Obesity is a serious medical epidemic that is affecting children and adolescents of current generation. These young people are much more at risk because extra pounds in kids are more detrimental to their health than gaining excess weight in adult life. Obese children and adolescentsare more likely to become obese as adults. Also earlier in lifea child gets obese, severe is his obesity during adult life. Obesity also makes them prone to cardiovascular diseases, high blood pressure, high cholesterol, type 2 diabetes, gall stones which were previously considered adult diseases.
Is my child obese?
BMI is the most practical measure to determine overweight and obesity (BMI is calculated from the weight and height of the child using standard formulae). Although BMI does not measure body fat, it is a reliable indicator. BMI for children are age and sex specific. Then the BMI is trnslated in to percentile using BMI for age growth charts for boys and girls. 85th to 95th percentile is considered overweight and obesity is being equal or more than 95th percentile.
You can calculate your kid's BMI and percentile here.
Why is my child overweight/obese?
By far, the most important cause of obesity is intake of calories that is consistently more than the energy spent.
Genetic factors:
It has long been recognised that obesity runs in families. Weight of the mother and obesity in parents and other family members are known risk factors. But recent and sudden increase in incidence of obesity in the current generation suggests that changes in nongenetic factors are more important.
Social factors:
Obesity is more common in low socioeconomic groups. Lack of time for cooking, lack of access to healthy food, ignorance about healthy food choice, lack of space and time for physical activity, food insecurity- all appear to contribute to this.
Behavioural factors:
Parenting behaviour that decides food habits of the family, feeding pattern of infants(breastfeeding), concern for a healthy life style, eating out, physical activity , having family meals - all go a long way in deciding child's food habit and likelihood for obesity. Stress in the family can cause some kids to overfeed as a coping strategy. High risk behaviours like smoking, alcohol use and early sex experimentation are associated with poor dietary and health attitudes.
Environmental factors :
The overall decline in physical activity over the generations combined with the availability of cheap, energy dense food and sweetened beverages can be singled out as a leading risk factor. The availability of gadgets that encourage children to watch tv or play video games rather than engage in play or physical activity, the sedentary life style where physical activity is not part of social life can cause kids to burn less energy . This when combined with a constant access to high calorie food predispose to obesity.
Some medical conditions like Cushing's disease, hypothyroidism and genetic disorders like Prader -Willi, Cohen's syndrome, Bardet-Biedl syndrome are known to be associated with obesity.
Why should I be concerned?
Obesity in kids have many immediate health consequences. Also as they are likely to grow in to obese adults they are prone to weight related health problems in adulthood.
Obese children are more likely to suffer from
1. High blood pressure.
2. High cholesterol.
3. Impaired glucose tolerance that predispose to Diabetes.
4. Breathing problems including Asthma.
5. Sleep problems including Sleep Apnoea which is involuntary stopping of breathing for few seconds during sleep.
6. Type 2 Diabetes- More commonly seen in obese kids and teens. Earlier onset may result in advanced complications like kidney problems and heart problems. occuring in early adulthood.
7. Obesity puts an enormous stress on the young skeletal system resulting in bone and joint problems.
8. Obese children attain puberty earlier than peers resulting in psychological issues. Menstrual irregularities are common in obese girls.
9. Liver complications.
10. Psychosocial complications: Obese kids and adolescents are often targets of bullying and social discrimination. Such social stigmatisation can put enormous stress on their young minds which can lead on to low self image. Low self esteem can hinder their social functioning and academic performance. Sometimes the negative images of obesity is so strong that teenagers often impose calorie restriction on themselves serious enough to cause pubertal delay and growth failure. For most children the emotional trauma often persists in to adulthood.
What can my family and I do to encourage healthy weight?
Remember that the goal is to reduce the rate of weight gain and allowing your child to grow in to the pounds that he/ she has accumlated. Children and adolescents must not be placed in a weight reduction diet without the advice or monitoring by a health care professional. Remember that obesity does not ocur overnight, it takes years of eating in excess of required energy to build up the extra weight. So the emphasis must be clearly on a healthy life style which includes making smart food choices and encouraging them to engage in appropriate amount of physical activity. It is important for parents and caregivers to be positive role models.
