Overview
Childhood obesity is having an excessive amount of body fat that threatens the health of children or adolescents. About 10% of children in our country are obese, and 20% are overweight. This rate is constantly rising.
Obesity that begins in childhood leads to adult obesity; it lays the foundation for serious health problems such as type 2 diabetes, heart disease, and psychological issues.
Diagnosis
BMI percentile charts are used for children:
- Normal: 5-85 percentile
- Overweight: 85-95 percentile
- Obese: Above 95 percentile
- Severely obese: Above 99 percentile
Symptoms and Health Effects
- Overweight appearance
- Tiring, shortness of breath (with exertion)
- Joint pain
- Hormonal issues during puberty
- Low self-esteem, depression
- Academic problems
- Social isolation, bullying
- Sleep apnea (snoring, waking at night)
- Dark patches in skin folds (acanthosis nigricans - sign of insulin resistance)
Complications (Even in Childhood)
Physical:
- Type 2 diabetes (previously known as "adult diabetes")
- High blood pressure
- High cholesterol
- Fatty liver disease
- Sleep apnea
- Asthma
- Orthopedic problems (joints, spine)
- Early puberty
- Polycystic ovary syndrome (in girls)
- Gallstones
Psychological:
- Low self-esteem
- Depression, anxiety
- Eating disorders
- Peer bullying
- Social isolation
Long-term:
- Adult obesity (80%)
- Cardiovascular disease
- Some cancers
- Early death
Causes
Nutrition:
- High-calorie, processed foods
- Sugary drinks
- Fast food
- Snacks
- Large portions
- Irregular meal habits
Inactivity:
- Excessive screen time (TV, tablet, phone)
- Lack of active play
- Not doing sports
- Going to school by car
Family factors:
- Obese parents
- Unhealthy family eating habits
- Stress, emotional eating
Other:
- Insufficient sleep
- Hormonal disorders (rare)
- Some medications (steroids)
- Genetic predisposition
- Socioeconomic factors
Risk Factors
- Family history (obese parents)
- Gestational diabetes
- High birth weight
- Rapid weight gain in infancy
- Low socioeconomic status
- Urban life, lack of safe play areas
- Some genetic syndromes
When to See a Doctor
- If BMI percentile is above 85
- If you think your child has a weight problem
- If there are accompanying medical issues
- If psychological impact is visible
- If your family has a history of diabetes, heart disease
Diagnosis and Treatment
Diagnosis:
- Height, weight, BMI and percentile measurements
- Body fat measurement, waist circumference
- Blood pressure measurement
- Blood tests: fasting glucose, insulin, cholesterol, liver enzymes, thyroid
- HbA1c
- Sleep study (if suspected)
Treatment (family-centered approach):
1. Nutrition:
- Pediatric dietitian support
- Completely eliminate sugary drinks
- Reduce processed foods
- Plenty of vegetables, fruits, whole grains
- Healthy protein sources
- Portion control
- Regular mealtimes
- Healthy family meals together
2. Physical activity:
- At least 60 minutes of moderate-to-high intensity activity per day
- Limit screen time (max 2 hours/day)
- Active play with family
- Sports activities
- Walking, cycling
3. Behavior change:
- Goal setting
- Food diary
- Rewarding (non-food)
- Family support
- Coping with emotional eating
4. Medical treatment (in adolescents, when needed):
- Liraglutide, semaglutide (new generation medications, over age 12)
- Bariatric surgery (over age 16, very selected cases)
Prevention and Recommendations for Families
Starting from infancy:
- Breastfeed for at least 6 months if possible
- Healthy introduction of complementary foods
- Delay sugary snacks
- Eat at the family table
In childhood:
- Offer healthy meal options
- Water, ayran instead of sugary drinks
- Add vegetables and fruits to every meal
- Prepare meals at home
- Do not turn on screens during meals
- Teach the child to listen to their own hunger (do not force feeding)
- Do not use food as a reward
- Develop active lifestyle habits
- Limit screen time
- Ensure adequate sleep (age-appropriate)
- Manage stress
- Parents should model (their own habits)
- Pay attention to body image (do not speak negatively about the child's body)
- Regular pediatric check-ups