What you might not know about childhood obesity


April 2019

Article by Teri Kohlrusch, Certified Pediatric Nurse Practitioner

As a pediatric nurse practitioner, I care for children and youth of all ages, with a primary focus on health and wellness. A big part of that is guiding families in how they can adopt proper nutrition habits early on in their kids’ lives – starting even as young as in infancy. When these habits start in early childhood, it significantly improves our ability to maintain health throughout the rest of our lives.

In the backs of our minds, parents always have the fear of our children breaking an arm playing sports or getting pink eye at school. But sometimes, we put too much focus on the here and now, and forget about the long road. A slow-moving, but important health concern is overweight and obesity in children. Not only can it impact our children’s physical well-being, but it can have an effect on their mental health as well. And unfortunately, this problem is on the rise. Since 1970, the percentage of children with obesity has tripled.

Fortunately, there are ways to help your child get healthy and stay healthy. Here’s how I answer the most common questions I get from concerned parents:

When is a child considered obese?

A child is considered overweight when their BMI is at or above the 85th percentile. They have obesity when their BMI is at or above the 95th percentile. About 30 percent of children in the United States are overweight and 17 percent are obese.

How does being overweight or obese affect my child’s overall health?

Twenty years ago, type 2 diabetes was rarely reported in kids. But with the rise in pediatric obesity, there has been a dramatic increase of this condition in youth. A national study found that type 2 diabetes accounts for up to 15 percent of all diabetes diagnoses in children over age 10.

Other health consequences tied to obesity seen routinely in children are fatty liver disease, high cholesterol, hypertension and hormonal changes, such as early puberty and polycystic ovary syndrome.

Being overweight as a child increases the risk of being overweight as an adult. That means if health consequences don’t develop in childhood, they are still likely to develop later. Obesity as an adult may also lead to:
  • Heart disease
  • Hyperlipidemia
  • Stroke
  • Cancer
  • Orthopedic issues

Can being overweight or obese affect my child’s mental well-being?

There are higher rates of depression and poor self-esteem in children who struggle with their weight. There is also a higher risk of disordered eating, such as binge eating. Children who are overweight are more likely to be bullied and shamed by other children, teachers, coaches and even family members. All of this can lead to mental health concerns.

Are some children more at risk for obesity?

Any child can be at risk. But that risk can vary depending on many factors. Some, like genetics, are simply part of who they are. There are medical conditions and medications that can promote weight gain, too.

But many other factors are lifestyle habits that can be changed, like:

  • Eating highly processed or sugary foods for snacks and meals
  • Emotional eating (which is defined as eating food for reasons other than to satisfy hunger and nutritional needs)
  • Lack of sleep
  • Limited physical inactivity

While the overall rates of obesity have remained steady in recent years, there has been an increase in severe obesity in African American boys, Hispanic girls and Caucasian girls.

How can I prevent obesity in my child?

Families need to work together to eat better and stay physically active. The whole family needs to supports each other in a team effort. And parents, especially, need to practice healthy habits themselves and be good role models. You won’t have success if one child can’t have a soda, but parents or siblings can. Here are some specific things families can do that help:

  • Replace the junk food and sugary beverages in your home with better options. Add a fruit or vegetable as part of every meal. Challenge everyone in the family to drink more water, or skim or fat-free milk. And provide fruits and veggies as snacks. Keep produce washed, cut up and in plain sight in the refrigerator to make it the easiest choice when hunger strikes.
  • Make and eat meals together as a family. Preparing home-cooked meals and eating them as a family has been shown to protect against overweight and unhealthy eating habits in kids. When you include your child in food preparation, it helps get them excited about what they’re going to eat. And having conversations around the dinner table enhances family connectedness. Make a routine of wrapping up each meal together with light physical activity, like going for a family walk or bike ride.
  • Avoid using food as treats or rewards. Instead, aim to reward your kids with fun activities like spending time at their favorite park, playing their favorite board game or going on a special outing to the zoo, museum or their favorite store. This can be hard, as unhealthy foods such as candy and desserts are often tied to love and celebrations in our culture. But since food rewards can lead to emotional eating, it’s really important to try to not use them. When snacks and unhealthy foods are given as awards and prizes, children learn to use them to cope in times that they experience negative emotions such as anxiety, sadness, stress, loneliness or frustration. They turn to these types of food because they want to feel better – and that can quickly become an unhealthy habit. Keep food reserved for satisfying hunger and providing nutrition.
  • Make it a priority to get enough sleep on a consistent schedule. We make important hormones overnight that regulate feeling full. Kids ages 3-5 should get 10-13 hours of sleep per night. Kids ages 6-13 should get 9-11 hours per night. And kids ages 14-17 should get 8-10 hours per night.
  • Put down the screens. The average child spends 7 hours every day looking at TVs, phones, tablets and computers. Excess screen time is linked to obesity as well as to sleep and learning problems. But research shows that getting just 1 hour or more of physical activity per day helps prevent those issues.
As you start working these tips into day-to-day life with your family, be cautious to not turn eating into a negative subject. Restricting food can promote both weight gain and disordered eating. If your child is still hungry after a meal, that’s OK! Just encourage them to make a healthy choice to fulfill their hunger – like eating an extra fruit or vegetable.

How can I help my child who has weight challenges?

To get started, remember 5-2-1-0:
  • 5 or more servings of fruit/vegetables per day
  • 2 hours or less of screen time (TV/computer/video games) per day
  • 1 hour or more of exercise per day
  • 0 sugar-sweetened beverages a day (juice, pop/soda, whole milk)

While it may seem simple, making changes to reach these goals can be challenging. Try taking small, obtainable steps toward them first. Your child’s primary care provider can help. Talk with them to get started making a plan that fits your family.

Our organization also offers resources in the community that help families eat better and move more. You can check out PowerUp4Kids.org for kid-friendly, better-for-you recipes. PowerUp also hosts fun events and activities throughout western Wisconsin that we invite your family to get involved in. Some are even right here at Amery Hospital & Clinic!

Similarly, HealthPartners works with One Heartland to put on Camp 5210 for kids ages 7-17 each summer. Being supported in an environment with other kids who have the same struggles can help, so this sleepaway camp focuses on lifestyle changes all while having fun outdoors. HealthPartners offers scholarships to Camp 5210. To apply, contact Katy Ellefson at 715-268-0290 or to learn more at healthpartners.com/Camp5210.

How do I talk to my child about his or her weight?

Weight is a topic that needs to be approached in a sensitive manner. Don’t focus on appearance or the number on the scale. And avoid using the words “fat,” “overweight” or “obese.” (It’s even important to watch how you talk about yourself or others with regard to weight, as children can easily redirect those comments to themselves.)

Instead, focus on making changes with your child that will help them eat healthier and increase their physical activity. Support your child’s ideas and discuss how they want to adopt better eating and activity habits, reduce screen time and get more sleep. The key is setting lifestyle change goals as a family – and committing to those changes as a family, too.

Being overweight is not who your child is. Empathize and listen to what they are saying, and remind them of the positive qualities they have. It’s important to always end these conversations on your child’s strengths.

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