Tips for encouraging healthy food choices:
We must make sure that the energy provided by the child's diet is sufficient to support growth and development and to maintain desirable body weight. Choose a variety of foods to meet the recommended dietary allowances for all nutrients including iron and calcium for children and adolescents.
1. Use whole grain cereals and products instead of refined grain products.
2. Serve a variety of fruits and vegetables daily. Include seasonal as well as as exotic ones to improve variety.
3. Limit juice intake. Look for juices that has 100% juice and no added sugar.
4. Serve fat free or low fat milk and dairy products.
5. Include lean meat, poultry, fish , lentils and pulses as source of protein.
6. Aviod calorie rich, high fat, high sugar, salty or deep fried snacks. Avoid sweetened beverages.
Tips for healthy eating habits
Start in infancy:
1.Breastfeed exclusively for first 6 months and for atleast 12 months. Breastdfeeding is found to be protective against overweight in later childhood.
2. Delay introduction of juice and restict juice intake in young children.
3. Avoid overfeeding infants and young children. Left to themselves they are found to self regulate their caloric intake to meet their needs.
4. Introduce them to healthy food and keep offering them even if children refuse them initially. Avoid giving them foods that provide empty calories without any nutritional value.
Older kids:
1. Stock up your fridge and kitchen shelves with fresh vegetables, fruits , whole grain products and health snacks.
2. Avoid bringing home high calorie foods including sweetened beverages.
3. Learn to read food labels and identify healthy food choices. Make kids get actively involved in grocery shopping and in making such choices.
4. Downsize your portion levels reasonably to appropriate levels.
5. Encourage children to drink plenty of water.
6. Minimise eating out, particularly in fast food joints.
7. Actively involve children in cooking. Stick to healthy cooking- avoid using too much oil/fat and deep frying.
8. Make meal time a family time. Switch off TV while having meals.
9. Encourage kids to eat slowly, this gives time for brain to track sugar level and send satiety signals.
10. Use smaller plates and narrow, tall cups.
11. Never use food as reward or withold food as punishment.
12. Set an example by eating healthy foods and exercising to maintain normal weight.
13. If enough healthy choices are not available at school, offer healthy lunch and snacks for kids to take to school.
Improve physical activity:
Regular physical activity has many benefits other than weight management alone which includes reducing stress levels, improving social interaction, improving sleep, reducing blood pressure and strengthening muscles and bones.
1. Be active yourself. Kids tend to copy the adults in the family. Being active may stimulate and establish their interests in physical activity.
2. Do fun activities together as a family- Go for a walk, enjoy hiking, swimming, biking with the kids.
3. Do not make exercise as a chore. Insted make it enjoyable by letting children choose the activity or sports the are interested in.
4. If possible walk them to school instead of driving.
5.Include their peers in the activities.
6. Encourage toddlers to walk rather than pushing them around in strollers.
7. Encourage young kids to play games like jumping rope, playing hide and seek that makes them run about instead of sedentary play.
8. Encourage kids to join extra curricular activities and sports clubs at school. Offer help by taking them over and showing interest in their activities.
9.Emphasise on physical activty to the management and administrative staff of schools and child care centres.
Limit screen time:
1. Switch off the TV. Make an aggrement that the family has no more than 2 hours(or less) of TV viewing.
2. Do not watch TV during meal time.
3. Do not have TV in the bedroom (yours/ child's).
4. Watch programmes instead of watching TV. Recorded programmes also help you to fast forward commercials.
5. Try to avoid letting a toddler watch Tv alone. Watch with him and explain to him the difference between programmes and commercials.
6.Avoid video games or regulate the time they play video games. Encourage them to do yoga or exercycling while watching TV.
My child is overweight. How can I support him/her?
The role of parents are crucial in helping obese children to cope with their problems and help them reach and maintain their optimum weight. In addition to the above mentioned strategies,
1. Build your child's self esteem. Explore their field of interests and encourage them to put on their best performance.
2.Make them feel loved and appreciated.
3. Discuss with them about their health issues and interventions in a blame free, non judgemental manner.
4. Plan realistic goals and celebrate small successes.
5. Emphasise on the importance of healthy eating and phsical activity without focussing on the weight issue.
6. Avoid putting too much pressure on your kid regarding his weight issue.
7. Support them and work with them to cope with bullying, name calling and discrimination.
8. Learn to identify early symptoms of depression and deal with it promptly.
9. Be patient, be optimistic and stay positive.
Is my child obese?
