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May 27, 2024

Childhood Obesity: Understanding Risks and Prevention Strategies

Childhood obesity has been one of the primary concerns regarding children’s health of late, thanks to its rising incidence. As per WHO data, 37 million children globally under the age of 5 and 390 million children between the ages of 5 to 19 were overweight in 2022. That’s a concerning number.

This brings the topic into the limelight. In this article, we have broken down the various aspects of childhood obesity including the risk factors.

We have also discussed some useful prevention strategies to ensure you can steer away your child from this complication.

What is Childhood Obesity?

A complex long-term condition, children are termed as obese when they are above their healthy weight as per their age, height and sex assigned at birth. Medically speaking when children aged 2 years and older are above the 95th percentile of body mass index (BMI) for their age, they are said to be obese in childhood. It is important to note that BMI for children is different from those of adults. For children, BMI is specific to their age and sex, as their body changes with age. You can find the BMI chart for children from your healthcare provider.

Being obese as a child can have a lifelong impact. However, it is important to remember that being obese as a child does not necessarily mean the person will be obese as an adult.

5 Concerning Facts

  1. Obesity in children and adolescents has been on the rise for decades. It is estimated to be one of the most serious global public health challenges of the 21st century.
  2. The percentage of children suffering from weight issues has increased by almost 50% in the last two decades.
  3. Almost every country in the world is affected by this issue.
  4. 75-80% of adolescents who are obese continue to be obese adults.
  5. The prevalence of childhood obesity in Malaysia hit a record high of 14.8% in 2019.

Symptoms of Childhood Obesity

Most children carry a few extra pounds. But that doesn’t mean they are overweight. Some children have larger-than-average body frames. Moreover, children usually carry different levels of body fat at different stages of their development. So understanding whether your child’s excess fat is a cause for concern or not can be difficult.

This is where the body mass index (BMI) comes into play. BMI is a guideline of weight in relation to height, that is used to measure overweight and obesity. Paediatricians usually use BMI and growth charts to determine whether a child’s weight is a matter of concern or not. They may conduct other tests to figure out if a child’s weight can lead to other health problems.

Causes of Childhood Obesity

Many factors contribute to the development of childhood obesity, however, the main reason is the same. Every child needs a certain amount of calories for proper development. However, when they take in more calories than required, the body stores the extra calories as body fat.

Every child is unique. Hence, every child’s body has its own way of using the energy from the calories consumed. Some children are at a greater risk of gaining weight than others. Most importantly, obesity is not a result of a lack of willpower or laziness.

The primary causes of obesity are:

1. Genetics

A family history of obesity increases the likelihood of a child becoming obese. When the biological parents or siblings of a child are obese, the child is more likely to develop the condition. However, not all children with a family history of obesity develop the condition.

It has also been observed that children who face racism or violence are more likely to develop obesity. Certain other genetic factors include

  • Gestational diabetes i.e. high blood sugar during pregnancy
  • Pre-pregnancy obesity in either or both biological parents
  • Excessive weight gain of the mother during pregnancy.

2. Home and family environment factors

Family and home environment have a significant influence on a child’s weight gain. These factors include:

  • Consuming sugar-sweetened beverages
  • Eating larger portion sizes
  • Types of food offered to the children
  • Increased consumption of highly processed foods
  • Dining out frequently instead of cooking meals at home
  • Higher screen time
  • Lack of physical activity
  • Exposure to second-hand smoke
  • Lack of quality sleep
  • Traumatic experiences as a child

3. Social Determinants of Health

The conditions under which a child is born, lives, works, plays and learns are social determinants of health. These can have a vast impact on a child’s health, and in turn, their weight. The living area of the family, proximity to unhealthy food options, and food and drinks served at schools and daycare centres affect a child’s eating patterns. These factors also influence the amount of physical activity a child gets every day.

Other socioeconomic factors can also contribute to childhood obesity such as:

  • Proximity to fast food
  • Access to transportation, whether a child walks to nearby places or uses transportation methods instead.
  • Accessibility to healthy food options and their cost.
  • The child’s support system
  • Access to recreational facilities such as parks in one’s community.

4. Other Conditions

In some rare cases, childhood obesity can be triggered by certain health conditions. Hormonal imbalances such as hypothyroidism, growth hormone deficiency, hypothalamic tumour, Cushing syndrome and others.

Sometimes rare genetic conditions can also be contributing factors. Certain medications such as corticosteroids, and second-generation antipsychotics can increase the risk of overweight and obesity in children as well.

Complications associated with Obesity in Children

Higher weight can lead to a range of complications in everyone, more so in children. Here are some of the primary ones:

Physical Complications Due to Childhood Obesity

Childhood obesity increases the risk of:

Pre-diabetes, type 2 diabetes and insulin resistance: Probably the most important risk of obesity in children is the likelihood of development of diabetes and insulin-related issues as a child or later as an adult.

