Up to one out of every five children in the U. S. is overweight or obese, and this number is continuing to rise. Children have fewer weight-related health and medical problems than adults. However, overweight children are at high risk of becomingoverweight adolescents and adults, placing them at risk of developing chronic diseases such as heart disease and diabetes later in life. They are also more prone to develop stress, sadness, and low self-esteem.

What Causes Obesity in Children?

Children become overweight and obese for a variety of reasons. The most common causes are genetic factors, lack of physical activity, unhealthy eating patterns, or a combination of these factors. Only in rare cases is being overweight caused by a medical condition such as a hormonal problem. A physical exam and some blood tests can rule out the possibility of a medical condition as the cause for obesity.

Although weight problems run in families, not all children with a family history of obesity will be overweight. Children whose parents or brothers or sisters are overweight may be at an increased risk of becoming overweight themselves, but this can be linked to shared family behaviors such as eating and activity habits.

A child's total diet and activity level play an important role in determining a child's weight. Today, many children spend a lot time being inactive. For example, the average child spends approximately four hours each day watching television. As computers and video games become increasingly popular, the number of hours of inactivity may increase.

What Diseases Are Obese Children at Risk For?

Obese children are at risk for a number of conditions, including:

• High cholesterol
• High blood pressure
• Early heart disease
• Diabetes
• Bone problems
• Skin conditions such as heat rash, fungal infections, and acne

How Do I Know if My Child Is Overweight?

The best person to determine whether or not your child is overweight is your child's doctor. In determining whether or not your child is overweight, the doctor will measure your child's weight and height and compute his ''BMI,'' or body mass index, to compare this value to standard values. The doctor will also consider your child's age and growth patterns. Assessing obesity in children can be difficult, because children can grow in unpredictable spurts. 

How Can I Help My Overweight Child?

If you have an overweight child, it is very important that you allow him or her to know that you will be supportive. Children's feelings about themselves often are based on their parents' feelings about them, and if you accept your children at any weight, they will be more likely to feel good about themselves. It is also important to talk to your children about their weight, allowing them to share their concerns with you.

It is not recommended that parents set children apart because of their weight. Instead, parents should focus on gradually changing their family's physical activity and eating habits. By involving the entire family, everyone is taught healthful habits and the overweight child does not feel singled out.

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The obesity epidemic among youth today only continues to escalate. Due to the increase in modern technology, more forms of entertainment involve sitting rather than moving.  Children are exposed to more computers, video games, movies and television than ever before, which in turn decreases the overall time spent expending daily calories. The resulting weight gain among our youth heightens their risk for possible heart disease, cancer, diabetes and more. This makes it all the more important for children to start exercising as early as possible. Besides physical benefits, such as improved bone and muscle strength, exercise is also shown to also improve one’s emotional and psychological state.

By taking up physical exercise early in life, children have the advantage of a leaner, stronger figure, with lower risks of obesity. Running, bicycling, skating and swimming are several simple options that allow for aerobic activity, which improves overall heart strength. Stretching exercises will foster a student’s flexibility and improve the functioning of joints. Push-ups and pull-ups help build muscle strength, as well as weightlifting workouts at the school gym. Kids can get a head start in managing their physical health by choosing from a wide selection of exercise options, which will only prove more beneficial as they mature.

Students spend the majority of their school day in the classroom with limited time for physical activity. As important as it is for children to be well-rounded on subjects that increase class performance, there is another type of education that is just as important for their overall well-being. Physical education is a chance for children to put down their pencils and have fun as they work toward staying fit. It can also be the ideal outlet kids need to let loose, while providing them with lifelong benefits unlike any other in their schedule.  Studies show that children who have physical outlets coupled with academics perform better in other areas of their life as well.

