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Obesity In Children, Ambulatory Care

WHAT YOU NEED TO KNOW:

Obesity

is a medical condition that occurs when a child weighs more than is healthy for his or her age, height, and gender. It happens over time if your child eats more calories than he burns. Obesity is diagnosed with a physical exam and measurement of body mass index (BMI). Healthcare providers use your child's height and weight to measure the BMI. A child is obese when the BMI is at least 95% higher than it should be, based on his or her age and gender.

The risks of obesity include

many health problems. Some may develop while he is a child. Others may develop when he becomes an adult.

• Heart disease, high blood pressure, and high cholesterol
• Arthritis, knee, and hip pain
• Diabetes
• Gallbladder and liver disease
• Asthma and sleep apnea (your child stops breathing for several seconds at a time while he sleeps)
• Abnormal monthly periods in girls, and other hormone problems
• Low self-esteem, being bullied, depression, and eating disorders
• A higher risk of obesity as an adult

Contact your child's healthcare provider for the following symptoms:

• Signs of gallbladder or liver disease, such as pain in your child's upper abdomen
• Hip or knee pain and discomfort while your child is walking
• Signs of diabetes, such as constant hunger, thirst, and frequent urination
• Signs of depression, such as lost interest in social activities and not wanting to go to school
• Trouble breathing during physical activity
• Signs of sleep apnea, such as daytime sleepiness, snoring, or bed wetting
• Severe headache or vision problems

Treatment for obesity

is based on your child's age, how severe his obesity is, and if he has other health problems. Your child's healthcare provider may suggest that your growing child maintain his body weight. As he continues to grow, his BMI will decrease. Even a small decrease in BMI can reduce the risk of many health problems.

• Lifestyle changes are the first step in treating obesity. These include making healthy food choices and getting regular physical activity.
• Other treatments may be suggested by your child's healthcare provider if your child is older and has medical problems caused by obesity. These treatments are used in addition to lifestyle changes to treat severe obesity. Medicines can help decrease the amount of fat your child's body absorbs from the food he eats. Another treatment is surgery to insert a gastric band or bypass part of your child's stomach.

How you can help your child:

• Set small goals, and work on 1 or 2 goals at a time. An example of a small goal is to offer fruits and vegetables at every meal. Aim for progress, not perfection.
• Teach your child how to make healthy choices at school and when he is away from home. Praise your child when he makes healthy choices. Do not talk about diets or weight. Do not allow teasing in your home.
• Do not use food to reward or punish your child. Reward him with fun activities or social events with friends.
• Try not to bring chips, cookies, and other unhealthy foods into your home. Shop for healthy snacks such as fruit, yogurt, nuts, and low-fat cheese.

Eating changes your family can make:

• Stick to a schedule of 3 meals a day and 1 or 2 healthy snacks. Meals and snacks should be 2 to 4 hours apart. Only offer water between meals. Eat meals at the table.
• Eat dinner together as a family as often as possible. Ask your child to help you prepare meals. Limit fast food and restaurant meals because they are often high in calories.
• Reduce portion sizes. Use small plates. Fill your child's plate half full of fruits and vegetables. Do not put serving dishes on the table. Do not make your child finish everything on his plate.
• Limit soda, sports drinks, and fruit juice. These sugary beverages are high in calories. Offer your child water as his main beverage.
• Pack healthy lunches to take to school and work. An example is a turkey sandwich on whole wheat bread with an apple, baby carrots, and low-fat milk.

Activity changes your family can make:

• Encourage your child to be active for 60 minutes most days of the week. Find sports or activities that are fun for your child, such as cycling, swimming, or running. Also be active with your child. Go for a walk, go bowling, or play at a park.
• Limit TV, video games, and computer time to 1 to 2 hours each day. Do not let your child have a TV in his bedroom. Do not allow eating in front of a TV or computer. Turn off electronic devices at a set time each evening.
• Enforce a regular bedtime. Make sure your child gets at least 8 hours of sleep each night. Sleep schedules that are not consistent can affect your child's weight.

Follow up with your child's healthcare provider as directed:

Your child may need follow-up visits to check his weight. You and your child may need to meet with a dietitian. Write down your questions so you remember to ask them during your visits.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.