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Obesity in children

Obesity isn’t only a problem in adults. The number of children who are obese is growing and has more than tripled in England over the past 25 years. Worldwide, over 42 million children under five were overweight in 2013. If the current trends continue, the number of overweight or obese children will increase to 70 million by 2025.

Children need a healthy, balanced diet that gives them enough energy to grow and develop. This usually means they need to take in more energy than they use and this extra energy forms new tissues as they grow. However, if children regularly take in too much energy, this is stored as fat and they will put on excess weight.

Children who are very overweight and have too much fat in their body are classed as being obese. The main cause is regularly taking in more energy (calories) from food and drink than your body uses and not doing enough physical activity.

Children who are obese are more likely to develop serious health problems later in life, such as diabetes, heart problems and even cancer.

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  • Diagnosis Diagnosis of obesity in children

    For adults, a measurement called the body mass index (BMI) is often used to work out whether you’re a healthy weight for your height. As children are growing, their height, weight and body fat can change a lot. BMI measurements are also very different between boys and girls. This means that the standard BMI can’t be used as a measure for children.

    Special charts, called BMI centile charts, have been developed to show whether children are under- or overweight for their age. These charts compare a child’s BMI against other children of the same sex and age. Your GP or health visitor will use these charts to assess your child and check for other health conditions related to being overweight or obese. Your GP or health visitor may also ask about the foods your child eats and how active they are.

    Bupa Health Assessment: BMI

    If you are concerned about your BMI, Bupa can help you get a diagnosis.

  • Treatment Treatment of obesity in children

    There are a number of different treatments for obesity in children. But no one treatment will work on its own. You’ll need to make changes to the foods your child eats and the activities they do. It’s also important to make changes as a whole family.

    Your GP may refer your child to see a paediatric dietitian, a doctor who specialises in child nutrition and diet. Your child’s dietitian will come up with a plan that's tailored to your child based on their age and BMI. However, losing weight isn’t always advisable in children so your dietitian may suggest that you aim to keep your child’s weight the same. As your child grows taller and their weight stays the same, their BMI will improve.

    Self-help

    It’s important to make changes as a whole family, rather than giving your child separate meals or making them start ‘dieting’. This may mean making changes to mealtimes and snacking habits, or starting activities that you can all do together. Lifestyle changes work best for your child when they are long-term and permanent.

    Some lifestyle and behaviour changes to try are listed below.

    • Set goals and give rewards and praise. Aim to make long-term changes to the foods your family eats and the activities you do. Choose smaller goals to begin with as this may help you to focus and succeed. Give your child praise and rewards for their success, but make sure these aren’t food-related.
    • Get active. Children over the age of five need to do at least 60 minutes of moderate to vigorous intensity physical activity every day. This can be all in one go or a number of sessions of 10 minutes or more. Include exercises that strengthen their muscles and bones, such as climbing or any activity that involves lifting their own body weight. Try building activity into everyday life, such as walking or cycling to school. Help your child to choose more structured activities that they enjoy too, such as dancing or swimming.
    • Cut down on the amount of time your child spends watching television or using a computer. Try to limit this to less than two hours a day or 14 hours a week.
    • Eat healthily. Your doctor or dietitian may ask you to keep a record of the food and drink your child has. They can also help you to create a healthy eating plan. This can be made up of healthy foods which balance the energy each day that your child is using in their day-to-day activities. This means cutting down on foods that have a lot of sugar or fat in them, and eating more fruit and vegetables and low-fat foods. It's also important to consider portion sizes. The right portion sizes depend on your child’s age, gender, current weight and how much activity they do. Also remember that children don't need to eat as much as adults.
    • Involve the whole family. It’s important to get everyone to eat healthily and become more active so that your child doesn’t feel that they have been singled out. If you’re overweight, you could lose weight with your child. Look at how you eat as a family. Try to sit down together for meals and set a good example with the foods you eat and the activities you do.

    Medicines

    A medicine called orlistat may help older children who are 12 and over lose weight. However, it’s used very rarely and is only usually prescribed in a specialist clinic. Your doctor will only prescribe orlistat if your child is very obese and has other health problems caused by their weight.

    Surgery

    Weight-loss surgery for children is very rarely done. Your child’s specialist will only suggest it if other treatments have failed. Your child will also need to have been through puberty, be very obese and have other health problems to be considered for surgery.

    Your doctor will discuss your child’s treatment choices with you.

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  • Causes Causes of obesity in children

    There are a number of different things that can cause obesity in children including:

    • eating a poor diet, such as too many high-fat and sugary foods, or portion sizes that are too large
    • inactivity, for example, not doing enough exercise and spending too much time watching television or in front of a computer
    • genetic (inherited) conditions, although these are rare

    Some studies have shown that your lifestyle when you’re pregnant and in early motherhood may affect your child’s weight. For example, smoking is linked with obesity in later life while breastfeeding may reduce the chance of obesity. For more information, see our frequently asked questions.

    If you’re obese, your children are also more likely to be obese. This may happen because you share the same eating or activity habits, or a combination of both.

  • Complications Complications of obesity in children

    If your child is overweight or obese, he or she is more likely to develop serious health problems in the future. Sometimes, damage happens early while he or she is still a child, such as the development of flat feet, which can make walking painful.

    When your child gets older, or becomes an adult, they are more likely to develop health problems if they are obese. These include:

    Obesity can also affect your child’s emotional and mental health. Your child may have low confidence or self-esteem, which may lead to depression. Being obese can also lead to eating disorders, such as bulimia.

