{"id":16937,"date":"2018-07-10T10:19:23","date_gmt":"2018-07-10T16:19:23","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=16937"},"modified":"2024-03-14T13:38:02","modified_gmt":"2024-03-14T19:38:02","slug":"pediatric-obesity-requires-lifestyle-changes","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/pediatric-obesity-requires-lifestyle-changes\/","title":{"rendered":"Childhood obesity requires lifestyle changes"},"content":{"rendered":"
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Source: Getty Images.<\/figcaption><\/figure>\n

Your child loves video games. Doesn\u2019t like to play outside. Craves fast food. And he or she is looking a little chubby. Should you worry?<\/p>\n

Maybe.<\/p>\n

About 17 percent of American children and adolescents are obese, according to the Pediatric Endocrine Society, said Dr. Karin VanBaak, an assistant professor for the Department of Family Medicine, Division of Sports Medicine at the University of Colorado School of Medicine. She spends most of her time as a family physician at UCHealth Family Medicine Clinic – Boulder<\/a>. She also teaches family medicine residents at A.F. Williams Family Medicine \u00ad\u2013 Stapleton. \u00a0And she serves as a team physician for CU Boulder Athletics.<\/p>\n

VanBaak<\/a> is particularly interested in the overlap between primary care and sports medicine, including mental health, preventive care, lifestyle management of chronic illnesses and the management of medical problems in athletes.<\/p>\n

One issue that interests her in the overlap between primary care and physical activity is pediatric obesity.<\/p>\n

Who makes a diagnosis of pediatric obesity?<\/strong><\/h2>\n

The formal diagnosis of obesity in children can be made by their physician<\/a> based on a child\u2019s weight and other growth measurements, she said.<\/p>\n

These guidelines come from the Pediatric Endocrine Society <\/a>and the European Society of Endocrinology<\/a>.<\/p>\n

The condition should be taken seriously, she added.<\/p>\n

But won\u2019t most kids \u201cgrow out of it?\u201d<\/p>\n

\u201cSome kids\u2019 weight will normalize as they grow, but I think that just focusing on the weight or BMI number is a mistake,\u2019 she said. \u201cI think it\u2019s our job as physicians to identify how a kid got into this situation in the first place. The habits that lead to pediatric obesity are harmful in the short and long term, increasing the lifelong risk or medical problems.\u201d<\/p>\n

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Dr. Karin VanBaak<\/figcaption><\/figure>\n

Obesity at a young age can increase the child\u2019s risk \u201cof just about anything you can think of,\u201d she said. \u201cWe tend to focus on the risks of early high blood pressure, diabetes and heart disease. But obesity in kids also increases their risk of mental health problems, musculoskeletal pain and injury\u201d and it also can contribute to social and academic difficulties, she added.<\/p>\n

There can be many and varied causes.<\/p>\n

\u201cGenetics definitely plays a role,\u201d VanBaak said. But the whole picture is a combination of genetic predisposition, biologic factors and lifestyle.<\/p>\n

\u201cI do think that\u00a0it’s important to focus on preventable causes,\u201d she said. \u201cDiet is important, and we will often ask families about how many sugar-containing beverages children are consuming. Lack of physical activity is another major risk factor, and the risk factor of too much screen time is related to physical activity.\u201d<\/p>\n

Is the solution a change in diet?<\/strong><\/h2>\n

The treatment is not simple, she said.<\/p>\n

\u201cIt takes a multifaceted approach and commitment by the child, parents and sometimes others, including teachers,\u201d VanBaak said.<\/p>\n

\u201cWe have strong evidence that the best treatment is family-centered and focuses on lifestyle modifications,\u201d including diet and increased physical activity.<\/p>\n

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Source: Getty Images.<\/figcaption><\/figure>\n

\u201cWe might also suggest behavioral strategies to help address any family or personal stressors that may lead to or result from obesity.\u201d<\/p>\n

Ultimately, though, the best treatment is prevention, she added. And prevention pretty much follows the same path as treatment.<\/p>\n

