Obesity in children

Published by Bupa's Health Information Team, January 2011.

This factsheet is for people who are concerned about childhood obesity, or who would like information about it.

Children who carry a lot of excess weight are classed as being obese. Children can become obese if they regularly eat and drink more energy (calories) than their body uses or do too little physical activity. Obesity means children are more likely to develop serious health problems.

About childhood obesity

Children need a healthy, balanced diet that gives them enough energy to grow and develop. This means that children usually 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 weight.

If you’re obese, it means you have a considerable amount of excess weight and too much fat in your body. Obesity is caused by regularly eating and drinking more energy (calories) than your body uses, as well as not doing enough physical activity. This often means eating too many high calorie foods, for example foods that contain lots of sugar and fat. Obesity means you’re more likely to develop serious health problems.

The number of overweight and obese children in the UK has increased over the past 30 years. In 2006, around one in six children aged between two and 15 were obese.

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. These health problems may develop when your child becomes an adult, but sometimes early damage can be done, and the problems may develop while he or she is still a child. Obese children usually become obese adults.

When your child gets older, or becomes an adult, he or she is more likely to develop the following health problems if they are obese:

• high blood pressure
• type 2 diabetes
• high cholesterol levels
• asthma
• development problems in the feet
• liver disease
• sleep apnoea

Obesity can also affect your child’s emotional and mental health. He or she may have low confidence or self-esteem, and being obese can also lead to eating problems, such as bulimia, and depression.

Causes of obesity in children

There are a number of different things that can cause obesity in children. Possible causes of obesity include:

• eating a poor diet, for example too many high-fat and sugary foods
• inactivity, for example, not doing enough exercise and spending too much time watching television or in front of a computer
• genetic (inherited) conditions, though these are rare
• not being breastfed

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

Diagnosis of obesity in children

For adults, a measurement called body mass index (BMI) is used to work out whether you’re the right weight for your height. However, because 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 to measure children.

Special charts, called centile charts, have been developed to show whether children are under or overweight for their age. Your GP or nurse will use these charts to assess your child.

Your GP will also check to see whether your child has other health conditions related to being overweight. Your GP may also ask you and your child about the foods you eat and how active you are.

Treatment of obesity in children

There are a number of different treatments for obesity in children. However, no treatment will work on its own. You will need to make changes to the foods you and your child eat and the activities you do, as well as changing some of the behaviour of the whole family.

Your GP may ask you to help your child to lose weight, but it’s more likely that your GP will recommend that you help to maintain your child’s weight. So, as your child grows taller, his or her BMI improves and the weight stays the same.

Self-help

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

Some lifestyle and behaviour changes are listed below.

• Setting goals and giving rewards and praise. You and your child should be aiming to make long-term changes to the foods you eat and the activities you do, so that your child will be able to manage his and her weight when they become an adult. However, choosing some short-term goals to reach may help you to focus and succeed. Give your child praise and rewards for their success, but make sure these aren’t food-related. Instead try giving them a small gift or do an activity they enjoy.
• Get active. Children need to do between 60 and 120 minutes (one to two hours) of moderate to vigorous intensity physical activity every day.  This can be one session of activity or a number of sessions of 10 minutes or more. Try building activity into everyday life, such as walking or cycling to school or playing with other children. Do activities together as a family, for example, going to the park and playing football. Help your child to choose more structured activities that they enjoy, for example dancing or swimming.
• Cut down on inactive pastimes. Reduce 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 nurse may ask you to keep a record of the food and drink that you and your child have. Based on what your child is eating, what he or she likes and dislikes and how old your child is, your doctor or nurse may create a healthy eating plan. This can be made up of healthy foods which give your child less energy each day than they are using in their day-to-day activities. This is likely to mean cutting down on foods that have a lot of sugar or fat in them and eating more fruit and vegetables and low-fat foods.
• 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 should lose weight with your child. Look at how you eat as a family, try and 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 can sometimes be used to help older children lose weight. However, it is used very rarely. Orlistat is only to be given to your child if he or she is over the age of 12, is very obese and has other health problems because of their weight.

Surgery

There are operations available that can help older children to lose excess weight. Surgery will only be suggested if other treatments haven’t worked; if your child has been through puberty; if he or she is very obese; and if they have other health problems. Weight-loss surgery for children is rare.

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

Prevention of obesity in children

Obesity in children is caused by many different things, some of which are difficult to change. For example, there is a greater choice of food available in our shops, and computers and television play a bigger part in many people’s lives than they did in the past. However, you can make a difference to the food your child eats every day and how active they are.

If you're worried that your child is becoming overweight, you can make long-term changes to your child's diet and eating habits, while increasing the amount of activity he or she does. The National Institute for Health and Clinical Excellence (NICE) recommends the following.

• Include starchy foods in meals such as potatoes, bread, rice and pasta, choosing wholegrain where possible.
• Eat plenty of fibre-rich foods, such as oats, beans, grains, fruit and vegetables, wholegrain bread, and brown rice and pasta.
• Eat at least five portions of a variety of fruit and vegetables each day.
• Eat a low-fat diet and don’t increase your fat and/or calorie intake.
• Eat as little as possible of fried foods, sweets which are high in added sugars and fat and high-fat foods such as take-away meals or fast food.
• Reduce the amount of sugary drinks you have, including fruit juices with added sugar, and drink more water.
• Watch the portion size of meals and snacks, and how often you’re eating.
• Eat regular meals, including breakfast, in a pleasant, sociable environment without distractions.
• You should eat with your child and make sure that everyone is eating the same food.
• Make enjoyable activities – walking, cycling, swimming and gardening – part of everyday life.
• Minimise sedentary activities, such as sitting for long periods watching television, at a computer or playing video games.
• Encourage active play, for example dancing and skipping.
• Be more active as a family, for example walking and cycling to school and the shops, going to the park or swimming.
• Encourage your child to participate in sports or other active recreation, and make the most of opportunities for exercise at school.

Never put your child on a weight-loss diet without getting advice, as this can affect his or her growth. Talk to your GP or a dietitian if you're concerned about your child's weight.

For answers to frequently asked questions on this topic, see Common questions.

For sources and links to further information, see Resources.