More schools are sharing the responsibility to encourage student fitness with their enhanced physical education programs. For example, SPARK, a well established and award-winning public health organization, is combating obesity through providing educators with research-based physical activity programs for Pre-K – 12 grade students. SPARK focuses on assisting teachers with implementing school games related to aerobics, jogging, sports and more. Teachers receive curriculum, training and equipment that outlines how to get the most out of each physical activity that their classes participate in. Emphasis is placed on proper nutrition for students, as well as the positive effects activities have on academic performance.

Schools that provide physical education for youth with an emphasis on the positive instill a lifelong motivation to stay fit.  The American Heart Association recommends that children engage in a minimum of one hour of physical activity per day, and schools can easily assist in meeting that goal by providing just half of that important time.  In addition, such classes help build teamwork among students and help participants find interests that they may choose to further pursue. It is important to note that studies have demonstrated that kids who are physically fit also perform better on standardized testing.

To offer the best physical education possible, schools should provide quality equipment, safe facilities and trained supervision. Teachers must be aware of the best, new teaching methods available to maintain student interest and enthusiasm. Variations of traditional games, as well as creating new athletic diversions can be introduced on a vast scale depending on age level and ability.  Success and diversity are key to keeping the children involved. Skills developed during school activities may form the basis for additional physical pursuits. Most importantly, when schools make physical education a requirement for graduation, kids are guaranteed the chance to be exposed to a better sense of how to live a healthy lifestyle.

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Many parents look to enroll their children in after school activities and search for the option that best suits their son or daughter’s interests. One common question is how old a child should be before engaging in certain sports or exercise. Games like flag football, soccer and t-ball are usually appropriate starting at age four, whereas gymnastics is accommodating of all age groups. Competitive activities should be reserved for the older, extroverted child. Both individual and team sports allow for motor skill development as well as promote self esteem. Starting sports at an earlier age will decrease the childhood tendency toward sedentary activities inside the home when physical alternatives are not readily available.

Establishing lifelong healthy exercise habits begins in childhood. Lack of physical activity has been correlated with the ongoing surge in obesity, as well as the development of chronic health problems. On the contrary, involving youth in both physical education as well as extracurricular sports programs is associated with increased academic success, as well as psychological and physical well being. Educators and parents alike must set the example and offer appropriate, safe programs that encourage all children, regardless of ability.  The opportunity to strive towards a healthy future that includes exercise as part of the normal, daily routine will then be anticipated with ongoing enthusiasm amongst today’s youth.

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One of the common misconceptions around the obesity epidemic is that kids with excess weight have lifestyles that are much less healthy than those of their non-obese peers. 

It’s a familiar assumption that profession­als, policy makers and the average person often make. The truth is, this assumption is not borne out by data. A report from the Canadian Health Measures Survey 2007-2009 ( released by Statistics Canada early this year ) found no marked differences in physical ac­tivity between overweight and lean kids, at least not when corrected for the increased ef­fort it takes to move larger bodies.  Based on actual measurements of physical activity using sophisticated accelerometric devices, only 5% of Canadian adults and children meet the recommended levels for vigorous physi­cal activity per week. 

Specifically, overweight and obese girls aged six to 19 years had exactly the same minutes of moderate-to-vigorous physical activity (MVPA) as girls who are neither overweight nor obese (between 44 and 48 minutes per day). Only for boys was there a discernible relationship be­tween activity and BMI, in that overweight boys had 14 minutes and obese boys had 22 minutes less daily activity than “normal” weight boys, who accumulated around 65 minutes of MVPA per day. 

So, if overweight kids are not moving less — and if, as other data suggest, they are not necessarily eating more — why are some kids overweight and others not? If the environ­mental effects are pretty much the same for everyone, why do we even have lean and obese kids? 

This question was addressed by re­searchers from the Ludwig-Maximilians University of Munich, Germany,  in a study published in PLoS One this past January . The authors analyzed data on over 7,000 three- to 10-year-olds and almost 6,000 11- to 17-year­old children from a representative cross-sectional German health survey con­ducted between 2003 and 2006. The goal was to look at the impact of maternal BMI, mater­nal smoking in pregnancy, low parental socioeconomic status, exclusive formula-feeding and high TV viewing time on BMI. 

