FFFObesity In Children And Teens

No. 79; October 2023

The problem of childhood obesity in the United States has grown considerably in recent years. Approximately 14.7 million, or 19.7 percent, of children and adolescents are obese. Obesity is a complex medical condition and is difficult to treat. Overweight children are much more likely to become overweight adults, and obesity can lead to diabetes, heart disease, and other health challenges. Given these challenges everyone, including doctors and families, wants to find ways to better help children and adolescents who live with obesity. 

What is obesity?

Obesity is currently defined by someone’s height and weight. If a child’s Body Mass Index (BMI; a number calculated from height and weight) is more than 95th percentile for their age, then that is defined as obesity. Obesity most commonly begins between the ages of 5 and 6, or during adolescence. Studies have shown that a child who is obese between the ages of 10 and 13 has an 80 percent chance of becoming an obese adult. 

What causes obesity?

The causes of obesity are complex and include genetic, biological, behavioral and cultural factors. Obesity occurs when a person eats more calories than the body burns. If one parent is obese, there is a 50 percent chance that his or her child will also be obese. However, when both parents are obese, their children have an 80 percent chance of being obese. Although certain medical disorders can cause obesity, less than 1 percent of all obesity is caused by physical problems. Obesity in childhood and adolescence can be related to: 

  • Eating habits
  • Lack of physical activity or exercise (i.e., couch potato kids)
  • Genetics or family history of obesity
  • Not enough sleep
  • Living conditions (like not having healthy food options, not having a place to play actively) 
  • Medical illnesses (endocrine, neurological problems) 
  • Medications (steroids, some psychiatric medications
  • Stressful life events or changes (separations, divorce, moves, deaths, abuse
  • Family and peer problems 
  • Low self-esteem 
  • Depression or other emotional problems 

What are risks and complications of obesity?

There are many risks and complications with obesity. Physical consequences include:

  • Increased risk of heart disease 
  • High blood pressure 
  • Diabetes 
  • Breathing problems 
  • Trouble sleeping 
  • Joint pain 
  • Hormonal changes 

Child and adolescent obesity is also associated with an increased risk of emotional problems. Teens with weight problems tend to have much lower self-esteem. Depression, anxiety, and obsessive compulsive disorder can also occur. 

How can obesity be managed and treated?

Obese children need a thorough medical evaluation by a pediatrician or family physician to consider the possibility of a physical cause. In the absence of a physical disorder, the doctor may recommend starting by adjusting the child’s eating habits and increasing the level of physical activity. Since obesity often affects more than one family member, making healthy eating and regular exercise a family activity can improve the chances of successful weight control for the child or adolescent. 

Ways to manage obesity in children and adolescents include:

  • Ask for professional help 
  • Meet with a nutritionist to help adjust eating habits 
  • Focus on healthy habits as a family unit 
  • Give lots of positive encouragement and choose positive words to reduce the risk of shame 
  • Make sure your child is getting enough sleep 
  • Plan meals and make different selections 
  • Find out what your child eats at school
  • Ask for help selecting a variety of foods, if money is tight 
  • Increase physical activity (especially active playtime for children or sports) 
  • Do not use food as a reward 
  • Attend a support group (e.g., Overeaters Anonymous)

Obesity frequently becomes a lifelong issue. The reason obesity becomes a chronic or lifelong issue is because children, adolescents, and families have to learn all new habits, which is hard for anyone. New eating and activity habits have to become part of everyday life. There can also be a lot of outside factors including the cost of food and not living in a safe environment that can make it even harder to overcome obesity. Parents of an obese child can improve their child's self-esteem by emphasizing their strengths and positive qualities rather than just focusing on their weight. 

When a child or adolescent with obesity also has emotional problems, a child and adolescent psychiatrist can work with the child's family physician to develop a comprehensive treatment plan. Such a plan would include reasonable weight loss goals, dietary and physical activity management, behavior modification, and family involvement.