A child is considered obese when he/she has an increase in body fat that goes beyond the normal level (above the 97% percentile curve of same-sex peers; this corresponds to a BMI of ≥ 30).
At first, being overweight does not cause any discomfort. Children get used to the extra pounds. But over time, your child appears to you to be “chubby” or lies above the normal range of the corresponding growth curves.
Your child then starts gaining weight relatively quickly and there are additional complaints such as listlessness or shortness of breath when you indulge him/her in physical activities.(1)
Lifestyle Changes For Childhood Obesity
In some rare cases, childhood obesity is associated with medical conditions such as hormonal imbalances and hereditary diseases. Whatever the cause, the primary focus of treating and preventing childhood obesity revolves around reducing and maintaining a healthy weight.
Therefore, lifestyle changes can be an effective way to manage childhood obesity. A lack of exercise in children is often has nothing to do with conscious decisions but is at least partly due to changes in the living environment. The fact is that children today are more isolated and lonelier with less area available for playing (fewer play partners in the immediate vicinity, friends cannot be reached on foot, the street is no longer a play area). There are also no important movement routines for children (e.g. going to school). At the same time, attractive but sedentary leisure activities such as television, cell phones, and computer games are available.
It is of little help to children on a diet or to cut out certain foods. For children who are still growing, it is usually sufficient to maintain body weight, improve physical activity and nutrition, and prevent complications from being overweight and obese.
Let your pediatrician and nutritionist decide your child’s diet. Give your child less processed food and more fibers (fruits and vegetables) and encourage him/her to have outdoor activities and playing outdoor games.(4)(5)
The Development Of The Fat Body In Children
Children start their lives with a fat mass of around 11% of their body weight, which increases to 25% by the end of the first year (Baby fat). This fat gain is genetically programmed.
The subsequent phase of the regression of the adipose tissue is also programmed, up to the age of about 5½ years. At the end of kindergarten, the BMI reached its minimum – at this age, children should be slim. Only at the end of the 6th year of life does the fat mass slowly increase again (so-called adiposity rebound) and then increase with puberty – more pronounced in girls.(2)
Obesity arises – even in children – if the energy balance is positive in the long run. This means that the child consumes more energy on average each day than it burns.
There are small differences: Eating or drinking an additional 100 calories a day, that’s just 100g of yogurt. This excess is reflected in an additional 10 kg of body weight in a year.(3) But how does this positive energy balance arise?
Risk Factors For Obesity
For most overweight children, various unfavorable circumstances come together, so-called risk factors. These include:
Inheritance: Children whose parents are also overweight are at high risk of becoming overweight or obese. It is not only the genes that work but also usually social factors that affect the child through the parents.
Early Initiation: The overweight pattern of your children may be traced back to its initiation in the womb.
The Prenatal Programming Of The Metabolism Is Likely To Play A Role: Children who are undersupplied in the womb switch their metabolism to the economy mode in the long term. Because of this economical consumption of calories, they are more often overweight in the womb.
Maternal smoking during pregnancy also significantly increases the later risk of obesity.
Baby Food: There are indications that feeding with baby milk favors overweight. The bodyweight of the bottle-fed children is up to 650 g higher than breastfed children at the end of the first year of life. This is explained by the fact that children who are not or only partially breastfed consume 20% more calories compared to fully breastfed children. Breastfed children are not only less at risk of later overweight in childhood, but they are also less prone to allergies.
Lack of exercise and eating behavior play major roles in the development of childhood obesity. Compared to adults, the lack of exercise plays a greater role in the development of overweight in children than overeating.
- Gurnani M, Birken C, Hamilton J. Childhood obesity: causes, consequences, and management. Pediatric Clinics. 2015;62(4):821-840.
- Freemark MS. Pediatric obesity: Etiology, pathogenesis and treatment. Springer; 2018.
- Williams EP, Mesidor M, Winters K, Dubbert PM, Wyatt SB. Overweight and obesity: prevalence, consequences, and causes of a growing public health problem. Current obesity reports. 2015;4(3):363-370.
- Puhl R, Suh Y. Health consequences of weight stigma: implications for obesity prevention and treatment. Current obesity reports. 2015;4(2):182-190.
- Wadden TA, Bray GA. Handbook of obesity treatment. Guilford Publications; 2018.