It turns out that in both age groups, the estimated effects of all risk factors (except formula-feeding) on BMI were greatest for children with the highest BMI. In other words, it is not that lean kids don’t also watch a lot of TV or have mothers who smoked during pregnancy — rather, it’s that kids at the higher end of the BMI distribution appear far more sensitive to these factors than their leaner counterparts. 

Thus, kids who are genetically predis­posed to obesity are far more likely to pack on the pounds when spending hours in front of the TV than kids who are genetically less obe­sity prone. The same could probably be said for overeating or any of the other environ­mental drivers of obesity, which have much greater effects in terms of promoting weight gain in some kids than in others. 

From a prevention and treatment perspec­tive, this means that overweight and obese kids will have to work much harder at changing their lifestyles or avoiding obesogenic stimuli than thin kids, who can live a similar lifestyle without negative health consequences. It’s easy to see how this relates back to the topic of weight-bias and discrimination, where we so easily fall into the mode of blaming obesity largely on unhealthy lifestyles and will power, when thin people may just turn out to be genet­ically more fortunate.

This should not, of course, be used as an excuse to do nothing. Rather, it should be seen as a good reason to fully appreciate and empathize with kids who carry extra weight. Some will need to work very hard at control­ling their weight, while others seem to have simply drawn the “get out of jail free” card. 

In light of these data and the tremendous negative emotional and physical impact of weight bias, discussing inactivity (or exercise) in the context of obesity is not only obfuscat­ing the real issues, but it’s also a major distraction from addressing the real causes of the problem. 

This should in no way imply that the shockingly low activity levels of all Canadians (young and old, male and female, slender and obese) should not be cause for alarm, given the innumerable health benefits of physical activity and the increasingly recognized health risks associated with sedentariness. 

Similarly, we know that increasing physical activity and sensible exercise “prescriptions” can be important prevention and treatment strategies for weight management. 

It is, however, high time to reframe the discussion of inactivity and sedentariness as a discussion about fitness and health risk in general, rather than as a discussion on obe­sity. Continuing to link the necessary discussion about inactivity to the problem of obesity is not only scientifically unfounded but, by dangerously and unfairly reinforcing stereotypes (not reflected in the actual data), it may well do more harm than good when it comes to tackling both the epidemic of obe­sity and the epidemic of sedentariness. 

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Children

• Try some low-fat, low-sugar snacks.
• Eat more fruits and vegetables.
• Record what you eat for a few days. If what you eat does not resemble the Food Guide Pyramid, make some changes.
• Be active by doing something you like to do, such as dancing or jumping rope.
• Aim for 60 minutes of moderate physical activity most days of the week.

Parents

• Set limits on TV and computer time. Time spent with these electronic devices tends to reduce physical activity and often increases consumption of high-calorie snacks. The American Academy of Pediatrics recommends limiting TV, movies, and video and computer games for children to no more than 1 or 2 hours per day.
• Offer children healthier foods. Snack foods are a great place to start. Buy more yogurt and fruits and fewer chips and cookies at the grocery. Serve more ice water and fewer sodas. Regular soft drinks add 110 to 160 calories per 12-ounce serving.
• Encourage your children to be involved in something active and enjoyable. Suggestions include organized sports (such as softball or soccer), outdoor activities (such as scouting or 4-H clubs), or active playtime at home (such as roller skating, throwing Frisbees, or biking).
• Make time for the entire family to enjoy regular physical activities together.
• Assign active chores to all family members, such as vacuuming, washing the car, or mowing the lawn. Rotate chores among family members to avoid boredom.
• Be a healthy role model for your children. Children will be more likely to eat fruits and vegetables and be physically active if parents are setting a good example.
• Let your school know that you are concerned about what your child eats at school and how much physical activity is included in the school day. Have nutrition and exercise experts come speak to the PTA, school board, or site-based council.
• Buy only 100% fruit juice. Just 1/2 cup of fruit juice will supply one serving of fruit, so be aware of calories and serving sizes.
• Eat meals together at the dinner table.
• Avoid watching TV during mealtimes.
• Limit fast food eating to no more than once per week.
• Avoid using food as a reward or using the lack of food as a punishment.

