By: Soniya G. Shah, DO, Aurora Health Care

If there was something going on that was causing real harm to one out of every three of our children, we’d all be pretty alarmed, right? Well, the truth is, something harmful is happening right now. That something is childhood obesity. One in three children is now overweight or obese.

How Do We Define Obesity?

Obesity is different from being overweight. Obesity is having too much body fat. The term overweight refers to a person weighing too much.

Being overweight or obese are determined based on the child’s weight compared to height. The body mass index (BMI) is a calculation that gives us an easy-to-understand measurement telling us if we’re in a healthful weight/height category. It’s best to use a BMI calculator designed for children and teens. Note: We don’t use BMI for babies and toddlers.

With the BMI calculator at the link above, you’ll enter data about your child’s age, height and gender. The calculator will display your child’s BMI and explain which BMI category your child fits in. Here are the commonly accepted categories for childhood BMIs.

• Underweight – BMI below the 5th percentile (this means only 5 percent of kids the same height and age weigh less)
• Normal weight – BMI at the 5th and less than the 85th percentile for age and height.
• Overweight – BMI above the 85th and below 95th percentiles (this means a child weighs more than 85 to 95 percent of children the same height and age)
• Obese – BMI at or above the 95th percentile (meaning a child weighs more than 95 percent of kids the same height, age and gender)

Keep in mind, the BMI is a good indicator of body fat but not a true measure. It has its limitations. As an example, a muscular person’s BMI may be higher, but that person’s BMI reflects healthy muscle rather than unhealthy fat, so the high BMI may be quite healthy. Also, a child’s rapid growth during puberty can make a BMI more difficult to interpret.

If you have a question or concern about your child’s weight, see your health care provider for personalized guidance.

What Medical Problems Are Related to Obesity?

As with adults, obesity contributes to a number of health problems.

• Depression.This can be undiagnosed and untreated in children if it’s overlooked as normal childhood emotional changes.
• Shortness of breath. This can make physical activity, exercise and sports difficult. Shortness of breath can increase the chances of developing asthma or make it worse.
• Cardiovascular risk factors. High blood pressure, high cholesterol, abnormal blood lipid levels, insulin resistance and type 2 diabetes can lead to medical issues such as heart disease, heart failure and stroke later in life.
• Bone and joint problems and pain.
• Sleep problems, such as obstructive sleep apnea. With this condition, excess fatty tissues may obstruct the child’s airways. During sleep the upper airway can become partly or completely blocked. This makes the child’s diaphragm and chest muscles work harder to ensure adequate oxygen. The hard effort can result in a snore, gasp or snort. A person with sleep apnea may not be aware of the issue but will likely not sleep well.
• Liver or gallbladder disease. The gallbladder is a small sac under your liver. It stores bile produced by the liver and then passes it along to the intestines to help digest fats. Inflammation is a common gallbladder problem. The inflammation can be caused by painful gallstones that block the ducts.
• Overweight girls may have irregular menstrual cycles and fertility problems in adulthood.

Another physical and emotional element that can affect overweight children is that they may tend to be taller and more sexually mature than others their age. Some people may expect them to act more maturely. This can create undue pressures on a child.

How Can We Help Our Children Adopt a Healthy Lifestyle?

The first step is to live healthfully yourself. Children of an overweight or obese parent are more likely to have weight problems, too. As you help your child, you’ll also help yourself.

• Eat breakfast every day. The best breakfast is low sugar and high in protein which helps kids feel full longer. A low-sugar breakfast also helps them avoid the mid-morning sugar slump that can cause focus and learning problems. Good breakfast choices include oatmeal, Greek yogurt, bananas, almond butter, blueberries, strawberries, raspberries, kiwi or cereal (with at least 5 grams of fiber and less than 5 grams of sugar).
• Serve more fruits and vegetables at meals and for snacks. (See the list of fruits above for ideas. If you have juices, make wise juice choices).
• Cut back on soft drinks and high-fat, high-calorie snacks. If you usually buy enough snacks for each day of the week, next week buy for fewer days and have good fruits those days (see the fruit list above). Then each week further reduce snack purchasing. Take care to not be too restrictive with sweets. If sweets are totally denied when kids are used to having them around, they may rebel and eat more of them when they have a chance or sneak sweets on their own. The transition to more healthful diet habits doesn’t need to happen overnight.
• Don’t use food as a reward. Instead, consider playing a favorite game, going to a park, going to the library to checkout a good book or movie, or spending a bit more quality time with your child doing what your child enjoys.
• Forego the clean-plate club. Of course children should eat fruits and vegetables, but if kids are satisfied with the amount they’ve eaten, don’t force them to keep eating. They should only eat when they’re hungry, and parents should be aware of kids’ hunger cues.
• Eat fast food less often. Make preparing a good meal at home or even a picnic a family affair.

Get Moving

Being active is another important element of your whole family’s health. It’s recommended that kids are active about 60 minutes a day. It doesn’t have to be all at once. Explore activities with your child to see what’s most enjoyable. Ask if they have games they play at school that they enjoy. Some might be fun to do at home. While your kids are moving, plan to get moving too.

The whole family can benefit from spending less time with screens (phones, tablets, computers, TVs) and more time moving around. For more about good ways to be active and the right weight for your child, see your health care provider. Health habits that are established in childhood can lead to better health for your child’s lifetime.