Childhood obesity is one of the serious diseases that affect children and cause them to suffer, and deprive them of many things that other children enjoy. An obese child does not live a happy childhood, because his life is threatened by many risks. Childhood obesity is a global problem that threatens the lives of children because of its serious negative effects on their health. For this reason, and in an attempt to understand childhood obesity and know its causes and risks, and methods of treatment and obesity in children, we will learn through the Dalili Medical website to answer the most important questions related to childhood obesity for parents.

**Definition of obesity in children**

 

Obesity is a condition represented by an abnormal or excessive accumulation of fat in the body, which may lead to health risks and harm.

The body mass index (BMI) is an effective tool for determining the weight status of all age groups and genders. This index helps to know whether the weight is within the normal range or if there is an increase or decrease. It is calculated by dividing a person's weight in kilograms by the square of his height in meters.

Obesity is a common issue among children, with the latest statistics from the Centers for Disease Control and Prevention showing that 19.3% of children are obese. In more detail, the percentages are as follows:

- 4% of children aged 2 to 5 years.

- 3% of children aged 6 to 11 years.

- 2% of children aged 12 to 19 years.

**Children aged 5-19 years**

Overweight and obesity in children aged 5 to 19 years are defined as follows:

- A child is considered overweight if his or her body mass index for his or her age exceeds the average normal weight by one point, according to the standards approved by the World Health Organization. Obesity is defined as when the body mass index is greater than the average normal weight by two points according to the same standards.

**Children under 5**

For children under 5 years of age, a child is considered overweight if their weight-for-height is two points above the average weight for their height according to the World Health Organization’s Child Growth Standards. Obesity in this age group is defined as when their weight-for-height is three points above the average weight for their height according to the same standards.

What can obese children do to lose weight?

 

Obesity education and behavioral changes are key elements of weight management. Children should be helped to understand their ideal weight, as well as being taught how to follow a healthy diet and exercise appropriately.

**Grades of obesity:**

- **Grade 1 obesity:** BMI between 30 and 35.

- **Grade 2 obesity:** BMI between 35 and 40.

- **Grade III obesity:** Also known as extreme or severe obesity, where the body mass index exceeds 40.

**When is gastric sleeve surgery the most appropriate option for children?**

 

Gastric sleeve surgery is an effective solution to help children overcome obesity, as it removes the upper part of the stomach that contains the hunger hormone, which reduces the child's feeling of hunger. It also reduces the size of the stomach by 80%, which allows for eating smaller amounts of food, thus leading to gradual weight loss that contributes to improving the child's psychological and health.

**Benefits and advantages of obesity surgery for children**

 

Obesity surgery for children plays an important role in treating many serious health problems associated with obesity, including:

- Eating disorders.

- Type 2 diabetes.

- Cardiovascular diseases.

- High blood pressure inside the skull.

- Fat accumulation in the liver, leading to fatty liver disease.

- Sleep apnea, which about 22% of obese children suffer from.

**Can obesity surgeries be performed on children?**

Treating childhood obesity is very similar to treating obesity in adults, as childhood obesity can be treated through changes in behavior and diet, or using medications, and in some cases surgery can be used.

One study showed that drug therapy, along with behavioral and dietary changes, plays a major role in treating childhood obesity. However, this does not mean that surgeries are ineffective, as obesity surgeries can be performed on children, but we must be aware of some potential risks.

**What is the appropriate age for obesity surgeries on children?**

 

Obesity surgeries on children do not depend exclusively on age, as specialized surgeons allow these surgeries to be performed on children who have passed puberty, provided that their body mass index is greater than 35.

In addition, determining the appropriate time to perform the surgery also depends on the child's general health and diseases associated with obesity, such as diabetes and high blood pressure.

What are the bad habits that lead to obesity in children?

 

Obesity in children is a growing problem, as reliance on fast food has become common, especially among adolescents, with the decline in the culture of exercise. Children also spend a lot of time in front of electronic screens, and rely heavily on transportation such as cars, escalators, and elevators instead of walking or using stairs.

