverages includes both soft drinks as well as fruit and juice drinks, which often have multiple sugars added to them. In fact, the intake of sugary beverages has been deemed so hazardous to the health of children and such a major cause of obesity, that several cities have placed extra taxes or warning labels on them.There are also genetic factors at play in the development of childhood obesity, many of which are just now being researched or discovered. Article How Much Fast Food Do U.S. Children Eat? Article When Should Children Be Screened for High Cholesterol? For example, scientists have discovered that the FTO gene may confer a tendency toward binge eating and development of obesity in adolescents.Managing Childhood ObesityHaving a child receive a diagnosis of obesity is hard for any parent. If you are worried that your child may be overweight or obese, be sure to discuss your concern with your child's pediatrician and ask for help. They can provide strategies that can lead to weight loss and that are appropriate for your child and your situation.If your child has been given a diagnosis of obesity, you can work with him/her in a positive way to make daily physical activity more fun—especially if he/she does not have access to physical education at school—and to encourage healthy eating habits. (This includes taking steps to encourage healthier habits on holidays that are traditionally associated with sugar consumption, like Halloween and Easter, and making it an overall priority to eat at home more often.)Don’t underestimate the power of eating a home-cooked meal around the family table. Not only does this encourage quality time with your children, but studies have shown time and again that there are many health benefits to be gained by eating at home.For instance, in a study presented at the 2015 AHA meeting in Orlando, researchers led by Geng Zong, PhD, research fellow at the Harvard T.H. Chan School of Public Health in Boston, found that people who ate an average of 11 to 14 lunches and dinners prepared at home each week had a 13 percent lower risk of developing obesity and type 2 diabetes as compared with those who ate zero to six home-prepared lunches and dinners.Other studies have connected eating out of the house, especially fast food, to overweight and obesity in children and young adults. According to a report released by the U.S. Centers for Disease Control and Prevention (CDC), based on data from the National Health and Nutrition Examination Survey (NHANES), over one-third of children and adolescents are consuming fast food on any given day.As the CDC notes, “Consumption of fast food has been linked to weight gain in adults.” Poor nutrition choices with calorie-dense foods have also been linked to childhood obesity. In addition, fast food is known to have high sodium and saturated fat, which can lead to high blood pressure and cardiovascular disease over time.In contrast, foods cooked at home often have higher dietary quality and less sodium and saturated fat. In one analysis of nearly 10,000 participants in NHANES from 2007 to 2010, researchers concluded that “cooking dinner frequently at home is associated with consumption of a healthier diet whether or not one is trying to lose weight.”A number of treatments are now available for obesity. In addition to lifestyle changes, these include anti-obesity medications and bariatric (weight-loss) surgery. While lifestyle changes, like diet and exercise, are first-line therapy for everyone, this is especially true for children. Kids may experience greater side effects from medications or more invasive treatments. However, it is important to discuss all the possibilities and best options for your child with their pediatrician.A Word From VerywellAlways remember that obesity is treatable and, given the number of children across the country and around the globe who have been diagnosed with overweight or obesity, you are certainly not alone in your fight against it.While it will take dedication and patience to put into place and stick to a plan to help your child deal with and ultimately overcome obesity, it will pay off greatly in the long run, setting a course for a better, healthier future for your child.Sources:American Heart Association Scientific Sessions 2015 Daily News. TriStar Publishing, Inc. November 9, 2015.Micali N, Field AE, Treasure JL, Evans DM. Are obesity risk genes associated with binge eating in adolescents? Obesity (Silver Spring) 2015;23:1729-36.Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of childhood and adult obesity in the United States, 2011 – 2012. JAMA. 2014;311(8):806-814.Smemo S, Tena JJ, Kim KH, Gamazon ER, et al. Obesity-associated variants within FTO form long-range functional connections with IRX3. Nature 2014;507:371-5.Vikraman S, Fryar CD, Ogden CL. Caloric intake from fast food among children and adolescents in the United States, 2011 – 2012. NCHS Data Brief No. 213, September 2015. Accessed online at http://www.cdc.gov/nchs/data/databriefs/db213.htm on September 25, 2015.