Pediatric obesity is a significant problem in the United States. According to the Centers for Disease Control, the number of children who meet criteria for being overweight, which is at or above the 95th percentile on body mass index growth charts, ranges from about 10 percent in infants and toddlers to approximately 18 percent in adolescents and teenagers.

Why is this a concern?

We are concerned about children being overweight because obesity is associated with a number of chronic diseases that are historically associated with adults. For instance, high blood pressure, elevated cholesterol, and type 2 diabetes are now observed with far greater frequency in the pediatric population. This puts these overweight children at increased risk for the early onset of heart disease and other serious health problems.

Isn’t it difficult to assess obesity in children?

As children grow, we obviously expect them to gain weight. Therefore, to assess growth and weight concurrently, we use a measurement called the body mass index. Pediatricians routinely check BMI as part of the standard health evaluation because this is our best tool for assessing whether your child is overweight or obese. The doctor will show you the BMI growth chart, which makes it easy to determine if your child’s BMI is rising and if the growth pattern is cause for concern.
Obesity is related to type 2 diabetes?

Yes, there is a strong association between obesity and the onset of type 2 diabetes (T2DM), a condition that is on the rise in children. The good news, however, is that when you lose weight, you can reverse T2DM. Often the doctor can identify the early indicators of T2DM, such as insulin resistance, and the condition can be prevented.
What can parents do to help children maintain a healthy weight?

The best way to ensure normal weight in your kids is with a healthy diet and daily exercise. The American College of Pediatricians promotes the “5-2-1 Rule” to prevent obesity. The rule stands for five servings of fruits and vegetables, less than two hours of screen time (e.g., computer, TV, video game), and at least one hour of physical activity, each on a daily basis. In addition, it is important that parents serve as healthy role models for their children. If your children learn healthy living habits from you early in childhood these practices are more likely to become habituated later in life.
How can I help if my child is overweight?

Assess the child’s daily activity level. If it is limited, think of fun ways to increase it, such as joining a sports team, going for walks with the family, or just going outside to play. Focus on simple changes in terms of the food you provide. Eliminating juice, soda, and sports drinks can be a big help. Switch to whole-grain foods and be diligent about maintaining healthy portion sizes. Another trick to keep food from becoming a battle is to provide your child with options. For instance, let your child choose what he or she wants to eat, but make both options healthy (e.g., apple vs. orange). So your child doesn’t feel deprived, allow treats in moderation on special occasions.

The changes your pediatrician encourages making with your overweight child are good guidelines for everyone. Importantly, these changes are more likely to take hold if the whole family participates.

Woo is board certified in pediatrics and in pediatric endocrinology. She is on the medical staff at Cayuga Medical Center and can be reached at Northeast Pediatrics and Adolescent Medicine in Ithaca at 257-2188.

By Melissa L. Woo