Pediatrics > Obesity In Children
Key points
Children and adolescents with a body mass index (BMI) above the 95th percentile for age and sex are defined as obese
Obese children usually first present at routine check-ups during which weight and BMI are assessed
Evaluation should include a fasting lipid profile and a fasting blood glucose level with insulin and C-peptide levels to assess degree of insulin resistance. Obese children newly diagnosed with diabetes should be evaluated for possible diabetic ketoacidosis and initiation of treatment and education
Treatment of obesity in children is difficult and involves dietary modification, increased physical activity, and behavior and lifestyle changes for the whole family
Treatment is often a long process requiring motivation and dedication, and the most difficult aspect of management is the subsequent maintenance of weight loss
Therapeutic failures and recurrence are common. Obese children often become obese adults. However, if obesity is treated early, the risk for obesity in adulthood is decreased
It is easier to prevent obesity than it is to treat it. Prevention of obesity can be fostered through breast-feeding infants and providing a healthy, balanced diet and routine physical activity for all children
Urgent action:
Hypoxemia with signs of obesity hypoventilation syndrome (Pickwickian syndrome) requires referral for further evaluation, including assessment for apnea
Obese children with hypertension should receive advice about lifestyle changes and weight reduction, and may need referral to a pediatric hypertension specialist
Background
Description
Obesity is associated with a high calorie intake and low level of physical activity. The recent increase in the incidence of childhood and adolescent obesity is thought to be related to the increased consumption of fast foods and sugar-sweetened beverages and decreased physical activity
Long-term morbidity is significantly increased