Is surgery recommended to treat childhood obesity?

 

Slimming surgery is an option for children in very special cases. However, if the obesity is severe and associated with health complications, the doctor may recommend surgery as a treatment. In general, the legal age for slimming surgery ranges from 16 to 70 years.

How to talk to a child about obesity?

 

The way you talk to children about obesity can positively influence their desire to maintainMaintain a healthy weight. Try to keep the conversation about the importance of a healthy lifestyle. Here are some points to consider:

- Use terms like "overweight" instead of "fat".

- Avoid comparing your child to his peers, and help him not to compare himself to others.

- Don't classify foods as good or bad, but use expressions like "healthy" and "healthier".

- Avoid making negative comments about his body shape.

- Instead of setting goals for weight loss, focus on taking steps towards a healthy lifestyle.

When should you see a doctor?

 

It is important to visit the doctor periodically to monitor your child's growth. If you notice a significant increase in your child's weight recently, it is best to consult a doctor. The doctor will review your child's condition according to growth charts and take genetic aspects into account, which helps him diagnose obesity in its early stages.

What are the causes of obesity among children?

 

Children's size and weight change during their different stages of growth, and during these periods the percentage of fat in their bodies increases. Obesity is defined as an increase in the amount of fat tissue in the body compared to the child's gender and stage of development.

When is this percentage of fat considered a disease that threatens the child's health?

 

The real indicator of the severity of the amount of fat or weight gain is the body mass index, which is a reliable measure to determine the percentage of weight gain above the normal rate. This is calculated by dividing the weight in kilograms by the square of the height in meters, which is known as the body mass index (BMI).

**How ​​do parents contribute to their children's weight gain?**

 

There are many daily habits that parents routinely practice, which may seem normal, but they negatively affect the health of their children.

**Parents as a bad role model:** If you are obese and do not make any effort to lose weight, you are sending a message to your child that it is acceptable to be fat like you. Children also tend to imitate the behaviors of their parents, so if you are one of the people who prefer to eat fast food, your children are likely to follow the same pattern, which may lead to weight gain and health problems later.

**Parents' preoccupation with their children:** If you do not spend time in the kitchen and do not make an effort to provide healthy foods for your children, you contribute greatly to their increased likelihood of obesity, as fast food lacks the necessary nutrients.

**The harms of watching TV:** If you are busy with your work and use TV as a means to calm your child, you unfortunately increase his chances of obesity. Recent studies indicate that watching TV and exposure to fast food advertisements can contribute to weight gain in children.

**Causes of obesity in children:**

**Genetic factors** Genetic factors significantly affect the percentage of body fat, eating patterns, and the rate of burning calories. Some genetic disorders have been identified that contribute to weight gain, such as disorders in the leptin gene and its receptors, in addition to melanocortin receptors.

**Quality of food intake** High-calorie foods, such as fast food and sweets, and excessive consumption of baked goods made from white flour, contribute to weight gain in children.

**Lack of physical activity** Lack of exercise leads to not burning excess calories, which contributes to the accumulation of fat in the body.

**Sitting for long periods without moving** Many children nowadays tend to spend long hours in front of TV screens and mobile phones, which negatively affects their health and weight.

**Family dietary pattern** The family's eating habits and cooking methods affect the child's food choices, and how he deals with food in terms of quantity and speed of eating.

**Genetic factors** Genes play a role in a child's exposure to obesity, as children who belong to families suffering from obesity are more likely to develop it.

**Psychological factors** Some children involuntarily resort to eating larger quantities of food when they feel anxious, angry, or afraid of their parents, or even to cope with boredom. The child may lose sense of the amount of food he has eaten if he is busy watching his favorite movie on TV.

**Sleep disorders** Irregular sleep hours or not getting enough sleep can lead to a false feeling of hunger, which prompts the child to eat a lot.