BMI is the most practical measure to determine overweight and obesity (BMI is calculated from the weight and height of the child using standard formulae). Although BMI does not measure body fat, it is a reliable indicator. BMI for children are age and sex specific. Then the BMI is trnslated in to percentile using BMI for age growth charts for boys and girls. 85th to 95th percentile is considered overweight and obesity is being equal or more than 95th percentile.
You can calculate your kid's BMI and percentile here.
Why is my child overweight/obese?
By far, the most important cause of obesity is intake of calories that is consistently more than the energy spent.
Genetic factors:
It has long been recognised that obesity runs in families. Weight of the mother and obesity in parents and other family members are known risk factors. But recent and sudden increase in incidence of obesity in the current generation suggests that changes in nongenetic factors are more important.
Social factors:
Obesity is more common in low socioeconomic groups. Lack of time for cooking, lack of access to healthy food, ignorance about healthy food choice, lack of space and time for physical activity, food insecurity- all appear to contribute to this.
Behavioural factors:
Parenting behaviour that decides food habits of the family, feeding pattern of infants(breastfeeding), concern for a healthy life style, eating out, physical activity , having family meals - all go a long way in deciding child's food habit and likelihood for obesity. Stress in the family can cause some kids to overfeed as a coping strategy. High risk behaviours like smoking, alcohol use and early sex experimentation are associated with poor dietary and health attitudes.
Environmental factors :
The overall decline in physical activity over the generations combined with the availability of cheap, energy dense food and sweetened beverages can be singled out as a leading risk factor. The availability of gadgets that encourage children to watch tv or play video games rather than engage in play or physical activity, the sedentary life style where physical activity is not part of social life can cause kids to burn less energy . This when combined with a constant access to high calorie food predispose to obesity.
Some medical conditions like Cushing's disease, hypothyroidism and genetic disorders like Prader -Willi, Cohen's syndrome, Bardet-Biedl syndrome are known to be associated with obesity.
Why should I be concerned?
Obesity in kids have many immediate health consequences. Also as they are likely to grow in to obese adults they are prone to weight related health problems in adulthood.
Obese children are more likely to suffer from
1. High blood pressure.
2. High cholesterol.
3. Impaired glucose tolerance that predispose to Diabetes.
4. Breathing problems including Asthma.
5. Sleep problems including Sleep Apnoea which is involuntary stopping of breathing for few seconds during sleep.
6. Type 2 Diabetes- More commonly seen in obese kids and teens. Earlier onset may result in advanced complications like kidney problems and heart problems. occuring in early adulthood.
7. Obesity puts an enormous stress on the young skeletal system resulting in bone and joint problems.
8. Obese children attain puberty earlier than peers resulting in psychological issues. Menstrual irregularities are common in obese girls.
9. Liver complications.
10. Psychosocial complications: Obese kids and adolescents are often targets of bullying and social discrimination. Such social stigmatisation can put enormous stress on their young minds which can lead on to low self image. Low self esteem can hinder their social functioning and academic performance. Sometimes the negative images of obesity is so strong that teenagers often impose calorie restriction on themselves serious enough to cause pubertal delay and growth failure. For most children the emotional trauma often persists in to adulthood.
What can my family and I do to encourage healthy weight?
Remember that the goal is to reduce the rate of weight gain and allowing your child to grow in to the pounds that he/ she has accumlated. Children and adolescents must not be placed in a weight reduction diet without the advice or monitoring by a health care professional. Remember that obesity does not ocur overnight, it takes years of eating in excess of required energy to build up the extra weight. So the emphasis must be clearly on a healthy life style which includes making smart food choices and encouraging them to engage in appropriate amount of physical activity. It is important for parents and caregivers to be positive role models.
Tips for encouraging healthy food choices:
We must make sure that the energy provided by the child's diet is sufficient to support growth and development and to maintain desirable body weight. Choose a variety of foods to meet the recommended dietary allowances for all nutrients including iron and calcium for children and adolescents.
