Overweight in children

Overweight in children: description

In the industrial nations, more and more people are suffering from obesity. Children are also affected: In Germany, depending on the definition, ten to twenty percent of all children and adolescents are overweight. About a third of them are even obese (obese). Expressed in figures: In Germany 1.4 to 2.8 million minors are too fat and about 700,000 are obese.

Worldwide, around ten percent of children between the ages of five and 17 are overweight. In Europe, even every fifth child is too fat. Childhood obesity is particularly widespread among children in the USA, where more than 30 percent of the offspring weigh too many kilos.

Overweight in children: symptoms

Overweight children – depending on the extent of the excess fat pad – suffer from various complaints. They are often less physically resilient and fatigue during exercise and sports faster than normal-weight peers. Some sprouts get shortness of breath and shortness of breath during sleep or even short nocturnal respiratory failure (sleep apnea) – especially in case of severe obesity.

In addition, children who weigh too much often experience increased perspiration and orthopedic problems such as back or knee pain. The latter is due to the fact that a large body weight in the long term, the joints heavily loaded (especially spinal joints, hip, knee and ankle) and accelerated their wear.

Obese children are often larger than normal-weight peers when they enter puberty. The growth spurt that usually sets in during puberty then turns out to be lower. If overweight children, on the other hand, are smaller than their peers, this should be specifically clarified by a doctor.

Being overweight in children can also have psychological effects. Teasing by other children and constant admonitions from parents to eat less can put a lot of strain on those affected.

Overweight in children: causes and risk factors

Obesity in children may be due to a variety of causes, most of which occur in combination:

heredity

Child obesity in many cases means that the parents and / or grandparents too many kilos on the scales bring. Genetics are one of several factors that determine body weight. But that does not mean that overweight parents inevitably have overweight children. It also depends on other factors like nutrition.

Large portions in pregnancy

If pregnant women regularly eat “for two”, move a little and gain a lot of weight or even develop gestational diabetes, the risk of the child becoming overweight later on increases.

Smoke

Very often overweight is observed in children whose parents (especially mothers) have smoked during pregnancy. In addition, active and passive smoking in pregnancy pose further health risks for the offspring such as miscarriage and sudden infant death syndrome.

Unfavorable diet

Diet has a major impact on the development of obesity in children, from birth. Studies show that breastfed children do not become overweight as often as bottle children.

As with adults, it also applies to children and adolescents: those who consume more energy in the long term than they consume are more likely to become overweight. Especially the regular enjoyment of fast food (such as burgers, pizza, fries), sweets and sweet drinks (soda, cola etc.) promotes overweight in children.

Most children in the family learn about eating habits: if mom and dad eat unhealthily, the offspring will take over.

lack of exercise

Sitting for hours in front of the TV or computer contributes significantly to the development of obesity in children. This is all the more true, if the sprouts also incidentally consume sweets, chips & Co. Here, too, the role model function of parents comes to fruition: If they spend their free time mostly with the chip bag on the couch, the next generation will imitate them soon.

stress

Anger or overwork in the school, quarrels in the family, neglect by the parents – some children are exposed to stress at different levels and often can handle it badly. Many seek refuge and comfort in their food. In addition, stressed offspring are constantly under power and can not relax. This also contributes to the development of obesity in children.

lack of sleep

Children who sleep very little are at a higher risk of becoming overweight than sleepy peers.

Overweight in children: examinations and diagnosis

The pediatrician is the first point of contact to clarify child obesity. He will first gather important information in conversation with the parents and possibly the children themselves. Above all, they affect dietary habits, physical activity, possible ailments, underlying illnesses and psychological stress on the child and the intake of medicines (such as cortisone). In addition, the doctor asks if other family members already have obesity or obesity.

This is followed by the physical examination. It includes, among other things, a blood pressure measurement and the measurement of height and weight of the child. In adolescents, the ratio of hip to waist circumference is determined to determine the body fat distribution (android type: fat pad especially on the body trunk, gynoider type: fat pad especially on the buttocks and thighs).

Overweight in children: how much weight is too much?

Obesity in children is not as easy to determine as in adults. It is indeed – as in adults – the body mass index (BMI) determined, ie the ratio between the body weight (in kilograms) and the square of the height (in square meters). However, the calculated value must then be compared to the values ​​of gender and age-specific growth curves (percentile curves) to assess whether a child’s BMI is overweight or even obese:

Children and adolescents are overweight if the calculated BMI is above the age- and gender-specific 90th percentile (90th percentile means that 90 percent of all children of the same gender and age have a lower BMI).

At a BMI above the 97th or the 99.5. Percentiles, even obesity (obesity) or extreme obesity (extreme obesity).

Further investigations

Overweight in children is caused in rare cases by an underlying disease such as hypothyroidism (hypothyroidism). Such causative diseases must be excluded in the clarification of increased body weight.

