Houston, we have a problem! Not limited to Houston, the United States has a problem. Very simply as a people, we are too fat. Childhood obesity is a serious problem in the United States, putting children and adolescents at risk for a lifetime of poor health, social shamming, and early death. Statistics from the Centers for Disease Control and Prevention (CDC) found between 2017-2020 children age 2-19 years had a prevalence of obesity of 19.7%. That is 1 in 5 children. Obese children are likely to become obese adults. Obese children, particularly obese teenagers, are more likely to have high blood pressure, high cholesterol, type 2 diabetes, sleep apnea, and joint problems to list a few.
It will come as no surprise to most readers that being overweight is not healthy. However many readers and many parents are not aware that they and their children are obese. As a culture we have become accustomed to being overweight, to having our friends and family be overweight. Consider the saying “beauty is in the eye of the beholder”. This expression in various forms has been around for centuries to explain the concept of perception and the interpretation of perception. David Hume, a philosopher, said “beauty in things exists merely in the mind which contemplates them”. Maybe this is why people don’t recognize they are obese.
To be more accurate in the diagnosis of obesity, a screening tool has been developed. It is called Body Mass Index (BMI) which is a number obtained using a person’s weight compared with their height. This screening tool, while imperfect, helps determine obesity when compared to other children of the same age/sex. More information about the calculation is available at cdc.gov/healthyweight/bmi/calculator.htm if you want to check on yourself or your child.
Obesity is a chronic, complex disease and has many contributing factors including too many calories, too little physical activity, not enough sleep and too much screen time. Treatment suggestions include intensive lifestyle changes including dietary, physical activity and behavioral habits. Dietary recommendations include the following: Avoid calorie dense, nutrient poor foods such as sweetened beverages and fast foods. This includes fruit juice. Control portions. Reduce saturated fats for children older than 2 years. Low fat milk and yogurt are rich in calcium and Vitamin D. Increase intake of fiber, fruits, and vegetables. Eat regular meals particularly breakfast and avoid constant “grazing” particularly after school. Many foods can be enjoyed with portion control and attention to the calories. Perhaps the most important part of any meal is the sharing of attention and affection for those sitting around the table.
Unfortunately there is no simple, quick solution and, like New Year’s resolutions, a family’s plan needs to have small achievable changes in lifestyle habits with individual agreement with the plan. Recognizing the seriousness and the difficulties in treatment the American Academy of Pediatrics has recently published Guidelines for Treatment of Obesity. Ask your pediatrician for help. There is no easy fix but professional help is available.
by Sally Robinson, MD Clinical Professor
Keeping Kids Healthy
Published 12/2022
Also See: UTMB Pediatrics - Pediatric Primary Care