Pediatric Obesity in a Nutshell


Published Date: September 6, 2023

Pediatric Obesity in a Nutshell



Pediatric obesity…

Pediatric obesity is a chronic, complex, and multifactorial medical condition that is treatable using a comprehensive approach. The prevalence of childhood obesity is rising and affects children and adolescents worldwide. It is often not addressed with professional guidance or current educational resources.

Every child…

Every child deserves to live a healthy life without dealing with obesity and its negative consequences. Why should children carry this burden into their adult years? Healthy children will one day become healthy adults. When we teach healthy habits and reinforce them at a young age, we can break the “vicious cycle of childhood obesity”, which in turn can help prevent adult obesity and its sequelae.

Did you know…

Did you know that pediatric obesity places kids and teenagers at risk for chronic health conditions and life-threatening diseases now and in the future? Medical conditions associated with obesity include (but are not limited to) metabolic syndrome, sleep disturbances (obstructive sleep apnea most common), prediabetes, type 2 diabetes, dyslipidemia, hypertension, degenerative joint disease, exercise intolerance, polycystic ovary disease (female), hypogonadism (male), gallbladder disease, cancers, anxiety, depression, poor quality of life, and poor self-esteem.

In terms of the “nutrition pillar”…

In terms of the “nutrition pillar” it is essential to discuss the foods to limit (saturated fat, salts, sugar, or sweetened beverages). It is also our responsibility to help them learn about healthy food choices (fruits, reduced-fat dairy, protein, vegetables, whole grains, and water).

Activity is vital for health…

Activity is vital for health, so, it is discussed in the “physical activity pillar”. It includes biking, dancing, jogging, playing karate, playing team sports, swimming, walking, weight training, etc. Sedentary behavior in children is discouraged and includes spending many hours in the car, playing video games, reading, watching TV, using the computer/phone/tablet, etc.

The time to diagnose monitor and treat obesity in children is now

Failure to do so is unacceptable and unethical. It is the same as failure to diagnose, treat, and monitor coronary artery disease, diabetes, hyperlipidemia, hypertension, and other chronic medical conditions. So, realize the importance of addressing obesity as a disease, like all the other ones taught in medical schools.

Remember, childhood obesity is a serious matter

The American Academy of Pediatrics (AAP) pediatric obesity guidelines emphasize that the cornerstone of obesity prevention is risk assessment and anticipatory guidance. For children who are over the 85th percentile for weight and height (overweight and obesity), the cornerstone of treatment is intensive lifestyle intervention using the broad categories of optimizing nutrition, activity, and behavioral support.

It is imperative…

It is imperative to use a comprehensive approach to obesity prevention and treatment and move beyond BMI percentiles and numbers on the scale.

Choosing a healthy lifestyle is the first line of defense against obesity in kids and teens.

OMA (Obesity Medicine Association)’s definition of obesity is:

a chronic, relapsing, multi-factorial, neurobehavioral disease, wherein an increase in body fat promotes adipose tissue dysfunction and abnormal fat mass physical forces, resulting in adverse metabolic, biomechanical, and psychosocial health consequences.”

Since obesity is multifactorial, it needs to be properly treated, monitored, and managed by qualified healthcare professionals using a comprehensive framework, such as the OMA’s “four pillars of clinical obesity treatment”, which are:

  • nutrition
  • physical activity
  • behavior
  • medication

Behavior is key

Behavior is key for obesity prevention, management, and treatment in kids and teenagers. In the “behavior pillar”, it is crucial to discuss habits for eating, sleeping, dealing with mood and stressors, and using screening time. Kids and teens must learn to eat based on their body needs rather than emotions. It is encouraged to eat meals together as a family. They also need to have a good support system (family & friends) that encourages them to adopt healthy habits for life. There is an association between childhood obesity and screen time. Today, we are living in a world of technology, which is used in schools as well as at home.  Since 2020, many children and adolescents continued to have screen time for many hours per day. Increased screen time may negatively affect children’s weight and metabolic health.

Even children face weight bias and stigma

The disease of obesity is associated with chronic stress, often exacerbated by weight-based victimization and bullying. For this reason, ongoing assessment is necessary for psychosocial and physiological support. The use of trauma-informed care principles can be very useful.

September is National Childhood Obesity Awareness Month

It is a dedicated time to sharing information and teaching children and their parents about how to prevent childhood obesity and improve their metabolic health. It is a way to raise awareness about obesity, which is a complex medical condition that can affect the lives of many children. It is also a time to promote educational resources and tools about pediatric obesity.

It is imperative…

It is imperative to remember that patients dealing with obesity need our support and they need to be heard. They rely on us to be professional resources and partners in health as they maintain or regain their health and well-being. They need our help, time, trust, patience, encouragement, positive attitude, non-judgmental approach, etc.

The 5-2-1-0…

The 5-2-1-0 Healthy Children Initiative is endorsed by the American Academy of Pediatrics (AAP). These guidelines recommend that all children:

  • Consume five fruits and vegetables a day;
  • Limit recreational screen time to 2 hours or less per day;
  • Engage in at least 1 hour of active play;
  • Drink 0 sugar-sweetened beverages.

You, as a trusted health professional…

You, as a trusted health professional can help kids and teens have better health today for a healthier tomorrow. Take action now by learning more about pediatric obesity, using scientific tools to screen children, encouraging them to have healthy behaviors that can last a lifetime, and making a referral to a specialist when needed.

Written by: Nermeen (Nina) Asham, BScN, RN

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