  • Prediabetes is when the blood sugar levels are on the higher side, but not high enough to be type 2 diabetes.
  • In type 2 diabetes, the body cannot use insulin properly.
  • With insulin resistance, the body does not respond to insulin as it should.

High cholesterol and high blood pressure: A poor diet can lead to the buildup of plaques in the arteries, causing the arteries to narrow and harden. This, in turn, increases the risk of stroke and heart attack later in life.

Breathing issues: It has been observed that children who are obese often suffer from asthma. Obesity also increases the likelihood of the development of obstructive sleep apnea, a serious disorder where a child’s breathing stops and starts repeatedly during sleep.

Joint pain: The extra weight causes extra stress on the hips and knees, leading to pain in the hips, knees and back. This can lead to injuries as well.

Non-alcoholic fatty liver disease: This is a disorder where fatty deposits build up in the liver. This usually has no symptoms but can lead to scarring and damage to the liver.

Emotional and Social Complications of Childhood Obesity

The emotional and social issues faced by obese children should never be ignored. Children who are obese are often teased and bullied by their peers. This can lead to a loss of self-esteem, anxiety and depression. Certain children face social isolation as well.

This trauma and emotional distress can sometimes continue well into adulthood.

How can you prevent your child from getting obese?

This question can not be answered in a few words, because honestly speaking there’s no simple method to prevent childhood obesity. While certain contributing factors such as healthy eating and physical activity are in your control, some are not such as genetic predisposition. However, as a parent, the most important step you can take is to establish healthy eating habits and physical activity. Let’s take a closer look at these two:

Eating Healthy

The earlier your child picks up the habit of choosing healthier eating options, the better. If you are unsure about how to go about it, you can seek help from a qualified nutritionist. Making your child aware of sugar and its effect on health can work wonders in ensuring they avoid sugar-laden food and drink items as much as possible. Here are a few steps you can take as a parent:

  • Cook meals at home: Home-cooked meals are a great way to ensure your child gets the right kind of nutrition from quality ingredients. This will also ensure that the entire family avoids fast food, which has less nutritional value and more fats and calories.
  • Focus on fruits and vegetables: While shopping for groceries, focus more on fruits and vegetables and less on convenience food such as prepared meals, cookies and chips, which are laden with sugar and fat.
  • Cut down on sweetened beverages: In Malaysia, we have a culture of consuming drinks with every meal, and more often than not these drinks are laden with sugar, be it milo or a simple ice limau. It makes your child feel too full to eat healthier food too.
  • Have family time during meals: Make mealtimes a time for the family to bond. This is a great way to take your child off screens be it TV or mobile. Eating at the table also leads to more awareness about what is being eaten, taking the time to eat, and chewing the food properly.
  • Pay attention to portion sizes: As a parent, you are responsible for the portion sizes your child eats. A child isn’t required to eat as much as an adult. Allow your child to eat till they feel full, don’t force them to eat everything on the plate. It’s important to remember this when you eat out as well.

Physical Activity

Another important aspect of preventing childhood obesity or managing the condition in a child who already has it is physical activity. Physical activity not only burns calories but also strengthens muscles and bones as well as improves the child’s sleep quality.

Childhood is the best time to instil a mentality towards fitness in children. In most cases, this ensures that they remain fit as adults too. Here are a few things you can do to improve your child’s activity level:

Limit screen time

Screen time is an inevitable evil now. Although it is difficult to limit screen time for educational activities, limit recreational screen time to not more than two hours a day.

This includes exposure to TV, smartphones, tablets and computers. Children below 2 should not have any screen time at all.

Focus on activity, not exercise

All children should be moderately to vigorously active at least one hour per day. It is not necessary to have a structured program, it can be free play activities such as jump rope or hide and seek. Such activities are great to burn calories. Finding activities that your child likes is the key. Experiment with various activities to find what your child likes and then schedule such activities one to two times a week.

Support is the Key

Children need immense support from their parents in their journey towards better health. It is most important to shower them with love and care and assure them that you are in this together. Your child’s image of themselves is guided to a great extent by your image towards them. They will feel good about themselves if you accept them at any weight. Avoid placing any blame on your child, yourself or others.

Another important thing is to talk about your child’s weight in a non-judgemental manner. Have open discussions with your child so that they can share their concerns with you freely. Work gradually towards changing their eating habits and physical activity, avoid taking any rash decisions. Focus on developing healthy habits together as a family rather than singling your child out. This will not only improve your child’s morale, it will improve the health of others in the family too.

Require expert advice or specialized treatment? Please arrange an appointment with our specialist.

Nor Syafiqah Zainal
Clinical Dietitian

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