1. Use whole grain cereals and products instead of refined grain products.
2. Serve a variety of fruits and vegetables daily. Include seasonal as well as as exotic ones to improve variety.
3. Limit juice intake. Look for juices that has 100% juice and no added sugar.
4. Serve fat free or low fat milk and dairy products.
5. Include lean meat, poultry, fish , lentils and pulses as source of protein.
6. Aviod calorie rich, high fat, high sugar, salty or deep fried snacks. Avoid sweetened beverages.
Tips for healthy eating habits
Start in infancy:
1.Breastfeed exclusively for first 6 months and for atleast 12 months. Breastdfeeding is found to be protective against overweight in later childhood.
2. Delay introduction of juice and restict juice intake in young children.
3. Avoid overfeeding infants and young children. Left to themselves they are found to self regulate their caloric intake to meet their needs.
4. Introduce them to healthy food and keep offering them even if children refuse them initially. Avoid giving them foods that provide empty calories without any nutritional value.
Older kids:
1. Stock up your fridge and kitchen shelves with fresh vegetables, fruits , whole grain products and health snacks.
2. Avoid bringing home high calorie foods including sweetened beverages.
3. Learn to read food labels and identify healthy food choices. Make kids get actively involved in grocery shopping and in making such choices.
4. Downsize your portion levels reasonably to appropriate levels.
5. Encourage children to drink plenty of water.
6. Minimise eating out, particularly in fast food joints.
7. Actively involve children in cooking. Stick to healthy cooking- avoid using too much oil/fat and deep frying.
8. Make meal time a family time. Switch off TV while having meals.
9. Encourage kids to eat slowly, this gives time for brain to track sugar level and send satiety signals.
10. Use smaller plates and narrow, tall cups.
11. Never use food as reward or withold food as punishment.
12. Set an example by eating healthy foods and exercising to maintain normal weight.
13. If enough healthy choices are not available at school, offer healthy lunch and snacks for kids to take to school.
Improve physical activity:
Regular physical activity has many benefits other than weight management alone which includes reducing stress levels, improving social interaction, improving sleep, reducing blood pressure and strengthening muscles and bones.
1. Be active yourself. Kids tend to copy the adults in the family. Being active may stimulate and establish their interests in physical activity.
2. Do fun activities together as a family- Go for a walk, enjoy hiking, swimming, biking with the kids.
3. Do not make exercise as a chore. Insted make it enjoyable by letting children choose the activity or sports the are interested in.
4. If possible walk them to school instead of driving.
5.Include their peers in the activities.
6. Encourage toddlers to walk rather than pushing them around in strollers.
7. Encourage young kids to play games like jumping rope, playing hide and seek that makes them run about instead of sedentary play.
8. Encourage kids to join extra curricular activities and sports clubs at school. Offer help by taking them over and showing interest in their activities.
9.Emphasise on physical activty to the management and administrative staff of schools and child care centres.
Limit screen time:
1. Switch off the TV. Make an aggrement that the family has no more than 2 hours(or less) of TV viewing.
2. Do not watch TV during meal time.
3. Do not have TV in the bedroom (yours/ child's).
4. Watch programmes instead of watching TV. Recorded programmes also help you to fast forward commercials.
5. Try to avoid letting a toddler watch Tv alone. Watch with him and explain to him the difference between programmes and commercials.
6.Avoid video games or regulate the time they play video games. Encourage them to do yoga or exercycling while watching TV.
My child is overweight. How can I support him/her?
The role of parents are crucial in helping obese children to cope with their problems and help them reach and maintain their optimum weight. In addition to the above mentioned strategies,
1. Build your child's self esteem. Explore their field of interests and encourage them to put on their best performance.
2.Make them feel loved and appreciated.
3. Discuss with them about their health issues and interventions in a blame free, non judgemental manner.
4. Plan realistic goals and celebrate small successes.
5. Emphasise on the importance of healthy eating and phsical activity without focussing on the weight issue.
6. Avoid putting too much pressure on your kid regarding his weight issue.
7. Support them and work with them to cope with bullying, name calling and discrimination.
8. Learn to identify early symptoms of depression and deal with it promptly.
9. Be patient, be optimistic and stay positive.
10.Use the help and support of resources available.Consult your Paediatrician or dietician when in doubt.
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