Childhood Obesity, Treatment Methods

Children's weight affects their health. However, to figure out if your child weighs too much, you have to consider not only how much your child weighs but also how tall your child is. Your child's healthcare provider uses both of these numbers to come up with an overall number. That is your child's body mass index (BMI). Your child's BMI is compared with the BMI for other children of the same age. Boys are compared with boys, girls are compared with girls.

  • A child is considered overweight when his or her BMI is higher than the BMI of 85 percent of boys or girls of the same age.

  • A child is considered obese when his or her BMI is higher than the BMI of 95 percent of boys or girls of the same age.

Obesity is a serious health concern. Children who are obese are more likely than other children to have a disease that causes breathing problems (asthma). Obese children often have skin problems. They are apt to develop a disease in which there is too much sugar in the blood (diabetes). Heart problems can occur. So can high blood pressure. Obese children may have trouble sleeping and can suffer from some orthopedic problems from their weight. Many obese children also have social or emotional problems linked to their weight. Some have problems with schoolwork.

Your child's weight does not need to be a lifelong problem. Obesity can be treated. Your child's diet will probably have to change, and he or she will probably need to become more active. But helping a child lose weight can save the child's life.

CAUSES

Nearly all obesity is related to eating more calories than are required. Calories in food give a child energy. If your child takes in more calories than he or she uses during the day, he or she will gain weight. This often occurs when a child:

  • Consumes foods and drinks that contain too many calories.

  • Watches too much TV. This leads to decreases in exercise and increases in consumption of calories.

  • Consumes sodas and sugary drinks, candy, cookies, and cake.

  • Does not get enough exercise. Physical activity is how a child uses up calories.

Some medical causes of obesity include:

  • Hypothyroidism. The thyroid gland does not make enough thyroid hormone. Because of this, the body works more slowly. This leads to weight gain.

  • Any condition that makes it hard to be active. This could be a disease or a physical problem.

  • Certain medicines that can make children hungry. This can lead to weight gain if the child eats the wrong foods.

TREATMENT

Often it works best to treat a child's obesity in more than one way. Possibilities include:

  • Changes in diet. Children are still growing. They need healthy food to do that. They usually need all kinds of foods. It is best to stay away from fad diets. Also avoid diets that cut out certain types of foods. Instead:

  • Develop an eating plan that provides a specific number of calories from healthy, low-fat foods.

  • Find low-fat options for favorites. Low-fat milk instead of whole milk, for example.

  • Make sure the child eats 5 or more servings of fruits and vegetables every day.

  • Eat at home more often. This gives you more control over what the child eats.

  • When you do eat out, still choose healthy foods. This is possible even at fast-food restaurants.

  • Learn what a healthy portion size is for the child. This is the amount the child should eat. It varies from child to child.

  • Keep low-fat snacks on hand.

  • Avoid sodas sweetened with sugar, fruit juices, iced teas sweetened with sugar, and flavored milks. Replace regular soda with diet soda if your child is going to drink soda. Limit the number of sodas your child can consume each week.

  • Make sure your child eats a healthy breakfast.

  • If these methods do not work, ask you child's caregiver about a meal replacement plan. This is a special, low-calorie diet.

  • Changes in physical activity.

  • Working with someone trained in mental and behavioral changes that can help (behavioral treatment). This may include attending therapy sessions, such as:

  • Individual therapy. The child meets alone with a therapist.

  • Group therapy. The child meets in a group with other children who are trying to lose weight.

  • Family therapy. It often helps to have the whole family involved.

  • Learn how to set goals and keep track of progress.

  • Keep a weight-loss diary. This includes keeping track of food, exercise, and weight.

  • Have your child learn how to make healthy food choices around friends. This can help the child at school or when going out.

  • Medication. Sometimes diet and physical activity are not enough. Then, the child's healthcare provider may suggest medicine that can help the child lose weight.

  • Surgery.

  • This is usually an option only for a severely obese child who has not been able to lose weight.

  • Surgery works best when diet, exercise, and behavior also are dealt with.

HOME CARE INSTRUCTIONS

  • Help your child make changes in his or her physical activity. For example:

  • Most children should get 60 minutes of moderate physical activity every day. They should start slowly. This can be a goal for children who have not been very active.

  • Develop an exercise plan that gradually increases your child's physical activity. This should be done even if the child has been fairly active. More exercise may be needed.

  • Make exercise fun. Find activities that the child enjoys.

  • Be active as a family. Take walks together. Play pick-up basketball.

  • Find group activities. Team sports are good for many children. Others might like individual activities. Be sure to consider your child's likes and dislikes.

  • Make sure your child keeps all follow-up appointments with his or her caregiver. Your child may start to see: a nutritionist, therapist, or other specialist. Be sure to keep appointments with these specialists as well. These specialists need to track your child's weight-loss effort. Also, they can watch for any problems that might come up.

  • Make your child's effort a family affair. Children lose weight fastest when their parents also eat healthy foods and exercise. Doing it together can make it seem less like a chore. Instead, it becomes a way of life.

  • Help your child make changes in what he or she eats. For example:

  • Make sure healthy snacks are always available.

  • Let your child (and any other children in your family) help plan meals. Get them involved in food shopping, too.

  • Eat more home-cooked meals as a family. Try to eat 5 or 6 meals together each week. Eating together helps everyone eat better.

  • Do not force your child to eat everything on his or her plate. Let your child know it is okay to stop when he or she no longer feels hungry.

  • Find ways to reward your child that do not involve food.

  • If your child is in a daycare or after-school program, talk to the provider about increasing physical activity.

  • Limit your child's time in front of the television, the computer, and video game systems to less than 2 hours a day. Try not to have any of these things in the child's bedroom.

  • Join a support group. Find one that includes other families with obese children who are trying to make healthy changes. Ask your child's healthcare provider for suggestions.

PROGNOSIS

  • For most children, changes in diet and physical activity can successfully treat obesity. It may help to work with specialists.

  • A nutritionist or dietitian can help with an eating plan. It is important to pick healthy foods that your child will like.

  • An exercise specialist can help come up with helpful physical activities. Again, it helps if your child enjoys them.

  • Your child may need to lose a lot of weight. Even so, weight loss should be slow and steady. Children younger than 5 should lose no more than 1 lb (0.45 kg) each month. Older children should lose no more than 1 to 2 lb (0.45 to 0.9 kg) a week. This protects the child's health. Losing weight at a slow and steady pace also helps keep the weight off.

SEEK MEDICAL CARE IF:

  • You have questions about any changes that have been recommended.

  • Your child shows symptoms that might be tied to obesity, such as:

  • Depression, or other emotional problems.

  • Trouble sleeping.

  • Joint pain.

  • Skin problems.

  • Trouble in social situations.

  • The child has been making the recommended changes but is not losing weight.