\u201cIt\u2019s much easier to prevent obesity than to reverse obesity,\u201d she said.<\/p>\n

\u201cThere is also some evidence that children with disordered sleep patterns are more likely to be obese and that addressing sleep patterns can help with obesity treatment.\u00a0We also know that breast-feeding infants rather than formula feeding infants seems to help decrease the risk of obesity later in life,\u201d she said.<\/p>\n

How much exercise is needed?<\/strong><\/h2>\n

A good diet is important, but so is exercise, she said.<\/p>\n

\u201cLet’s move! Movement is so important for kids. It has many, many health benefits,\u00a0and\u00a0just one of these is that it can help kids\u00a0maintain\u00a0a normal weight or\u00a0return to a normal weight.\u201d<\/p>\n

Current recommendations say that kids should get at least 20 minutes of vigorous\u00a0physical activity five days a week, and ideally kids will get at least 60 minutes of vigorous\u00a0physical activity five days a week.<\/p>\n

\u201cExercise is essential,\u201d she said, \u201cnot just for treating obesity or helping kids maintain a normal weight, but for lifelong overall health.<\/p>\n

\u201cI really like the Let’s Move initiative started by our former First Lady, Michelle Obama. One thing that I really like about this initiative is the focus on \u2018movement\u2019 and \u2018play\u2019 instead of \u2018exercise.\u2019 I worry sometimes that \u2018exercise\u2019 can turn into a chore for kids. Instead, it’s important for us to help our kids and families find a variety of ways to be active that they enjoy. I don’t think that exercise should\u00a0mean spending time on a treadmill watching TV. We find even wider benefits from getting kids outside, spending time with family, moving, and playing at the same time.\u201d<\/p>\n

She added that she \u201ccan\u2019t stress enough\u201d the importance of family involvement in treatment.<\/p>\n

Can medications\u00a0help?<\/p>\n

\u201cIf you ask Dr. Google, you will find a wide range of medications that promise to help with weight loss. Some of these are\u00a0options for adults, but we only use medication in children in rare cases, and we always try lifestyle changes first. The same goes for bariatric surgery and kids. We always\u00a0prefer to focus on the underlying cause. As family doctors, we think that it is never too early to develop lifelong\u00a0healthy habits.\u201d<\/p>\n

At what age should a parent become concerned that their child is overweight?<\/p>\n

\u201cThere is no simple answer to this question,\u201d she said. \u201cAnd the question illustrates the importance of having your child well known by their family doctor or pediatrician so the doctor and parents can follow their weight closely over time.<\/p>\n

\u201cOur guidelines give physicians different ways to measure obesity in kids over and under 2 years of age. That being said, we prefer to make the diagnosis based on weight trends over time, and not just a single measurement.\u201d<\/p>\n

Why is obesity in teens hard to treat?<\/strong><\/h2>\n

Obesity can be especially difficult to treat in teenagers, for several reasons.<\/p>\n

\u201cAdolescence is a stressful time with a wide variety of stresses that are unavoidable, including changes in social stresses, changes in academic expectations, time pressure, increased incidence of mental health issues, and others,\u201d she said.<\/p>\n

\u201cBecause of this, it can be a more complicated issue to untangle than obesity in younger children. The second issue is that by time someone is a teenager, they have had a long time to build ingrained habits and it can be more difficult to break out of those habits.\u201d<\/p>\n

VanBaak is particularly concerned about the current addiction to electronic devices.<\/p>\n

\u201cAs time goes on, family doctors and pediatricians are continuing to realize that time in front of electronic screens has an important role to play in the development of pediatric obesity. This can be tied into movement, but also has separate effects on mental health and learning.<\/p>\n

\u201cIt’s really important to try and follow the guidelines that we have that recommend limiting non-academic screen time to 1-2 hours per day.\u201d<\/p>\n

In other words, parents need to pay attention to their child\u2019s weight and overall well-being, working with their pediatrician or family physician to make sure they grow up healthy.<\/p>\n

Good resources:<\/strong><\/h2>\n

The following resources may be helpful for parents:<\/p>\n