Obesity in children

Behind the Headlines

Monday October 1 2007

Obesity levels have been increasing rapidly worldwide for the past two decades. The World Health Organization (WHO) has labeled it a global epidemic and a report released in 2006, revealed that for the first time ever, the number of overweight people in the world outnumber the world’s hungry.

The population of the UK is not going against the trend. The WHO has estimated the UK to be among the most overweight countries in the world, and according to government figures, the UK is now the fattest country in Europe with one in four adults obese.

 

The next generation

Obesity levels continue to rise within upcoming generations and if current trends continue, the forecast for the future health of today’s children is bleak. In 2004, the House of Commons health committee reported that this could be the first generation where children die before their parents as a consequence of childhood obesity.

 

Between 1995 and 2005 the proportion of obese children aged 2 to 15 increased from 10.9% to 18% in boys, and from 12 to 18.1% in girls.

The problem is society-wide with almost equal numbers in boys and girls. A popular misconception is that obesity is an issue for poorer people, however a recent study has shown that childhood obesity is also endemic among the middle class.

It has been estimated that if current trends continue, one-fifth of boys and one-third of girls will be obese by 2020.

 

Is your child obese?

Obesity and being overweight are conditions in which a person has an abnormally high amount of body fat. Adults are diagnosed as obese if they have a high Body Mass Index (BMI) score. A BMI measurement is a simple calculation of your height and weight.

 

The accepted method for diagnosing obesity in children is also by measuring BMI, however the calculation is slightly more complex.

This is because children are constantly growing, and there is no static benchmark to measure against, as a child’s BMI will change from birth to adulthood. Therefore, a childs BMI is compared against the population average, and the childs age, sex and height are taken into account.

You can find a BMI calculator for children here.

Another measurement for fatness in children is waist measurement. Adults who have a lot of abdominal fat are known to be at high risk of heart disease, but it has not yet been established what the risks are for children. However, there is increasing evidence that waist measurement is important for predicting long term health problems for children. This is an additional measurement to BMI, and will only be used by a Doctor when they would like additional information about a child's health. 

Both of these techniques can be performed in most GP’s surgeries and are straightforward and quick to do. The results from these tests can be used as important indications for required changes in lifestyle, diet and exercise.

 

What to expect from a visit to your GP

national institute for clinical health and excellence (NICE)suggests that Doctors do the following when they assess and treat a child for being overweight or obese.

 

 

To determine if a child is overweight;
  • The Doctor will use their own judgement to decide when to measure weight and height.
  • They will then perform a BMI calculation which will include age and gender specific information.
  • The Doctor won’t perform a waist circumference measurement routinely, but only sometimes, as this can give some information on the risk of longterm health problems.
  • The findings will then be discussed with the child and family.
To decide on the right course of treatment for a child;
  • The child’s symptoms will be assessed and the underlying causes behind the child being overweight or obese will be investigated.
  • The Doctor will then look at the child’s willingness and motivation to change their behaviour.
  • If the child is obese, the Doctor will try to ascertain if there are signs of any conditions related to obesity (such as hypertension, hyperinsulinaemia, dyslipidaemia, type 2 diabetes, psychosocial dysfunction and exacerbation of asthma) and what the risks are for these conditions developing.
  • They will also try to find out if the child is suffering from any psychological distress such as low self-esteem, or from teasing and bullying.
  • They will then look at the family’s history of being overweight or obese and any conditions related to these, and the child and family’s lifestyle, diet and physical activity.
  • Any environmental, social and family factors that may contribute to being overweight or obese and how successful previous treatment has been will be examined.
  • The childs growth and how far they have gone through puberty all also be taken into account.

Reproduced from: Lightening the load and originally sourced from the National Institute for Health and Clinical Excellence, 2006.

The consequences of child obesity

Obesity in adulthood

  • UK national statistics show a link between obesity and Type 2 diabetes. 80% of people with the disease are either overweight or obese. Obese women are almost 13 times more likely, and obese men nearly 5 times more likely to develop the disease.
  • Around a third of coronary heart disease and stroke and 60% of hypertensive disease in developed countries are due to being overweight estimated the WHO in 2002.
  • An INTERHEART study estimated that 63% of heart attacks in Western Europe were due to abdominal obesity (a high waist to hip ratio). Those with abdominal obesity had over twice the risk of a heart attack compared to those without.
  • The risk of death from cancer is increased by 35% in obese men and 45% in obese women, Cancer Research UK reported in 2003
  • The BMJ published a study showing that people who are obese when they reach middle age have more than a 70% increased risk of dementia 25-30 years later.

More statistics on diet, physical activity, and obesity can be found  here.

In addition to the social and psychological problems associated with obesity, the evidence shows that obese children are at a greater risk of developing a host of serious diseases.

Doctors have reported that they are seeing more cases of obese children suffering from health problems that are normally only seen in adults. These include coronary artery disease, high blood pressure and type 2 diabetes.

The Royal College of Paediatrics and Child Health reported in 2006 that the number of children developing type II diabetes has increased tenfold in the last five years, a figure which they attribute to the soaring numbers of obese children.

Obese children are up to 20% more likely to develop cancer as adults than those of a healthy weight, according to the National Obesity Forum.

Obese children are also more likely to become obese adults and these health problems can develop into serious illnesses such as cardiovascular disease, hypertension and stroke, and cancer. The health problems that were hinted at during childhood will start to show themselves as serious conditions and diseases.

The WHO states “Obesity poses a major risk for serious diet-related noncommunicable diseases, including diabetes mellitus, cardiovascular disease, hypertension and stroke, and certain forms of cancer. Its health consequences range from increased risk of premature death to serious chronic conditions that reduce the overall quality of life.”

 

Advice for parents

The simplest and best way of losing weight and maintaining a good weight is to exercise more and adopt a healthier diet.

 

  • Try to make sure your child eats 5 portions of fruit and vegetables a day. See the 5 a day website for tips.
  • Have a family fruit bowl for a quick snack instead of crisps and sweets.
  • Use encouragement instead of nagging
  • Be firm but offer incentives: 1 treat per week max
  • Try to replace the role junk food has in your child’s life with an activity. If they love going to a fast food restaurant for a special occasion like a birthday, try a water park instead.
  • Get your child interested in a sport that they will enjoy
  • If you can, get your child to walk to school or even just get off the bus one stop early
  • Fix the hours that they can watch TV and play computer games.

For more information on how children can avoid becoming obese, lose weight and become healthier, click here.

Don’t go overboard: use your common sense

One important thing to remember is that despite the scary statistics that we hear in the news, we still need to use our common sense. Most children are prone to having some ‘puppy fat’ which will usually disappear as they get older and their bodies stretch and grow. We undergo more change during these years than at any other time in our lives, and in order to have the right material these developments need, we need to eat sensibly.

Most overweight children don’t need to diet, or even lose weight. To be sure that your child really does need to start taking steps to reign in their weight, you can check the advice here, or you can visit your GP. See the section above for what to expect in the Doctor’s surgery.

Set an example

Finally, it may seem like common sense, but don’t forget that of all the influences that will shape your children throughout their lives, you are one of, if not the biggest. Setting an example will give your child something positive to aspire to and make healthy eating and getting exercise a normal part of daily life. It will also mean that you’re more likely to be around to help out when it’s their turn to worry about their kids!

 

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Edited by NHS Choices