**Risks of obesity surgeries in children**

Any surgery is associated with some risks and complications that may lead to the failure of the operation or threaten the patient's life. However, we must take into account that obesity poses a significant risk to your child's health, and surgery may be the only effective solution. The risks associated with obesity surgeries for children include the following:

**Risks of laparoscopic sleeve gastrectomy:**

- Bleeding.

- Infection.

- Malabsorption of nutrients.

- Narrowing of the inner diameter of the new stomach.

- Leakage of gastric juice from the site of stomach removal.

- A blood clot in the leg that may move to the lung or heart.

**Risks of laparoscopic gastric bypass surgery:**

- Ulcer or bleeding.

- Vitamin B12 deficiency, which leads to chronic anemia.

- Dumping syndrome as a result of the stomach contents emptying quickly into the small intestine.

- Iron deficiency anemia due to bypassing part of the small intestine, leading to poor absorption of iron and calcium.

What are the symptoms of obesity in children?

 

The following signs indicate that the child may be overweight:

- Accumulation of fat in the chest area.

- The appearance of stretch marks on the skin of the lower back and upper legs.

- Darkening of the skin around the neck area and a change in its texture to become similar to the texture of velvet.

- Difficulty breathing while running and moving, with the need to stop several times while playing.

- Excessive sweating.

- Chronic constipation.

- Early puberty in girls.

- Delayed puberty in boys.

- Flat feet orHip dislocation.

**Is obesity a symptom or a disease?**

 

Obesity is a major result of unhealthy eating habits and lack of physical activity, but the impact of some diseases on children's increased appetite or metabolic rate cannot be ignored, in addition to their impact on their ability to move.

Among these diseases are:

- Hypothyroidism.

- Insulin resistance.

- Cushing's syndrome.

- Joint diseases and chronic pain conditions.

Some medications used to treat other health conditions may also lead to weight gain as a side effect, which requires parents to pay attention to this issue and try to address this increase through exercise and modifying eating habits.

Examples of these medications include:

- Anticonvulsant medications.

- Antidepressants and anxiety medications.

- Antihistamines during allergy attacks.

- Steroids.

- Insulin for children with type 1 diabetes.

**Complications of physical obesity in children:**

- Constant feeling of fatigue and exhaustion.

- Insulin resistance.

- The emergence of type 2 diabetes, which has become common among children after it was considered a disease specific to adults.

- High blood pressure.

- Cardiomyopathy.

- Increased levels of cholesterol in the blood.

- Fatty liver.

- Cirrhosis and scarring of the liver.

- Formation of gallstones.

- Gastroesophageal reflux.

- Bone problems, such as foot deformities.

- Joint pain due to excess pressure due to weight.

- Respiratory disorders, such as asthma.

- Difficulty breathing during sleep (sleep apnea), which leads to frequent awakenings at night and difficulty concentrating the next day.

- Eating disorders, such as anorexia or bulimia.

- Skin infections.

- Teeth grinding, a condition that is increasingly common among overweight children

**How ​​is obesity diagnosed in children?**

 

Obesity is diagnosed by measuring the body mass index (BMI), but some blood tests can also be performed to determine the causes of obesity and its complications, such as:

**Cholesterol and triglyceride tests:**Cholesterol and triglyceride tests are among the basic tests required for patients suffering from obesity, diabetes, and cardiovascular diseases. These tests include measuring total cholesterol, high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), very-low-density lipoprotein cholesterol (VLDL), and triglyceride values. Normal cholesterol values ​​should be less than 1.7 mmol/L (150 mg/dL), while normal triglyceride values ​​are less than 150 mg/dL. The normal LDL/HDL ratio for adolescents should be less than 2.5, and for children less than 1.8.

**Fasting blood sugar test:** This test measures the blood sugar level after fasting for an entire night, and is necessary to detect diabetes associated with obesity in children. The normal fasting blood sugar level is 99 mg/dL or less, while values ​​​​from 100 to 125 mg/dL indicate the onset of diabetes.

