Childhood Obesity

What is childhood obesity?

Childhood obesity is a medical condition that impacts one-third of all children in the United States, and this condition has more than tripled in the last 40 years. Obesity can lead to other illnesses such as type 2 diabetes mellitus, elevated cholesterol, polycystic ovary disease, orthopedic issues, and obstructive sleep apnea.

Children with obesity are predisposed to obesity as adults. They may also have obesity-related complications for the rest of their lives. Obesity is caused by a complex interplay between environment, diet, physical activity, sleep, and biologic factors. If addressed early, it can be reversed. In rare cases, there are genetic or hormonal causes.

At Columbia, pediatric endocrinologists, gastroenterologists, nutrition experts, and bariatric surgeons collaborate to provide individualized care for each child with obesity. Our specialists provide individualized family-based nutritional assessment and counseling to address childhood overweight and obesity.

Through our Adolescent Bariatric Surgery Program, we provide multidisciplinary care to adolescents with severe obesity and can tell your whether your teen is a candidate for bariatric surgery.

How is childhood obesity diagnosed?

Childhood obesity is diagnosed when weight that is abnormally high for a child’s age and height. The body mass index (BMI) shows how a child compares to other children of the same age and sex:

• Normal weight: Between 5th and 84th percentile
• Childhood overweight: Between 85th and 94th percentile
• Childhood obesity: Above 95th percentile
• Severe obesity: 120% of the 95th percentile
• If your child has rising percentiles, you should discuss a program of weight management with the doctor.

Untreated, childhood obesity can lead to the following complications:

• Type 2 diabetes
• High cholesterol and/or high triglycerides
• High blood pressure
• Nonalcoholic fatty liver disease
• Obstructive sleep apnea
• Headaches
• Depression and anxiety

How can childhood obesity be prevented?

Childhood obesity can often be prevented by helping children to have healthy lifestyles. Here are some ways you can help prevent children from developing obesity:

• Eliminate sugar-sweetened beverages such as soda, sports drinks, and fruit drinks from your child’s diet and your household.
• Follow regular meal patterns and include at least one serving of fruits and/or vegetables with each meal and snack.
• Avoid high-calorie, nutrient poor foods such as fried and fast foods.
• Provide age-appropriate portion sizes.
• Limit TV and screen time to fewer than one or two hours daily.
• Encourage at least 60 minutes of active play or moderate to vigorous physical activity daily.
• Create bedtime routines and help your child obtain age-appropriate sleep patterns.
• Remove TVs from the bedroom. Turn off all screens (smartphones, computers, tablets) before bedtime.

What is the treatment for childhood obesity?

After ruling out any underlying medical condition, we will review your child's diet and lifestyle, recommending important changes. Our experts provide evaluations on a regular basis, monitoring your child's body mass index (BMI).

If your child becomes overweight with complications or obese, you may be referred for nutritional and behavioral counseling or to a multi-disciplinary weight management program.

Our dietitians will conduct an initial comprehensive assessment in collaboration with a doctor. Sometimes, blood tests to check cholesterol, blood sugar, and other tests might be needed. Ask if your child needs to be fasting before a blood test, and for how long.

Treatment focuses on identifying changes in your child's diet and other lifestyle activities that can be changed.

If diet and lifestyle are not effective in maintaining proper weight, and obesity is extreme, or causing other medical problems, adolescents may receive medical or surgical therapy.

When is surgery an option?

Surgery is considered when an adolescent has severe obesity or obesity with severe health complications and is unable to lose sufficient weight to reverse their health complications.

Surgery is a tool for weight loss, and it is only effective long-term when accompanied by healthy eating and physical activity behaviors. Experts at our comprehensive Adolescent Bariatric Surgery Program provide multidisciplinary evaluation for adolescents with severe obesity to assess their complications and suitability for bariatric surgery. Using state-of-the-art testing our team will also tailor nutritional therapy to each patient’s needs.