Childhood Obesity

  • Medical Author:
    John Mersch, MD, FAAP

    Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.

  • Medical Editor: David Perlstein, MD, MBA, FAAP
    David Perlstein, MD, MBA, FAAP

    David Perlstein, MD, MBA, FAAP

    Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.

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What is the treatment for childhood obesity?

The treatment for childhood obesity is no different than many diseases -- determine the cause(s) and control or eradicate it (them). Since the overwhelming number of obese individuals are consuming too many calories relative to their energy expenditure ("burning them off"), therapy is directed toward reversing this metabolic equation. Simply put, consume fewer calories and use more up. There are many dietary programs that attempt to address this issue. None is superior over the long term unless the participant embraces these nutritional changes as part of a larger lifestyle recommitment. Drugs and surgery should be restricted to severe cases of childhood (and adult) obesity.

Is it possible to prevent childhood obesity?

Benjamin Franklin's famous dictum "an ounce of prevention is worth a pound of cure" is ironically the perfect approach to childhood obesity. The CDC has recently raised the notion that should the alarming increase in childhood obesity not be reversed, the consequences may make the current pediatric population be the first generation to not exceed the life span of their parents. Studies have indicated that childhood obesity must be attacked prior to the teen years. Twenty percent of obese 4-year-old children will grow up to become obese adults; 80% of obese teens will continue their obesity into adulthood. All of the above-reviewed consequences of pediatric obesity are brought forward into the adult years. Here are three amazing observations: (1) children 6 months to 6 years of age watch an average of two hours of television per day; (2) 18% of children less than 2 years old have a TV in their bedroom. Of this toddler population, 34% watched more than two hours of TV daily; (3) children 8-18 years of age spend an average of seven and a half hours per day involved with entertainment media activity such as television, computer games, video games, and cell-phone calls/texting.

Social and cultural changes are necessary to effectively address the pediatric obesity epidemic. A basic approach would entail the following:

  1. Advocate breastfeeding during the first year of life. Studies strongly reinforce that breastfed children have a lower risk of infant, childhood, and adolescent obesity.
  2. Drastically overhaul the school breakfast and lunch programs to favor heart-healthy food choices. Encouraging salad bars, banning sugar drinks, and flavored milk are options.
  3. Guarantee safe neighborhood environments which foster outside play activities.
  4. Limit TV/computer/social-network communication or other activities which encourage sedentary behaviors.
  5. Encourage vigorous physical education programs for 60 minutes daily.
  6. Revamp restaurant portion sizes. Studies had repeatedly demonstrated a link to the rise in pediatric obesity with fast-food restaurants' adoption of supersized portions as well as the bundling of food options (for example, deals for hamburger, french fries, and soda).
  7. Encourage the development of activity-friendly infrastructure in communities -- bike lanes, regional parks, etc. Many studies have shown that the social and cultural changes above must be accompanied by a strong family and community support structure, without which these approaches often fall short.
  8. Encourage avoidance of "empty carbohydrate" calories (for example, high fructose corn syrup) and emphasize "healthy fats" (for example, olive oil) in lieu of saturated fats/oils.

What research is being done on childhood obesity?

The National Institutes for Health (NIH) web site lists over 300 open studies currently focused on the pediatric age range (http://clinicaltrials.gov/search/
open/term=obesity+%5BCONDITION%5D+AND+child+%5BAGE-GROUP%5D
). These studies are exploring the various causes and associations of obesity, the physical, emotional, and financial impact of pediatric obesity, as well as a broad array of management tools, potential medications, and other therapies for the treatment of childhood obesity.

Medically Reviewed by a Doctor on 1/29/2016
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