**Ways to get rid of and prevent obesity in children**

 

**Exercise regularly:**Exercise is an effective way to lose fat and build a healthy and balanced body. Children can practice a variety of sports activities such as swimming, football, basketball, cycling, and other fun sports that enhance their health.

**Follow a healthy and balanced diet:** It is not recommended to apply strict diets for children with the aim of losing weight, because they need a variety of nutrients to support their growth and development. Therefore, it is important to focus on preparing a healthy and balanced diet that includes all the necessary nutrients while avoiding harmful foods.

**Avoid sweets and sugars:** Sugars and sweets are factors that contribute to weight gain and obesity, and they are popular foods among children. Therefore, it is preferable to reduce their consumption and replace them with healthy alternatives.

**Avoid fast foods rich in fats:** Fast food and fried foods are major sources of harmful fats, which are major causes of obesity. They can be avoided by choosing healthy alternatives prepared at home.

**Increase water consumption:** Drinking water helps promote a feeling of fullness and satiety, which contributes to weight control. It is important to encourage children to drink sufficient amounts of water daily.

**What foods should obese children avoid?**

 

- Whole milk

- White bread

- Potatoes

- Fast food

- Soda drinks and processed juices

To help your obese child, it is important to avoid or reduce some foods in his diet, due to their negative impact on his health and the health of the family in general.

**Whole milk**Whole milk is considered a food rich in saturated fats, so it is preferable to reduce its consumption by children who suffer from obesity. One cup of whole milk contains the equivalent of two teaspoons of butter.

**White bread**Many children like to eat white bread as a staple part of their meals, but this type of bread contains a low percentage of fiber compared to brown bread. Fiber is important because it helps keep the child full for a longer period, which reduces his desire to eat foods rich in calories.

**Potatoes**French potatoes and potato chips contain high amounts of fat and salt, so it is recommended to avoid these foods in schools and at home.

**Fast food and ready-made foods**Fast food and ready-made foods are unhealthy options, as they contain large amounts of fat and calories, which may negatively affect the health of children who suffer from obesity.

Because they contain a huge amount of saturated fat andAdded sugars and sugars.

**Soft drinks and processed juices** Sugary drinks make up more than a quarter of the sugar we consume, with about 600 ml of soft drinks containing 18 teaspoons of sugar. Although juice is made from fruit, it can be very high in calories due to added sugar.

**Types of obesity surgeries for children and adolescents**

 

Obesity surgeries include a range of options, but laparoscopic sleeve gastrectomy and laparoscopic gastric bypass are the most common surgeries among young people. Here is some information about these surgeries:

**Laparoscopic sleeve gastrectomy** This surgery is performed under general anesthesia, where about five small incisions are made in the child’s abdomen. A thin, flexible tube with a tiny camera at the end, known as an endoscope, is inserted through one of these incisions. Through the other incisions, the surgeon inserts small surgical instruments designed for laparoscopic surgeries.

Using the inserted instruments and images transmitted by the camera, the surgeon removes the curved part of the stomach known as the fundus, leaving the remaining part of the stomach and stitching it. After removing the fundus, a small, thin part that resembles a banana remains, which reduces the size of the stomach, and thus fills more quickly, which means eating less food.

In addition, the removed part of the stomach contains an area that secretes the hormone ghrelin, which is responsible for the feeling of hunger, which helps reduce the child's feeling of hunger.

**Laparoscopic Gastric Bypass**Laparoscopic gastric bypass surgery is performed under general anesthesia, just like in gastric sleeve surgery. Small incisions are made to insert the endoscope and the necessary instruments. This surgery involves dividing the stomach into two parts: the small upper part and the large lower part. After that, a part of the small intestine is connected to the small upper part, which helps reduce the amount of food eaten due to the small size of the stomach, in addition to bypassing a part of the small intestine, which leads to the absorption of fewer calories and nutrients.