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Principles of Health: Diabetes

Obesity, Childhood

by Paul Moglia, Kenneth Dill, Michael A. Buratovich

Causes and Symptoms

A chronic or recurrent imbalance between energy expended (how active one is) and energy ingested (how much one eats and drinks) will promote ill health. When ingestion regularly exceeds energy expenditure, the unused energy is stored in adipose tissue or body fat. Animal species that developed the capacity to store fat had a better chance of surviving times of scarcity. Rou-tine fat storages energy, as commonly occurs when high levels of physical activity are less and less necessary for survival, produces its pathology. Almost every person who eats and drinks more than he or she uses in energy (usually calculated in calories) will produce adipose tissue to store the excess energy.

Peptide hormones such as leptin and adipo-nectin regulate and balance energy expended with energy ingested. When leptin is absent (leptin deficiency), massive obesity is present; people with this condition improve upon administration of leptin. Adiponectin, the most abundant hormone in fat cells, is also an insulin sensitizer and an anti-inflam-matory signaler. Leptin and adiponectin, along with other peptide hormones, initiate a series of signaling processes that eventually lead to signaling hormones that turn on the food-seeking abilities of organs and muscles.

The formal definition of obesity in children is a body mass index (BMI) greater than or equal to the 95th percentile. Children between the 85th and 95th percentiles are at risk for obesity; those less than the 85th percentile have normal weight when correlated with their height.

Michelle Obama discusses her Let’s Move anti-childhood obesity movement (photo courtesy of Medill DC)

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Childhood obesity has many detrimental effects and comorbidities (other diseases and disorders) that often extend into adolescence and adulthood. It is simplistic to say that obese children will become obese adults. Still, childhood obesity often produces a metabolic syndrome that children bring into adolescence and adulthood. This syndrome has severe implications for quality of life and life expectancy. Metabolic syndrome is a combination of high insulin levels (hyperinsulinemia), obesity, high blood pressure (hypertension), and abnormal lipid levels (dyslipidemia). Metabolic syndrome ini-tiates a process that leads to an excess of insulin production that, in turn, promotes high blood pressure and dyslipidemia. Together, these produce aortic and coronary atherosclerosis (hardening of the arteries) and clogging of the arteries by fatty deposits in the blood.

Genetic factors play a fundamental role in child-hood obesity, as genetically obese families illustrate. People cannot exchange the genes that they have inherited, but environmental factors are also important, as they are the only ones where management is possible.

The psychosocial impact of childhood obesity is no less serious than physical syndromes. The psychosocial consequences of childhood obesity include poor body image, low self-confidence, social isolation, recurrent anger, early forms of eating disorders, clinical depres-sion, and negatively acting out in school and other social settings. Obese children are more likely to become underachievers who are underactive, less popular, and unhappy. Promoting physical activity is a critical intervention to lessen the psychological harm of obesity and control the amount and type of food and drink.

Treatment and Therapy

The most effective treatment for childhood obesity is prevention, and it can begin shortly after birth. Research shows that breastfed children have significantly lower rates of obesity in later years. All children must gain weight as they grow, and having an adequate amount of fat cells during early antenatal development is critically important for the maximal growth of key organs. Since baby fat is essential, its absence is problematic. As infants become toddlers and toddlers become children, the difference between healthy weight gains and weight gains that suggest the onset of obesity often requires the expert eye of a pediatrician or family physician. A healthy 5-pound weight (2.8 kilo-gram) gain in one five-year-old child may not be healthy in another child of the same age.

It is not until adolescence that children play a significant role in choosing and purchasing food. Until then, whatever children eat is most likely what adults have purchased or provided. Preventing obe-sity and correcting it when it occurs requires a thoughtful selection of food and beverage items at home and school. Fast and take-out foods are always an easy solution to busy, hectic family schedules, but they are almost always obesity-promoting. Junk food snacks and a quick solution to the transient hunger pangs of youth are similarly harmful.

