Childhood obesity is a serious health threat that affects a growing number of American children and teenagers. A condition that can lead to lifelong negative health ramifications, childhood obesity must be diagnosed and treated by a pediatrician, in partnership with the child’s parents and family.
“In children, as with adults, obesity increases risk for many health concerns, including high blood pressure, diabetes, elevated cholesterol, heart disease, bone and joint problems and more,” explains Dr. Rebecca Butler, a pediatrician in Bartonville. “In addition, kids who are overweight or obese may have lower self-esteem and suffer bullying at school. It’s important for doctors and parents to work together to address the physical and emotional impact of obesity in young people.”
How Prevalent is Childhood Obesity?
One in five U.S. children and adolescents is obese – about 15 million people. In Texas, the trendlines are slightly worse than the national average. Childhood obesity affects some groups of people more than others.
Race & Ethnicity
Hispanic and Black children are most at risk:
| Race/Ethnic group | Obesity rate |
| Hispanic | 26.2% |
| Black | 24.8% |
| non-Hispanic White | 16.6% |
| Asian | 9.0% |
Family Income
The lower a family’s household income, the greater the prevalence of childhood obesity. This is tied to several environmental factors (more on this below):
| Family Income as % of Federal Poverty Level | Obesity rate |
| More than 350% FPL | 11.5% |
| 130-350% FPL | 21.2% |
| 130% or less FPL | 25.8% |
Age
Within the child and adolescent population, there are distinct age groups that are more affected by obesity. Prevalence increases along with age:
| Age Group | Obesity rate |
| 2-5 years | 12.7% |
| 6-11 years | 20.7% |
| 12-19 years | 22.2% |
How is Obesity Defined?
Obesity is generally defined as a body weight that is 20% higher than the average for the child’s age and height. The American Academy of Pediatrics recommends children be screened for obesity and overweightness utilizing the Body Mass Index (BMI). The BMI is a simple equation – the person’s weight divided by the height, squared: weight ÷ (height x height). For adults age 20 and over, the BMI score indicates if someone is underweight, normal weight, overweight or obese.
For children and teens, the BMI calculation is more nuanced. The age and gender of the child is factored in to help determine the BMI and then the result is evaluated in the context of BMI results across the entire population of children the same age and gender.
There are a variety of BMI calculators for both adults and children online, but for children, it’s best to let a pediatrician calculate the BMI and interpret the results, as there are several variables that help determine what range the child falls in.
Don’t Play the Blame Game!
“I’ve seen too many parents blame themselves for their child being overweight,” says Dr. Butler. “Similarly, it’s common for kids to feel guilty and believe it’s their fault. While it is true that diet and activity level influence weight, there are underlying factors that can cause obesity, and some are difficult for the parent or child to control.”
For example, obesity can be hereditary. Our metabolism – how efficiently a person burns calories – is one of the most important factors that influences weight. Metabolic tempo can vary as much as 20% in people! That means two children could eat the same amount of food and get the same amount of exercise and the one with a slower metabolism may burn fewer calories.
Insulin resistance, which some children are born with, is another condition that can contribute to obesity. Insulin resistance leads to the body storing extra sugar, instead of burning it.
Low leptin levels may be another contributing factor. Cells produce leptin to signal the brain when we are full; a leptin deficiency can lead to overeating.
Fortunately, these conditions can be treated and managed by working with your child’s pediatrician.
Environmental Factors
External forces and environmental conditions can negatively impact someone’s health, including body weight. These are known as the social determinants of health (SDOH).
SDOH is grouped into five broad areas:
- Economic stability
- Education access and quality
- Health care access and quality
- Neighborhood and built environment
- Social and community context
All of these factors can influence childhood obesity.
For example, some families live in what is commonly referred to as a “food desert” – an area in which there is not a grocery store or supermarket nearby. There are numerous neighborhoods in North Texas that fall within this definition. Compounding this problem is that people in these areas may not have access to a vehicle or to transportation services to get them to a grocery store.
“For many families, access to fresh fruits and vegetables and lean meats is difficult for a variety of reasons, including location, cost and time,” says Dr. Smita Mahapatra, a pediatrician with offices in Frisco and Mesquite. “A convenience store with processed foods high in sugar and fat may be easier to get to, not to mention less expensive.”
