Childhood obesity has reached epidemic levels in developed as well as in developing countries. Overweight and obesity in childhood are known to have significant impact on both physical and psychological health. Overweight and obese children are likely to stay obese into adulthood and more likely to develop non-communicable diseases like diabetes and cardiovascular diseases at a younger age. 

Definition of Childhood Obesity : Although definition of obesity and overweight has changed overtime, it can be defined as an excess of body fat (BF). The Center for Disease Control and Prevention defined overweight as at or above the 95th percentile of body mass index (BMI) for age and “at risk for overweight” as between 85th to 95th percentile of BMI for age. 

Causes of Childhood Obesity: It is widely accepted that increase in obesity results from an imbalance between energy intake and expenditure. However, there is increasing evidence indicating that an individual's genetic background is important in determining obesity risk. The ecological model, as described by Davison et al., suggests that child risk factors for obesity include dietary intake, physical activity, and sedentary behavior. The impact of such risk factors is moderated by factors such as age, gender.

  • Family characteristics parenting style, parents’ lifestyles also play a role.
  • Environmental factors such as school policies, demographics, and parents’ work-related demands further influence eating and activity behaviors. 
  • Genetics are one of the biggest factors examined as a cause of obesity. Some studies have found that BMI is 25–40% heritable. However, genetic susceptibility often needs to be coupled with contributing environmental and behavioral factors in obesity.
  • Basal Metabolic rate has also been studied as a possible cause of obesity. Basal metabolic rate, or metabolism, is the body's expenditure of energy for normal resting functions. Basal metabolic rate is accountable for 60% of total energy expenditure in sedentary adults. It has been hypothesized that obese individuals have lower basal metabolic rates.
  • It is noted  that children learn by modeling parents’ and peers’ preferences, intake and willingness to try new foods. Availability of, and repeated exposure to, healthy foods is key to developing preferences and can overcome dislike of foods. Mealtime structure is important with evidence suggesting that families who eat together consume more healthy foods. Furthermore, eating out or watching TV while eating is associated with a higher intake of fat. 
  • Fast food Consumption: Increased fast food consumption has been linked with obesity in the recent years. Many families, especially those with two parents working outside the home, opt for these places as they are often favored by their children and are both convenient and inexpensive.
  • Sugary beverages, Snack foods: Another factor that has been studied as a possible contributing factor of childhood obesity is the consumption of snack foods. Snack foods include foods such as chips, baked goods, and candy. 
  • Portion size: Portion sizes have increased drastically in the past decade. Consuming large portions, in addition to frequent snacking on highly caloric foods, contribute to an excessive caloric intake. This energy imbalance can cause weight gain, and consequently obesity.
  • Activity level: One of the factors that is most significantly linked to obesity is a sedentary lifestyle. Each additional hour of television per day increased the prevalence of obesity by 2%. Television viewing among young children and adolescents has increased dramatically in recent years. The increased amount of time spent in sedentary behaviors has decreased the amount of time spent in physical activity. Research which indicates the number of hours children spend watching TV correlates with their consumption of the most advertised goods,including sweetened cereals, sweets, sweetened beverages, and salty snacks.
  • Family factors: Family factors have also been associated with the increase of cases of obesity. The types of food available in the house and the food preferences of family members can influence the foods that children eat.  
  • Family habits: Whether they are sedentary or physically active, influence the child.
  • Psychological factors: Depression and anxiety - A recent review concluded that the majority of studies find a prospective relationship between eating disturbances and depression. However,this relationship is not        unidirectional; depression may be both a cause and a consequence of obesity.  
  • Eating disorder: Traits associated with eating disorders appear to be common in adolescent obese populations, particularly for girls. A number of studies have shown higher prevalence of eating-related pathology in obese children/youth.

Management of Childhood Obesity:

Childhood obesity can profoundly affect children's physical health, social, and emotional well-being, and self esteem. It is also associated with poor academic performance and a lower quality of life experienced by the child. Obesity has been described as being “one of the most stigmatizing and least socially acceptable conditions in childhood.” Overweight and obese children are often teased and/or bullied for their weight. They also face numerous other hardships including negative stereotypes, discrimination, and social marginalization.

Healthy Eating and Nutrition for Obese: Changing the eating habits of obese children is absolutely essential. Parental influence shapes your child’s eating patterns. 

  • Start your nutrition overhaul by limiting sweets and soft drinks in your home.  Cut back your fast food consumption and make a conscious effort to cook more. 
  • Preparing a meal and eating together is not only healthy in a nutritional sense, but it’s also an excellent way to sneak in some family time. Center your meals and snacks around fresh foods instead of processed items, baked goods, or salty snacks. 
  • Try fresh fruits and vegetables, Lean proteins, such as chicken and fish, Whole grains, such as brown rice, whole-wheat pasta, and whole-grain breads, Low-fat dairy products, including skim milk, low-fat plain yogurt, and low-fat cheese 
  • Chances are good that your overweight or obese child will drop some weight as they transition to a healthier way of eating. Consult your pediatrician if weight loss doesn’t occur. You may need additional help from a nutritionist or dietitian. Lifestyle Changes to Fight Childhood Obesity.

Prevention of  Childhood Obesity.

  • Increase Physical Activity: Increase your child’s level of physical activity to help them shed weight safely. Use the word “activity” instead of “exercise” or “workout” to keep them interested. Playing hopscotch outside, for example, may be more appealing to a 7-year-old than jogging around the block. Consider encouraging your child to try a sport for which they’ve expressed an interest. The U.S. Centers for Disease Control and Prevention recommends that children get at least one hour’s worth of exercise daily to remain healthy.
  • More Family Activities: Find activities the entire family can enjoy together. This is not only a great way to bond, but it also helps your child learn by example. Hiking, swimming, or even playing tag can help your child get active and start on the path to a healthier weight. Be sure to vary activities to prevent boredom.
  • Cut Down on Screen: Time limit screen time, too. Kids who spend several hours a day watching television, playing computer games, or using their smartphones or other devices are more likely to be overweight. Be sure to vary activities to prevent boredom.                                                            

Conclusion:

The growing issue of childhood obesity can be slowed, if society focuses on the causes. There are many components that play into childhood obesity, some being more crucial than others. A combined diet and physical activity intervention conducted in the community with a school component is more effective at preventing obesity or overweight. Moreover, if parents enforce a healthier lifestyle at home, many obesity problems could be avoided. What children learn at home about eating healthy, exercising and making the right nutritional choices will eventually spill over into other aspects of their life.