Dr. Tariq Jagnarine
Family Medicine, Endocrinology/ Diabetes

The number of overweight children around the world has doubled in recent years, and a quarter of all children worldwide are considered overweight or obese. Causes of obesity in children include unhealthy food choices, lack of physical activity, and family eating habits.
This rise in the number of overweight children is disturbing, because it causes health problems and can lead to social problems. Overweight children are more likely to be teased by their peers, or to develop low self-esteem or body image problems. Once children are overweight, it requires a lot of effort and commitment for them to return to a healthy weight.
Being overweight and obese are among the most important risks to children’s long- and short-term health. Overweight children are very likely to become overweight adults.

Levels of childhood obesity are increasing at alarming rates in many countries, including the United States, the United Kingdom, and Australia. In some parts of the world, one in five children and adolescents is either overweight or obese.
From 1985 to 1995, the number of overweight children aged 7 to 15 years old had almost doubled. The number of obese children has now more than tripled. At the current rate, it is predicted that 65 percent of young children will be overweight or obese by 2030.

The body stores unused energy (kilojoules) as body fat. To maintain a healthy weight, kids need to use (or ‘burn’) the energy from the foods they eat. If they eat more than they use, their body will store the extra energy as fat. Factors that may cause children to become overweight and obese include:
• Food choices – these include choosing high-fat and sugary foods, instead of healthier options.
• Lack of physical activity – Australian children are less active than they were in the past.
• Spending a lot of time on sedentary pursuits – Watching on average more than 2½ hours of television a day, as well as spending time using computers and other electronic games.
• Overweight parents – a family’s eating patterns can have a major influence on whether a child maintains a healthy weight. Some overweight parents may be less concerned about their children also being overweight than parents who have a healthy weight.
• Genetics – some rare gene disorders cause severe childhood obesity. In many other people, particular genes acting together probably make some children more susceptible to obesity. If there is a family tendency to become overweight, parents need to be even more aware of making healthy food choices for the whole family.

Children become overweight when the energy they ‘take in’ (through food and drink) is greater than the energy they ‘put out’ (through physical activity and exercise). A diet high in energy and fat, combined with low levels of physical activity and exercise, would lead to a person becoming overweight.
Children inherit body type and shape from their parents. Parents cannot change these factors, but they can influence their children’s eating habits and activity patterns, which would also affect their body weight.

As overweight and obesity become more common, there have been some major changes in how we live. These changes have led to people either eating more, or becoming less active, all of which have contributed to an increase in overweight and obesity. For example:
• The overall cost of food has gone down.
• More food is prepared away from home.
• Energy-dense foods and drinks are more readily available.
• Portion sizes have increased.
• Marketing of energy-dense foods and drinks has increased.
• The use of cars has increased.
• The number of two-income families has increased.
• The time spent in paid employment has increased.
• The role of physical education in the school curriculum has been reduced.
• Health problems associated with obesity

Most of the health problems associated with obesity will become obvious in adulthood. Early signs of these later problems are commonly found in children. Potential health problems for obese children include:
• Type 2 diabetes – while this condition is most commonly seen in adults, it is now also being diagnosed in children
• Eating disorders such as bulimia or binge eating
• Orthopedic disorders – problems with foot structure
• Liver problems, including fatty liver
• Respiratory disorders, such as blocked airways and restrictions in the chest wall, which cause breathlessness during exercise
• Sleep apnea – this is a condition that causes difficulty breathing when sleeping. It also causes snoring, waking often, and poor sleep. It makes people feel tired, and contributes to poor concentration during the day
• Cardiomyopathy – a problem with the heart muscle, caused when extra effort is needed to pump blood.
• Obesity in childhood leads to obesity in adulthood. Overweight or obese children are more likely to remain obese as adolescents, and become overweight or obese adults. About 80 percent of obese adolescents will become obese adults.

Obesity can have a major impact on how children feel about themselves, and how they interact with others. Obese adolescents are more likely to have low self-esteem, which may impact other aspects of their lives, such as the development of friendships and competency at school.
Being obese as a child or adolescent increases the risk of a range of diseases and disorders in adulthood, regardless of whether the adult is obese or not. It’s important to identify and start to reverse the condition before children become adults. Ideally, overweight and obesity should be prevented.

• Changing lifestyles and dietary patterns have contributed to increasing obesity rates in children.
• Lifestyle and diet changes can help children to maintain a healthy weight.
• Obesity can result in serious health problems in childhood and later life.
• Children who are obese tend to become obese adults.
Children who are overweight or obese can benefit from healthy eating and regular physical activity (exercise). Childhood is an important opportunity to develop healthy patterns for life, and prevent weight problems. Professional advice from a doctor or dietitian can help your child reach and maintain a healthy weight.
Encouraging children to eat healthy food and being physically active is important for their healthy future. It can be a challenge, and requires patience, positivity, practice, and time. Children have different body shapes at different ages, so it can be difficult to tell if a child is overweight. As the number of overweight children increases, our view of what is ‘normal’ can change. A doctor, school nurse, or experienced health professional would be able to give feedback on your child’s growth, BMI, and obesity level.