Families may have difficulty accessing a grocery store conveniently or live in an area where they don’t want their kids to play outside for safety reasons. Some communities lack playgrounds, parks, sidewalks and trails, which can make it challenging for young people to get enough exercise outdoors.
Tips for Healthy Eating
Whether working to reduce your child’s weight or simply maintain a healthy weight and lifestyle, here are a few ideas that will benefit the entire family:
- Pre-make as many meals as possible on Sunday, before the hectic school and work week gets underway. For example, grill or roast chicken and keep it in the fridge for quick, healthy meals later in the week.
- Double or triple a recipe over the weekend for use throughout the week — or put in the freezer for future meals.
- Stock up on frozen vegetables. These are relatively inexpensive, don’t go bad and can be cooked in a matter of minutes on the stove or in the microwave. Frozen vegetables generally are just as healthy as fresh ones, and are a far superior choice to canned vegetables, which tend to be loaded with sodium and sugar.
- For snacks, grab enough fresh fruit that will keep for several days – apples, unripe bananas and oranges are good choices. Steer clear of canned fruits, which are high in sugar and calories.
- Maybe you find out your child hates cooked spinach but will eat it in a salad. Experiment with serving healthy foods different ways – you may be surprised what your child embraces.
- Be mindful of portion sizes. Use measuring cups and kitchen scales to measure foods in proper quantities.
- Reserve desserts such as ice cream, candy and cookies for special occasions. They should not be an everyday expectation.
- Some breakfast cereals are fine for kids, but others have way too much sugar. Look for cereals lower in sugar and higher in fiber.
- Low-fat milk (2% or less) and water are always good drink options. Don’t allow chocolate milk, soft drinks, artificial juices, fruit punch and sports drinks – all are high in sugar and have little to no nutritional value.
- Lead by example: children mimic their parents. If your child sees you eating – and enjoying – healthy foods, they will learn from your example and imitate your behavior over time.
Keep Your Kids Moving!
One of the biggest barriers to children getting enough exercise is the many distractions they face. Television, video games, tablets, phones – all of these electronic devices can provide hours of entertainment and can quickly become addictive. If your child is staring at a screen for hours on end, chances are he or she is not moving around enough. That type of sedentary lifestyle can contribute to obesity.
“It’s so important that kids get outside and move around,” explains Dr. Mahapatra. “Children are supposed to have a lot of energy, and it’s important for their physical and mental health that they burn it off! It doesn’t even have to be an organized sport; riding a bike or going swimming helps to burn calories and keep kids healthy.”
The goal is to get at least one hour of physical activity per day and to limit screen time to no more than two hours per day. One way to ensure your children get enough exercise is to build in regular family activities – this could be a hike, a bike ride, swimming, etc.
GLP-1’s for Kids?
More and more adults are taking GLP-1 drugs to help lose weight. Originally prescribed to treat type 2 diabetes, these medications have proven effective at helping people shed extra pounds. But what about for children?
In late 2022, the U.S. Food & Drug Administration approved certain weight-loss drugs for use in children 12 and older. Shortly thereafter, the American Academy of Pediatrics issued new guidelines stating that GLP-1 drugs should be considered as a treatment option for adolescents and teens with obesity.
Recent studies indicate that children experience the same, generally mild, side effects in similar percentages as the adult population. According to the Journal of the American Medical Association, weight-loss drug use saw a 600% increase between 2020-2023 in the 12-25 age group.
“The reality is, diet and exercise alone are simply not sufficient for some kids to lose weight,” says Dr. Mahapatra. “Biology dictates weight in many cases and it’s best to have as many tools in our toolbox as possible to treat it. These drugs are not for everyone, but they may be an option to discuss with your pediatrician if your child is struggling with his or her weight.”
Obesity Must be Treated
Obesity in children, just like in adults, is a serious medical condition that requires treatment. The health complications arising from childhood obesity lead to shorter life expectancy and a diminished quality of life. The emotional toll obesity can take – especially on a young person – may be equally dangerous.
“If your child suffers from obesity, remember it’s not your fault and you’re not in this fight alone,” says Dr. Butler. “Your pediatrician is here to help improve your child’s health and self-esteem and thankfully, we have more tools than ever before to do it.”
This article has been reviewed and approved by a panel of Privia Medical Group North Texas physicians.
This article contains information sourced from:
The U.S. Centers for Disease Control and Prevention
