Addressing Childhood Obesity

Give Kids a Healthy Start

Obesity affects about 1 out of every 5 kids. Carrying too much body fat can affect almost every system in your body. It can contribute to many long-term health problems. These include heart disease, diabetes, and mental health issues.

“Prevention and detection of childhood obesity is important because the longer you have it, the more at risk you are of developing related complications,” explains Dr. Stavroula Osganian, an NIH scientific advisor on childhood obesity.

If you think your child has obesity, see their doctor. The doctor can calculate your child’s body mass index, or BMI. BMI is a measure that helps determine if your child’s weight is within a healthy range for their height, age, and sex. It’s not a direct measure of body fat. But it’s a useful way for doctors to screen for obesity. If your child’s BMI is high, the doctor can help you plan how to lower it.

“The earlier you take action, the better,” says Dr. Leonard Epstein, a psychologist at University at Buffalo. “It’s easier to help a child who’s young to make changes. And it’s easier for the parent, too.”

NIH studies are now testing ways to prevent and treat obesity in kids.

Starting Early

Researchers are studying interventions for childhood obesity as early as preconception and pregnancy, Osganian says. Studies have found that a mother’s weight, diet, and physical activity during pregnancy can affect a child’s risk of obesity. Scientists are trying to unravel how diet and exercise during pregnancy influence an infant’s weight, body fat, and Chemical changes in the body that create the energy and substances you need to grow, move, and stay healthy. metabolism.

Infants who have a high birth weight or gain weight too fast have an increased risk for childhood obesity. NIH research has also shown a link between obesity and a lack of sleep that begins as early as infancy.

An NIH-funded program called INSIGHT tested ways to address these early risk factors. The program taught first time moms healthy feeding and sleeping behaviors for their infants. Moms learned how to put their baby to sleep and calm them when fussy without using feeding to soothe them. They also learned how to use growth charts and how to limit sedentary time. Children of these parents showed healthier weight status through age 3 years compared with kids in the control group.

Having childhood obesity increases your chances of having obesity as an adult, says Dr. Charlotte Pratt, an NIH expert on child nutrition. Giving kids a healthy early start can help set them on the right path. But they also need to learn how to build healthy habits for themselves as they grow.

Growing Healthy Habits

Obesity comes from taking in more energy, or calories, than your body uses. So it’s important for kids to choose both healthy foods and appropriate portion sizes. Getting enough physical activity helps their bodies use more of the calories they take in.

“Parents can help prevent childhood obesity by focusing on their child’s diet, activity, and sleep within the home through the teenage years,” Pratt says. They can teach kids healthy habits by modeling these behaviors themselves. But helping kids keep up with healthy habits can get harder as they age.

“When kids are really young, all they want to do is run around,” Epstein says. “But something happens around ages 9 to 10. Their motivation to be active decreases, while their motivation to be sedentary increases. And being physically active as you get older means shifting from playing on the playground to more organized activities, like sports.”

Once a child develops obesity, “the lifestyle treatment that’s required to take a child who has obesity to a normal healthy weight is much different and more intensive than for prevention,” explains Dr. Sarah Armstrong, a pediatrician at Duke University. “You need at least 26 hours of intensive face-to-face nutrition and physical activity guidance for a child over [a] three to 12 month [period].”

That amount of time can be hard for a doctor to deliver. Armstrong’s team has developed an intensive obesity treatment program called Fit Together. It partners pediatricians with local parks and recreation centers. In the program, doctors screen kids for obesity and counsel on lifestyle changes. The parks and recreation centers provide physical activity options.

Kids who participated in the program were able to reach lower BMIs. Armstrong’s team is now trying to create more partnerships between doctors and local parks and recreation centers across the country.

Getting Healthy Together

Diet and physical activity are both key for obesity treatment. Epstein’s work has shown that treating the whole family can have added benefits. His group has developed family-based behavioral interventions. These target both parent and child for healthy eating and more physical activity. They also include guidance for parents on modeling healthy behaviors and positive parenting tools.

“The parenting tools help create a more positive family environment,” Epstein says. His studies have shown that family-based interventions help both parents and children lose weight. And the weight loss could be maintained for at least 10 years. The treatment has also helped reduce participants’ symptoms of depression and anxiety. And it led to siblings also losing weight, without getting the treatment themselves.

“Kids don’t just grow out of obesity,” Armstrong explains. “They tend to develop more severe forms of obesity as they get older, and they develop health complications. So we want to offer people the most effective, evidence-based treatments as soon as we can.”

Other NIH-funded researchers are assessing how kids’ eating behaviors, genetics, environment, and brain structure contribute to weight gain.

“If your child has a high BMI and needs their weight addressed, model those healthy behaviors and have a healthy environment for them,” Osganian says. “Be supportive. Talk openly with your child and their primary care provider about weight and staying healthy.”

Some kids with severe obesity may be unable to lose weight with intensive lifestyle changes. These kids can be evaluated by an obesity medicine specialist. The specialist can screen them for genetic causes and advise on other treatments.