Changing the Course of Childhood Obesity

As the new school year kicks off, albeit in a very different way from years past, it’s a good time to consider how the challenges of school affects children. Even before COVID-19 redesigned the traditional classroom, requiring face masks and physical separation, children and teens today faced increased pressures from forces that didn’t even exist in their parents’ or grandparents’ time. Many of these issues, such as increased use of devices and diet, lead to a more sedentary lifestyle and contribute to childhood obesity.

It is rare these days for children not to have frequent access to a television, computer or smart phone. Research suggests that children spend an average of seven hours a day looking at some type of screen. While it’s reasonable to expect that part of this is school-related, it nonetheless emphasizes how much of a focus devices have become in children’s lives. And where there is a screen there are likely video games, which take up an average of two-plus hours per day for children between the ages of eight and 17.

If gaming isn’t their thing, there are plenty of cartoons and movies and social media options to distract our youth. In fact, a Pew Research study found that 60 percent of parents say their children have been interacting with smart phones since before they turned five-years; about one-third said their children were on smart phones before the age of two. Everything they want fits in the palm of their little hands!

In addition to a lack of exercise, poor food choices — by choice or default — also contribute to excess weight. It is not surprising, then, that childhood obesity is high, with nearly one in five school-aged children having obesity. More problematic is that this problem will likely follow them into adulthood. This means the problems associated with obesity, including diabetes, hypertension, high cholesterol, liver disease, orthopedic issues and depression can start at a young age and continue throughout their lives. Greater parental awareness is critical to a more informed awareness of the impact of obesity on children.

Having children diet is a controversial issue as it could be linked to future eating disorders and negative psychological effects associated with food. A better approach is to work with parents and focus on prevention and management. Discussion of weight should be restricted to parents since they play an important role in determining their children’s attitudes towards lifestyle. Parents who make a point of counting calories or exercising to “make up” for an indulgent meal provide subtle cues for “appropriate” behaviors, which can be challenging for children to follow.

Instead, encourage a family approach to creating a healthy relationship with food by being mindful about food selection and consumption. Routine and family meals are a good way to develop good eating habits, as is having children participate in meal preparation. Regularly incorporating physical exercise and play as part of daily activities, not as a punishment for, sets a better and more enjoyable pattern. Parents also should be reminded that children — like adults — experience weight fluctuations, which can be as much as 50 pounds during puberty.

Childhood obesity is a real and serious problem with many of the same effects as adult obesity. Pediatricians and general practitioners who treat children and parents should be aware of any medical conditions or medications that might contribute to obesity, as well symptoms that might indicate weight-related problems such as stretch marks, acanthosis nigricans, shortness of breath, or gastroenterological issues. Compared to adults, however, the approach to dealing with physical outcomes must be different because children are still growing and developing, they don’t necessarily have control over their eating choices, and the potential psychological impact, such as social isolation resulting from obesity, is just as important as physical outcomes. It’s important to encourage positive changes at a young age so that it can have the most significant impact possible in helping a child avoid a lifetime of obesity.