Children with Obesity Tend to Become Adults who are Obese
Body mass index (BMI) is not necessarily an accurate measurement for overweight or obesity, since it does not distinguish lean mass from fat mass. An athlete, for example, may have a high BMI but is does not have obesity because his/her body weight is muscle.
- Normal adult BMI: 18.5 to 24.9
- Overweight adult BMI: 25 to 29.9
- Obesity, stage 1 adult BMI: 30 to 34.9
- Obesity, stage 2 adult BMI: 35 to 39.9
- Obesity, stage 3 adult BMI: Greater than 40
However, a child’s body composition varies as he or she ages. Obesity is instead assessed as an age- and sex-specific percentile for BMI, plotted on a curve, in children and adolescents aged 2 to 19 years. A BMI above the 85th, but lower than the 95th percentile signals overweight; a child with a BMI at or above the 95th percentile is considered to have obesity.
The incidence of overweight and obesity in Americans has seen a sharp increase in the past 30 years.
- Adults: According to survey data from the 2009 Behavioral Risk Factor Surveillance System, the Centers for Disease Control and Prevention (CDC) reported 72 million American adults have obesity, and 2.4 million more adults have obesity than in 2007. Those statistics indicate a serious problem.
- Children: Childhood statistical information tells a similar story. In 2003-2006, an estimated 17% of children aged 6 to 11 years had obesity--and that is a real concern.
Before the obesity epidemic, teenagers with diabetes had almost always had type 1, or the insulin-dependent form. However, 30% of adolescents diagnosed with diabetes now have type 2, or the insulin-resistant form, which typically affects older adults.
Obesity is more than merely an aesthetic problem. Don’t pass off obesity in a child as something the child will outgrow. Children with obesity tend to become adults with obesity (often more severe), with a higher risk of developing other health problems, as well as premature death—the same risks faced by adults, only earlier.
The path to obesity may start early. Interestingly, breastfeeding protects children from developing obesity. However, although 75% of mothers breastfeed, just 13% of infants rely on breast milk alone after 6 months.
In addition, children and adolescents with obesity, already at a vulnerable age, face psychological and social issues, including low self-esteem, discrimination, depression, anxiety, and loneliness—problems that can follow them into their adult years. And they are especially subject to bullying, regardless of socioeconomic status, sex, race, academic achievement, or certain other factors. A study published in Pediatrics in 2010 found that parents of children with obesity rated bullying as their top health concern.
Negative attitudes can persist into adulthood, too. Weight-based stereotypes abound, leading to prejudice, stigma, and discrimination of adults with obesity in the workplace and other areas of living—even among family. Moreover, several studies have shown that weight stigma can actually increase the risk of unhealthy eating habits and lower the level of physical activity, therefore, compounding the problem. Children with obesity who are teased about their weight are more likely to binge on food and engage in other unhealthy behaviors.
Steps to Manage Weight Without Medication
The management of adult and pediatric obesity is similar.
- Control portion sizes.
- Eat regular meals and don’t “graze” on after-school snacks (for adults, limit snacks).
- Avoid foods that are high in calories but low in nutrition. These include sugary drinks, fast food, chips, cookies, and candy—which are all available in vending machines at the workplace and schools.
- Eat foods rich in fiber (whole grains, fruits, and vegetables).
Increase physical activity.
- Spend a maximum of 1 to 2 hours a day watching TV, talking and texting on cell phones, using the computer for entertainment, and playing video games.
- Get an hour of vigorous physical activity each day.
- Walk or bicycle to work or school.
Parents should encourage healthy habits.
- Serve as an example of healthy eating and physical activity.
- Avoid stringent dieting, and don’t promote a fear of food.
- Don’t use food as a punishment or reward.
- Boost your child’s self-esteem.
- Breastfeed exclusively for 3 to 5 months.
Medications should be used only when the above measures don’t improve the problem or other conditions coexist. Surgery is a last resort and, in children with obesity, is appropriate only in a handful of cases.
March 25, 2015