On the basis of specific examinations, secondary diseases of overweight and, above all, obesity (such as lipid metabolism disorders, diabetes, gallstones) can be detected early. These include the measurement of blood lipid levels and blood sugar as well as ultrasound examinations of the liver and gallbladder.

If there is obesity (ie, severe overweight) in children, a psychological, psychosocial and behavioral diagnosis is also recommended. The person may be suffering from a serious psychiatric illness (such as depression, eating disorder). Sometimes there are also severe psychosocial stress such as behavioral and developmental disorders or extreme stress situations in the family. These factors must be clarified and taken into account in the therapy.

Overweight in children: treatment

Whether and how obesity in children is treated depends on the extent of excess fat deposits, possible comorbidities and the age of the person affected:

Obesity in children between two and six years sometimes increases. Therefore, a constant weight is recommended here: The sprouts should keep their current weight with a healthy, well-balanced diet and lots of exercise in order to “grow out” of the fat pads as they get older.

If obesity (severe overweight) is present in children between 2 and 6 years without concomitant diseases, weight constancy is also recommended. However, if comorbidities occur, those affected should lose weight.

Obesity in children over the age of six and adolescents only requires weight loss if comorbidities persist. Otherwise, it is sufficient to hold the weight. Obesity in this age group, on the other hand, should always be targeted for weight loss, regardless of whether comorbidities exist or not.

Overweight in children: What is the treatment?

Childhood obesity should be treated according to a multidisciplinary approach that includes nutrition counseling and conversion, regular exercise and sports and, where appropriate, psychological support. In certain cases of severe obesity in children, inpatient treatment may be useful as part of a long-term therapy program.

nutrition

To treat obesity in children, a balanced diet with regular meals is necessary. Optimized mixed diet, which was developed by the Research Institute for Child Nutrition (FKE) for offsprings aged between one and 18 years, is recommended:

• Plentiful: Low-calorie or non-alcoholic beverages, vegetable foods (vegetables, fruits, cereal products, potatoes)
• Moderate: animal foods (milk, dairy, meat, sausage, eggs, fish)
• Economical: high-fat and high-sugar foods (edible fats, sweets, munchies)

How many calories overweight children may take during the day depends, among other things, on the individual therapy goal.

When changing your diet, a specialist (such as dietician, nutritionist) can help.

Move

Regular physical activity is essential if you want to fight obesity in children. Especially suitable are endurance sports such as swimming, cycling and dancing. Many offspring are not motivated enough to go through their sports program alone. Then sports groups are recommended: If you pedal together with other obese or dabbling in the water, it is usually much more fun.

Even in everyday life, overweight children should move a lot, for example by taking the stairs instead of the elevator and using the bicycle or their own feet instead of getting into the car or the bus.

Therapeutic help

Above all, in obesity (ie heavy obesity) in children, the therapy should also include psychological support, such as in the form of behavioral therapy or family therapy. For example, the offspring receive help in changing their nutritional and physical behavior as well as in the event of psychological problems (such as depression or inferiority complexes).

Other forms of therapy

If obesity (severe overweight) in children can not be successfully treated by conventional therapy or serious comorbidities exist, other forms of therapy can be tried that have not been adequately tested. These include formula diets as well as medications to aid weight loss. The decision should be made by a therapist with experience in obesity in childhood and adolescence.

Overweight in children: disease course and prognosis

When treating obesity in children, one should aim for realistic goals and not expect quick success, as these are usually not lasting. The better chances for a lasting success result from small steps in the direction of the goal (weight constancy or weight loss).

Child obesity can interfere with physical and emotional development. This is especially true in case of severe obesity (obesity). Possible consequences are:

• accelerated growth in length and earlier skeletal maturity (due to increased levels of growth factor (IGF), which is increasingly formed in adipose tissue and in the liver)
• Tearing of the connective tissue during fast or heavy weight gain (“stretch marks”)
• Insulin resistance (reduced response of the body cells to the blood sugar-lowering hormone insulin) and subsequently diabetes mellitus
• increased testosterone levels in girls with signs of masculinization (virilization), such as male hair; decreased testosterone levels in boys
• increased estrogen levels in both sexes (in boys this increases the size of the breast, technical term: gynecomastia)
• early onset of puberty (earlier onset of first menstrual period, earlier onset of voice break, etc.)
• High blood pressure (hypertension)
• elevated blood lipid levels
• Overuse of tendons, joints and muscles with consequences such as back pain, lowering and spreading feet, X or O legs etc.

Especially severe overweight in children can lead to high blood pressure, diabetes and elevated blood lipid levels, which together favor arteriosclerosis. This can cause coronary heart disease (CHD), heart attack and stroke. For this reason, sufferers have a lower life expectancy than normal-weight peers.

Possible emotional consequences of (strong) Overweight in children and adolescents are, for example, stress, anxiety and depression.