Prevention and treatment are almost the same in dealing with childhood obesity. Parents control the food world of children, and making a variety of healthy choices becomes an integral part of achieving and maintaining healthy bodies that have modest amounts of adipose tissue, as children with a BMI of less than twenty are unhealthy. Obesity is much less likely to occur in families and schools that support healthy lifestyles: balanced nutritional consumption, physical activity and exercise, and sufficient sleep. (As a group, children who consistently get less sleep than they need are more likely to be obese than those who sleep enough. The specific number of hours any child might need is a function of several factors, including age.)

Successful school-based interventions in the management of obesity include:

prioritization of physical education classes;
healthy choices on the student menu and in vending machines;
proportional servings;
encouraging water as the primary beverage; and
the ready availability of after-school activities that involve physical activity, such as intramural sports.

When these elements are not present, effective obesity management for school-age children is difficult.

The key to successful long-term obesity prevention and treatment involves awareness of and respect for the individual child’s personal prefer-ences and enjoyments—nothing will enhance moti-vation more. Decreasing sitting time and the active encouragement of free play is far more effective than mandates to exercise or reduce food intake. Even in families where genetics plays a significant role in obesity, a healthy lifestyle will decrease the negative impact that obesity can have on the children’s overall health.

Perspective and Prospects

In 2010, the Centers for Disease Control and Prevention (CDC) reported that data from the 20072008 National Health and Nutrition Examination Survey showed that about 17 percent of US children and adolescents from ages two to nineteen are obese. Although a national study by the CDC showed that obesity among low-income pre-schoolers declined in nineteen states between 2008 and 2011, childhood obesity remains a public health crisis. Obesity has profound impacts on children’s long-term physical and psychological health and often leads to severe comorbidities in adulthood that are costly to treat and difficult to control. Focused strategies on modifying behavior and the slow but steady acquisition of healthy habits are the only ways that children will reliably manage the balance between calories consumed and calories burned. Adult habits, good and bad, are usually fos-tered during childhood. They reflect the level of care, attention, and perseverance of caregivers. Childhood obesity can be a problem of adults’ mismanagement much more than it is a problem of children’s choices. Parents and teachers make a major contribution to children when they provide a health-oriented environment in which children are more likely to acquire the habits that promote well-ness throughout their lives.

In 2006, to reduce the incidence rate of obesity in the United States, the Alliance for a Healthier Generation, the William J. Clinton Foundation, and the American Heart Association announced an agreement to fight childhood obesity. The five leading food manufacturers—Campbell’s Soup, Dannon, Kraft, Mars, and PepsiCo—vowed to reformulate their products to provide more nutritious choices for children. On February 9, 2010, President Barack Obama created the Task Force on Childhood Obesity and charged them with reviewing existing programs and formulating a national plan of action. First Lady Michelle Obama announced the start of her campaign to end childhood obesity, Let’s Move. The results of the Let’s Move campaign after five years, however, yielded mixed results. Positively, childhood obesity among children between two and five years old dropped 3.7 percent from 2010 to 2012, but the obesity rate increased by 2.1 percent for children twelve to nineteen during the same period. The overall childhood obesity rate remained at a constant 16.9 percent from 2008 through 2012.

Citation Types

Type

Format

MLA 9th

Moglia, Paul , and Kenneth Dill, and Michael A. Buratovich. "Obesity, Childhood." Principles of Health: Diabetes, edited by Michael Buratovich, Salem Press, 2020. Salem Online, online.salempress.com/articleDetails.do?articleName=POHDiab_0056.

APA 7th

Moglia, P., & Dill, K., & Buratovich, M. A. (2020). Obesity, Childhood. In M. Buratovich (Ed.), Principles of Health: Diabetes. Salem Press. online.salempress.com.

CMOS 17th

Moglia, Paul and Dill, Kenneth and Buratovich, Michael A. "Obesity, Childhood." Edited by Michael Buratovich. Principles of Health: Diabetes. Hackensack: Salem Press, 2020. Accessed December 14, 2025. online.salempress.com.

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