Childhood Obesity
Mary F Shackelton, MPH, ND.
303-448-9098
www.allnaturaldoc.com

Between 5-25 percent of children and teenagers in the US are obese (Dietz, 1983), and some data indicates that the prevalence of obesity among children is on the rise. Obesity is defined as total body weight which is more than 25% fat, or weight in excess of 120% of ideal body weight according to height and weight charts (Lohman, 1987).

The causes of childhood obesity are complex and can be familial, physical, endocrinologic, and emotional .

Family
• The risk of becoming obese is greater among children who have obese parents (Deitz,1983). However, it is unclear whether this is due to the genetic contribution to the condition, or whether the effect of parental modeling of eating and exercise behaviors is more influential.

Physical Exercise
• The average American child spends more time than ever watching television and sitting in front of the computer.
• Only 1/3 of elementary children have daily physical education, and fewer than 1/5 have extracurricular physical activity programs at their schools (Ross & Pate, 1987).

Endocrinologic
• Hypothyroidism, hyperinsulinism, and hypercortisolism are some potential yet
rare causes for obesity.

Dietary:
• Foods that contribute to weight gain are foods high in carbohydrates that are being emphasized in greater amounts in school lunch programs as well as at home (e.g.cookies, bread, grains, juices, soda, fast food, sweets, potatoes, chips).

Health Effects of Childhood obesity
Children who are obese have increased average blood pressure, heart rate, and cardiac output when compared to their non-obese peers (Wattigney, WA 1991). Elevations in insulin and glucose intolerance are nearly universal in obese children (Berenson, GS 1993). Thus they are predisposed to adult onset diabetes or Type II diabetes that is also on the rise nationally. Additionally, obese children also run the risk of suffering from orthopedic problems such as joint or muscle problems.

Treatment considerations
It is recommended that children suffering from obesity focus on slowing the weight gain, so the child will grow into their body weight over a period of months or years. The goal is not rapid change but sustained lifestyle and behavior modification that supports their health for life.

Physical Activity
Physical activity is essential for a lifetime reduction of obesity. Consistency and frequency with physical activity are the keys to success rather than high intensity and duration of workouts. Choosing team sports is valuable socially and may reduce having to "schedule" exercise. A reasonable and yet effective goal for exercise for children as well as adults is 20-30 minutes per day of moderate exercise (walking, skating, skateboarding, biking).

Dietary management
Rather than recommend a specific number of calories to adhere to per day and rather than prescribe a "diet", I recommend that parents and families learn how to merely eat "right". Talk with a qualified person to guide your food choices in the beginning.

Some simple tips include eating whole and nutritious foods only, decreasing processed and nutritionally deficient foods, and including more vegetables and fruits. It is important to avoid strategies that may be psychologically stressful for the child, those that may affect growth, and those that may hinder a child’s perception of normal eating.

Weight loss strategies I do not advocate include: diet drinks, diet bars, diet supplements or herbal supplements for weight loss, Slim Fast or other liquid diets, starvation or calorie restriction. These strategies are not aimed at the "cause" of the obesity, but rather are aimed at treating the symptom of obesity that is extra weight. To treat the cause of obesity, make permanent and healthy lifestyle changes.