Children who have a body mass index (BMI) at the same level or higher than 95 percent of their peers are considered to have obesity. Childhood obesity is a serious health threat to children. Kids with obesity have surpassed simply being overweight and are at risk for a number of chronic health conditions. Poor health stemming from childhood obesity can continue into adulthood.

Once considered a high-income country problem, overweight and obesity are now on the rise in low- and middle-income countries, particularly in urban settings. In Africa, the number of overweight children under 5 has increased by nearly 24% percent since 2000.

Overweight and obesity are linked to more deaths worldwide than underweight. Globally there are more people who are obese than underweight – this occurs in every region except parts of sub-Saharan Africa and Asia.

Childhood obesity doesn’t just affect physical health. Children and teens who are overweight or have obesity can become depressed and have poor self-image and self-esteem.

What causes obesity and overweight?

The fundamental cause of obesity and overweight is an energy imbalance between calories consumed and calories expended. Globally, there has been: an increased intake of energy-dense foods that are high in fat and sugars; and an increase in physical inactivity due to the increasingly sedentary nature of many forms of work, changing modes of transportation, and increasing urbanization.

Changes in dietary and physical activity patterns are often the result of environmental and societal changes associated with development and lack of supportive policies in sectors such as health, agriculture, transport, urban planning, environment, food processing, distribution, marketing, and education.

Family history, psychological factors, and lifestyle all play a role in childhood obesity. Children whose parents or other family members are overweight or have obesity are more likely to follow suit. But the main cause of childhood obesity is a combination of eating too much and exercising too little.

A poor diet containing high levels of fat or sugar and few nutrients can cause kids to gain weight quickly. Fast food, candy, and soft drinks are common culprits. Convenience foods, such as frozen dinners, salty snacks, and canned pastas, can also contribute to unhealthy weight gain. Some children develop obesity because their parents don’t know how to choose or prepare healthy foods. Other families may not be able to easily afford fresh fruits, vegetables, and meats.

People of all ages tend to gain weight when they’re less active. Exercise burns calories and helps you maintain a healthy weight. Children who aren’t encouraged to be active may be less likely to burn extra calories through sports, time on the playground, or other forms of physical activity.  Also, people who live in lower income neighborhoods might not have access to a safe place to exercise.

Psychological factors. Personal, parental and family stress can increase a child's risk of obesity. Some children overeat to cope with problems or to deal with negative emotions, such as stress, depression or to fight boredom. Their parents might have similar tendencies.

Socioeconomic factors. People in some communities have limited resources and limited access to supermarkets. As a result, they might buy convenience foods that don't spoil quickly, such as frozen meals, crackers and cookies

Health Risks Associated with Childhood Obesity. Children who have obesity have a higher risk of developing health problems than their peers who maintain a healthy weight. Diabetes (children and adults who are overweight are more likely to develop type 2 diabetes which may be reversible through diet and lifestyle changes),  heart disease (high cholesterol and high blood pressure raise the risk of future heart disease in children with obesity) and asthma (obesity is the most common comorbidity  with asthma) are among the most serious risks. Others are sleep disorders (such as excessive snoring and sleep apnea) and joint pain (joint stiffness and limited range of motion). Childhood obesity is also associated with a higher chance of obesity, premature death and disability in adulthood. But in addition to increased future risks, obese children experience breathing difficulties, increased risk of fractures, insulin resistance and psychological effects.

 Nonalcoholic fatty liver disease (NAFLD). This disorder, which usually causes no symptoms, causes fatty deposits to build up in the liver. NAFLD can lead to scarring and liver damage.

Childhood obesity can lead to reproductive problems like irregular menstruation and hormonal imbalances, heartburn, reflux, and other digestive problems.

Lifestyle Changes to Fight Childhood Obesity.

Lifestyle Changes is the mainstay of treatment.

If your child has been diagnosed with obesity or is overweight, adopting some or all of these measures can help your child reach and maintain a healthy weight. If your child is not currently overweight, the same steps can help prevent obesity over a lifetime. Another benefit: Embracing healthy lifestyle measures as a family will improve not just your child’s health but that of everyone in the household.

Make sure your child gets adequate exercise. In addition to burning calories, physical activity strengthens children’s bones and muscles, helps them fall asleep and get good quality rest, and can boost their mood and energy. Experts recommend that children get between 150 and 300 minutes per week of moderately intense physical activity. This can take many forms, from going outside for a hike or game of tag to sliding around the house in your socks to having a dance party in your living room. Some other popular ideas: Playing at a playground, playing hide-and-seek, jump-rope, having races on foot or bike, dance or martial arts classes, roller skating/rollerblading, swimming, and biking.

Serve healthy foods. Focus on serving your child whole foods like fruits, vegetables, whole grains, seeds, nuts, and lean proteins. Emphasize fresh fruits and vegetables in particular. Cut back on processed and convenience foods like cookies, crackers, fast food, and prepared meals, all of which can be high in sugar, fat, and calories.

Limit sweetened beverages. Fruit juice and sodas can be high in calories, low in nutrients, and can fill your child up, making it hard for them to eat the food that will keep them healthy and satisfied between meals.

Limit take out and eating out. Restaurant meals are often high in sodium and fat, which can contribute to obesity and high blood pressure. They are also often served in quantities much bigger than a child needs.

Eat together, sitting down, for family meals. Try to avoid the TV, computer, or video games at mealtimes, which can encourage overeating and distract kids from their satiety signals. Model healthful, mindful eating where you focus on and enjoy your food. And try to have everyone in the household eat the same thing.

Make sure your child gets enough good quality sleep. Not getting enough sleep can lead to weight gain by increasing levels of ghrelin, the hormone responsible for appetite. Too little sleep can also rob your child of the energy to exercise during the day and encourage cravings for sugary foods for quick energy.  To help your children get a good night’s sleep, serve their last meal at least two hours before bedtime, limit screen time in the evening, dim the lights, and have a consistent nighttime routine.

Teach stress-relieving practices. Stress can cause weight gain by weakening self-control, leading kids (and adults) to soothe themselves through food, and by causing hormonal changes that increase weight gain. Children’s yoga, breathing exercises, meditation, or quiet art projects can help to calm mind and body.

Be consistent (but leave room for exceptions).  Consistency is key! Daily healthy eating and exercise habits are important for long-term success. However, that doesn’t mean your child can’t enjoy a treat for special occasions or take a few days off from exercise if they’re tired or not feeling well. What you do most of the time is what matters.

Limit screen time. Being sedentary with video and computer games, watching TV, texting, and scrolling social media can make it hard to keep weight in check. The WHO recommends that children older than two get no more than two hours of screen time a day, and that children younger than two shouldn’t have any.

Practice positive messaging. Be careful about what you communicate about weight to children.  Avoid being critical of your body in front of your children, which may lead them to develop the same stigma around their body.

Medication. If diet and lifestyle changes aren’t sufficiently addressing or preventing obesity, you can talk to your child’s health care provider about prescription weight loss medications. Typically, these drugs are reserved only for severely obese adolescents who have been unable to lose weight through lifestyle changes.

SUPPORTING YOUR CHILD. It’s important that parents play a loving and supportive role in the upbringing of all children, but especially if your child is facing stigma or self-confidence issues from being obese. To support your child, try to build up their confidence by praising their successes and skills, and avoid commenting on your child’s body, appearance, or weight.

Also very important: Do not encourage your child to diet, skip meals, or go hungry. Growing children need solid nutrition. Focus on affirmative behaviors rather than deprivation. Provide healthful meals and snacks full of colorful fruits, vegetables, whole grains, lean proteins, and healthy fats.