  • Prevention Prevention of obesity in children

    Obesity in children is caused by many things, some of which you can change and others that may be more difficult. For example, there is a greater choice of processed food available in our shops and food outlets, which can contain lots of fat and sugar. Computers and television play a bigger part in many people’s lives than they did in the past so we are less active. However, you can make a difference to the food your child eats every day and how active they are. See our Related information to find out more about healthy eating and exercise.

    Never put your child on a weight-loss diet without getting advice, as this can affect their growth. Talk to your GP or a dietitian if you have any concerns about your child's weight.

  • FAQs FAQs

    Are there any medical conditions that can cause childhood obesity?

    Answer

    Certain medical conditions can cause obesity, but these are rare.

    Explanation

    There are some medical conditions that can cause obesity in children, but these aren't very common. They include the following.

    • Genetic conditions such as Prader-Willi, Cohen and Bardet-Biedl syndromes.
    • Hormonal conditions, for example, Cushing's syndrome and hypothyroidism.

    If your child does have an underlying medical condition, they will usually have other symptoms in addition to being overweight. Most children become overweight or obese because they take in more energy (calories) through food and drink than they need, or aren’t active enough.

    If you’re worried that your child is overweight, talk to your GP for advice.

    Does my lifestyle influence the risk of my child being overweight?

    Answer

    There is evidence that suggests your health, and choices you make when you’re pregnant and when your baby is born, may affect your child’s weight.

    Explanation

    If you’re very overweight when you're pregnant, your child may be more likely to become overweight as they get older. If you develop diabetes while you’re pregnant (gestational diabetes), this may increase the risk of your child becoming overweight or obese in later life too.

    Some research shows that smoking when you’re pregnant may increase the risk of your child being overweight or obese later in life. There are many other ways that smoking can harm an unborn baby too. If you smoke, it's important to stop before or when you become pregnant. If you do smoke and are pregnant or trying to get pregnant, contact your GP for advice.

    There is some research that shows breastfeeding your baby may help reduce the risk of them becoming overweight as he or she grows up. Breastfeeding has a number of health benefits for you and your baby, but it may not always be an option for every new mother. Talk to your midwife or health visitor about the benefits of breastfeeding, and if you're having any problems.

    I'm finding it difficult to get my child to eat healthily. How can I encourage them to try new food?

    Answer

    Children can sometimes be fussy eaters and it can be a challenge to get them to try new things. Try involving your child in preparing meals with you and gradually introduce new foods to their diet.

    Explanation

    Children need a healthy, balanced diet to help them grow and stay healthy. The foods they eat should include fruit, vegetables, starchy foods and protein. Encourage your child to choose a variety of foods from an early age. This will help them to get all the vitamins, minerals and nutrients they need.

    There are a number of ways you can introduce new foods in a fun way. We’ve made some suggestions here.

    • Involve your child in preparing and buying food as it will help them to get interested in cooking and different foods.
    • Make your meals a social occasion and eat together as a family.
    • Think about how you present food to your children and make it fun. Offer foods that are a novelty to eat, such as corn on the cob, or make a smiling face on a plate with vegetables.
    • Cook your children’s food using less fat by grilling or steaming it and cut the fat off meat first. Replace food like fish fingers with a portion of oily fish, such as sardines or salmon. Boys can have up to four portions of oily fish a week, but girls should stick to just two portions.
    • Encourage your child to eat more fruit and vegetables by offering them a variety each day – either cooked or raw. And it’s not just fresh fruit – dried fruit and juices also count towards your child’s daily portions.
    • Make small changes to introduce new foods gradually. At the same time, limit unhealthy snacks, such as cakes and biscuits.

    Try not to turn mealtimes into a battle over food as this is likely to make things worse. Instead explain the pros and cons of foods you eat or come across when you're out.

  • Resources Resources

    Further information

    Sources

    • 10 facts on obesity. World Health Organization. www.who.int, published May 2014
    • Obesity in children. PatientPlus. www.patient.co.uk/patientplus.asp, published 1 March 2013
    • Facts and figures on childhood obesity. World Health Organization. www.who.int, published 29 October 2014
    • Children. British Nutrition Foundation. www.nutrition.org.uk, published 2 March 2012
    • Management of obesity. Scottish Intercollegiate Guidelines Network (SIGN), February 2010. www.sign.ac.uk
    • Managing overweight and obesity among children and young people: lifestyle weight management services. National Institute for Health and Care Excellence (NICE), October 2013. www.nice.org.uk
    • A simple guide to classifying body mass index in children. National Obesity Observatory. www.noo.org.uk, published June 2011
    • Map of Medicine. Obesity in Children. International View. London: Map of Medicine; 2011 (Issue 3)
    • Obesity: identification, assessment and management of overweight and obesity in children, young people and adults. National Institute for Health and Care Excellence (NICE), November 2014. www.nice.org.uk
    • Obesity in children. BMJ Best Practice. www.bestpractice.bmj.com, published 28 May 2013
    • Obesity in children. Medscape. www.emedicine.medscape.com, published 4 December 2013
    • Childhood obesity. National Obesity Forum. www.nationalobesityforum.org.uk, accessed 4 December 2014
    • Obesity and overweight. World Health Organization. www.who.int, published August 2014
    • Physical activity for health. PatientPlus. www.patient.co.uk/patientplus.asp, published 19 July 2012
    • Clinical practice guidelines for the management of overweight and obesity in adults, adolescents and children in Australia. National Health and Medical Research Council. www.nhmrc.gov.au, published October 2013
    • The impact of childhood obesity on bone, joint, and muscle health. American Academy of Orthopaedic Surgeons. www.orthoinfo.aaos.org, published February 2014
    • Helping your child. Weight-control Information Network. win.niddk.nih.gov, published January 2012
    • Maternal obesity and child health. Public Health England. www.noo.org.uk, accessed 4 December 2014
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