Childhood obesity affects almost 1 in 5 children. Each September, the Center for Disease Control (CDC) and the American Association of Pediatrics (AAP) work to draw attention to the disease.
Dr. Rushika Conroy, director of Baystate Health’s Comprehensive Pediatric Weight Management Program, answers questions about childhood obesity and shares what parents can do to help their kids stay healthy.
When is a child considered obese?
You can’t just tell a child is obese by looking at them, especially as the child matures and grows.
There have been different ways of measuring obesity.
The Centers for Disease Control defines obesity as being at or above 95th percentile of body mass index (BMI) – when a child’s weight is above the average for their height and age. But BMI does not distinguish between muscle weight and weight from body fat. So, a healthy child who has built up muscle from being physically fit may, by the numbers, inadvertently show up as having obesity.
Try the CDC BMI Calculator
Some researchers have put their focus on percentage body fat – a percentage of at least 25% for males and 30% for females being considered to have obesity.
It’s important to talk to your child’s pediatrician if you’re concerned your child has obesity. They’ll be able to look at your child’s BMI and growth charts to determine if your child is normal weight, underweight, overweight or has obesity.
WHAT ARE THE MAIN CAUSES OF CHILDHOOD OBESITY?
In 95% of cases, obesity is caused by a combination of a strong family history of overweight or obesity, inactivity and not eating a healthy diet.
The National Library of Medicine says it’s a complex issue, since there are so many possible causes, such as:
- Lack of physical activity: Kids these days are generally getting less exercise, as parents worry about safety in their neighborhoods, gym classes are offered less frequently, and kids increase their screen time.
- Medications: Certain medications can cause weight gain.
- Sugary drinks: Sugary drinks, which include juice, are typically not as filling as other drinks, are low in nutrients but high in calories.
- Portion sizes: Over the years, portion sizes in the United States have significantly grown.
- Food as reward: Oftentimes, foods are used as rewards, especially for children. This can promote an unhealthy relationship with food.
The risk of obesity also rises when we don’t have access to healthy and affordable foods.
“Often, cheaper food is less healthy and the foods that are easier to get tend to be energy dense and nutrient poor. We see more people impacted by “food deserts,” which are low-income areas where there is limited access to grocery stores,” Dr. Conroy said.
You can learn more about food deserts and other health disparities in Baystate Health's Community Health Needs Assessment reports.
Is childhood obesity the parents’ fault?
There is a lot of stigma around obesity.
“People often think that it is someone’s fault, that parents can’t make healthy meals at home or can’t stop their kids from eating so much. We need to remember that obesity is a disease. There are multiple components involved in developing it, just as there are multiple components involved in treating it,” Dr. Conroy said.
There is a lot of pressure in childhood to make improvements to health. These changes can do wonders for their health into adulthood. But it isn’t as easy as eating less and exercising more. It is a slow and steady process, and you can see success if you work at it.
WHO IS MOST AT RISK for childhood obesity?
All children are at risk of developing obesity, but those at highest risk include those with:
- At least one parent who suffers from obesity
- Limited ability to be active and/or have access to healthy food choices
- Certain disease states and conditions
A pre-pandemic study found certain races and ethnicities had higher rates of obesity:
- 25.6% among Hispanic children
- 24.2% among non-Hispanic Black children
- 16.1% among non-Hispanic White children
- 8.7% among non-Hispanic Asian children
Older children also have higher rates of obesity:
- 12.7% among 2- to 5-year-olds
- 20.7% among 6- to 11-year-olds
- 22.2% among 12- to 19-year-olds
At what age should you be worried about your child having obesity?
Doctors tend to start worrying about obesity in a child after the age of two years.
“No baby needs to lose weight. In fact, even little kids with obesity are not put on a nutrition regimen to lead to weight loss. In young kids, weight loss can negatively impact their linear growth, so we set goals of maintaining weight and growing. This will lead to a decrease in BMI over time,” Dr. Conroy said.
What are the consequences of childhood obesity?
According to the National Institutes of Health, childhood obesity is associated with an increased risk of health problems including:
- Type 2 diabetes
- Heart disease
- Stroke
- Psychosocial problems
- Depression
- Certain types of cancer later in life
According to some studies, having obesity doesn’t necessarily lower a child’s self-esteem, but it is associated with increased risk of eating disorders.
HAS THE PANDEMIC CONTRIBUTED TO CHILDHOOD OBESITY?
While the pandemic has had a positive impact on some families' eating habits and health, for most, COVID-19 has had a negative impact on the rates of childhood obesity.
Many people are less active and burning fewer calories both because they are moving less during the day (as they are not leaving their homes) and because of decreased access to places where they can be active. In addition, the significant stress that COVID-19 has caused emotional disturbances in both adults and children, which in many leads to emotional eating.
In the beginning of the lockdown, many stocked up on non-perishable food items, which are often processed, nutrient poor, and filled with calories. When you add that all together, you get a lot of kids developing obesity and its complications, including type 2 diabetes.
We are also learning that kids with obesity that develop COVID-19 have worse outcomes from the virus than those who do not suffer from obesity.
Tips for preventing childhood obesity
While some things like genetics may be out of your control, there are some ways you can help your child live a healthy lifestyle.
- Eat Healthy: It may be unrealistic to say your family will never eat fast food or drink soda again. Instead make realistic goals, like finding time to plan healthy meals, sitting at the dinner table as a family, avoiding eating while on the screen, and making healthy snacks available.
- Keep Active: A child doesn’t have to go to the gym every day to have a healthy body. Find age-appropriate ways to keep your child active inside and outside the house.
Make sure to talk to your child’s pediatrician about concerns you may have or lifestyle changes you’re considering.