While all children gain weight as they grow older. However, when those extra pounds are much more than what are needed to support growth and development — doctors term the child as being obese. In fact, doctors no longer find puppy fat cute, instead they say that childhood obesity is a serious medical condition that is often a precurser to even more serious ailments such as diabetes, high blood pressure and high cholesterol.
In adults, a simple formula (the body mass index, or BMI) is used to work out whether a person is the right weight for their height. But BMI alone is not an appropriate measure for children, because they are still growing. Factors such as rate of growth, age and sex, and the BMI of other children of the same age must be taken into account when assessing a child's weight. That is why BMI is best interpreted with the help of a doctor, nurse or dietitian.
Why should I be aware of it?
Child nutrition and obesity are two issues parents can never take for granted. Over the past three decades in the US, the childhood obesity rate has more than doubled for preschool children aged 2-5 years and adolescents aged 12-19 years, and it has more than tripled for children aged 6-11 years .
While most obese infants will not remain so, they are at increased risk of becoming obese children. These children are in turn more likely to become obese adolescents, who are then very likely to remain obese as adults. Evaluation and treatment of obesity in childhood offers the best hope for preventing disease progression with its associated morbidities into adulthood.
All about childhood obesity
A child is obese if their weight is more than 20% higher than the ideal weight for a boy or girl of their age and height. The Institute of Medicine's report on Preventing Obesity in Children defines obese children as those "...children between the ages of 2 and 18 years who have body mass indexes (BMIs) equal to or greater than the 95th percentile of the age- and gender-specific BMI charts developed by the Centers for Disease Control and Prevention (CDC)" 
Although there are some genetic and hormonal causes of childhood obesity, most excess weight is caused by kids eating too much and exercising too little. Children, unlike adults, need extra nutrients and calories to fuel their growth and development. So if they consume the calories needed for daily activities, growth and metabolism, they add pounds in proportion to their growth. But children who eat more calories than needed gain weight beyond what's required to support their growing bodies.
Far less common than lifestyle issues are genetic diseases and hormonal disorders that can predispose a child to obesity. These diseases, such as Prader-Willi syndrome and Cushing's syndrome, affect a very small proportion of children. In the general population, eating and exercise habits play a much larger role.
Many factors — usually working in combination — increase your child's risk of becoming overweight:
- Regular consumption of high-calorie foods, such as junk foods, baked goods and vending machine snacks, contribute to weight gain. High-fat foods are dense in calories. Loading up on soft drinks, candy and desserts also can cause weight gain. Foods and beverages like these are high in sugar and calories.
- Inactivity. Sedentary kids are more likely to gain weight because they don't burn calories through physical activity. Inactive leisure activities, such as watching television or playing video games, contribute to the problem. 
- Genetics. If your child comes from a family of overweight people, he or she may be genetically predisposed to put on excess weight, especially in an environment where high-calorie food is always available and physical activity isn't encouraged.
- Psychological factors. Some children overeat to cope with problems or to deal with emotions, such as stress or boredom. Their parents may have similar tendencies.
- Family factors. Most children don't shop for the family's groceries. Indeed, parents are responsible for putting healthy foods in the kitchen at home and leaving unhealthy foods in the store. You can't blame your kids for being attracted to sweet, salty and fatty foods; after all they taste good. But you can control much of their access to these foods, especially at home.
- Socioeconomic factors. Children from low-income backgrounds are at greater risk of becoming obese. Poverty and obesity often go hand in hand because low-income parents may lack the time and resources to make healthy eating and exercise a family priority.
Childhood obesity and health
As with adults, obesity in childhood causes hypertension, dyslipidaemia, chronic inflammation, increased blood clotting tendency, endothelial dysfunction, and hyperinsulinaemia. This cluster of rrisk factors for heart disease, also known as the insulin resistance syndrome, has been identified in children as young as 5 years of age.
There are also substantial psychosocial consequences of childhood obesity. Obese children are stereotyped as unhealthy, academically unsuccessful, socially inept, unhygienic, and lazy. This results in decreased levels of self esteem and feelings of sadness, loneliness and stress. White girls, who develop a negative body image, are at a greater risk for the subsequent development of eating disorders.
What can I do about it?
Tips for dealing with obese children
When a child becomes obese, a serious attempt to treat it must be made. Here are some easy steps to help an obese child lose weight --
- Set attainable goals for weight loss. A dietitian or doctor would be able to advise on this, but for lay parents, a simple thumbrule is to keep the weight loss goal small, so that the child doesn't become overwhelmed or discouraged. Five to ten pounds is a reasonable first goal, or, if preferred, a rate of one to four pounds per month can be established.
- Dietary management. Getting the child to maintain a food record (diary) periodically is a good idea. The food diary should include not only the type and quantity of food eaten, but also where it was eaten, the time of day, and who else was present.
- Physical activity is necessary to maintain weight loss and to redistribute body fat into muscle. Initial exercise recommendations should be small and exercise levels should be increased slowly, to avoid possible discouragement. A reasonable goal is 20 to 30 minutes of moderate activity per day, in addition to whatever exercise the child gets during the school day.
Tips for behavior modification
- Self-monitoring -- accomplished by food and activity diaries, which help the child become more aware of his or her eating and exercise patterns.
- Nutrition education -- aimed at both the child and the family. It should include the components of a healthy diet and an understanding of food labels and the importance of dietary fiber. The patient should be taught that 3,500 calories equals one pound, that there are nine calories per gram of fat
and only four calories per gram of carbohydrate or protein. Furthermore, 25 percent of the energy from carbohydrates will be used in its conversion and storage as fat in the body.
- Stimulus control -- limiting the amount of fattening foods in the house, eating all meals at the dinner table and at designated times, serving food only once before storing leftovers (no second helpings). Parents should not verbally encourage the child to eat, and the child should not be forced to finish the entire meal.
- Eating behavior -- taking smaller bites, chewing food longer, putting the fork down between bites and leaving some food on the plate when finished.
- Physical activity -- setting up a weekly activity goal, signing a contract to perform the activity with a specific reward for reaching the goal. Family television viewing patterns should be modified as needed.
- Attitude changes -- teaching the child to turn negative self-statements into positive ones, and helping him or her cope with the negative remarks of others.
- Reinforcements and rewards -- providing verbal praise from family members as well as tangible rewards for the child's achieving dietary, activity and weight loss goals. Rewards should be determined with input from the child, and should encourage further physical activity, such as sporting equipment or a trip to the skating rink.
Tips for prevention of childhood obesity
One of the best strategies to combat excess weight in your child is to improve the diet and exercise levels of your entire family. This helps protect the health of your child now and in the future.
When to seek help
Not all children carrying extra pounds are overweight or obese. Some children have larger than average body frames. And children normally carry different amounts of body fat at the various stages of development. So you might not know just by looking at your child if his or her weight is a health concern.
If you're worried that your child is putting on too much weight, talk to his or her doctor or health care provider. He or she can provide a complete weight assessment, taking into account your child's individual history of growth and development, your family's weight-for-height history, and where your child lands on the growth charts. These evaluations help determine if your child's weight is in an unhealthy range.
A Body Mass Index (BMI) can be calculated from measurements of height and weight. Health professionals often use a BMI "growth chart" to help them assess whether a child or adolescent is overweight. A physician will also consider your child or adolescent's age and growth patterns to determine whether his or her weight is healthy.
- ↑ 1.0 1.1 1.2 Childhood Obesity in the United States: Facts and Figures
- ↑ Lancet Article on Child Obesity
- Child Obesity
- All About Obesity