Teachers

• Incorporate some form of movement into the classroom curriculum. Active students are more alert and ready to learn.
• Ask parents to bring healthy snack options when your class is having a bake sale or class event.
• Do not reward students with food, and do not punish students by taking away recess.
• Start a program at your school to raise awareness of the importance of physical activity among students and staff.
• Have a health educator speak to your class about different programs or places in your area where students can be involved in physical activity.
• Invite the school food service director to speak to your classes about healthy meal planning.
• Host a career day to help students learn about employment opportunities in health care and promotion.

School Food Service Directors and Managers

• Make sure school breakfast and lunch options are healthy and appealing. Invite teachers and students to work on ideas for marketing healthier food choices.
• Offer fruits, vegetables, whole grains, and low-fat dairy foods.
• Reduce access to high-fat, high-calorie, high-sugar foods and excessive portion sizes.
• Use the cafeteria setting to increase awareness of healthy food choices with brochures or posters about “Five-a-Day” fruits and vegetables or “1% or Less” dairy foods.
• Seek student input for school menu plans through contests, focus groups, or classroom activities.

School Administrators

• Promote healthier eating and physical activity in your school.
• Have a registered dietitian or certified nutritionist come to your faculty/staff meeting to bring unity on this issue.
• Make wellness programs available to school faculty and staff.
• Work with your school food service director to create an environment of healthy food choices for meals.
• Give the students healthier options in the vending machines. Try the new milk machines.

Site-Based Decision-Making Councils

• Set policies for what can and cannot be sold in school.
• Re-evaluate the contracts between your district and soft drink industries. The money and perks from these agreements may not be in the best interest of your students.
• Be involved in assessing the school’s eating environment, developing a shared vision, and creating an action plan to achieve it.
• Help schools offer daily opportunities for physical activity and inclusive education.
• Work with schools and community organizations to ensure that exercise equipment and supervised programs are available to meet the physical needs and interests of all students and school staff.

Communities

• Create a community that promotes physical activity for children and teenagers.
• Increase access to food choices for a healthy diet, such as dairy products, fruits, and vegetables.
• Work with your Cooperative Extension Service office, state and local health departments, and other partners to promote community physical activity programs.
• Increase public access to gyms, playgrounds, and walking/biking trails.

Civic Leaders

• Work with city planners and engineers to plan for sidewalks and bicycle paths. In addition, widen sidewalks so that they are less crowded, safer, and more inviting.
• Designate a place for and promote a farmers’ market.
• Create a community coalition to address childhood overweight.
• Increase the accessibility of public facilities.

Government

• Create policies to promote healthy eating and physical activity.
• Provide educators with health education materials to help students develop the knowledge, attitudes, skills, and behaviors for developing healthy eating patterns and a physically active lifestyle.
• Allocate funding for health promotion and monitoring programs.

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Limiting screen time and unhealthy snacks can combat obesity. Photo CreditPhotodisc/Photodisc/Getty Images

According to the Obesity Action Coalition, obesity in children more than tripled between 1980 and 2012. You can combat childhood obesity, by integrating various changes into the lifestyle of your child and family. These changes can improve your child's appearance and decrease his chances of developing health conditions such as high blood pressure and high cholesterol. Get full clearance from your doctor before making these changes.

Watch What They Eat

The amount of daily calories a child needs depends on his activity level. According to the We Can! program, a 4- to 8-year old inactive child requires about 1,200 to 1,400 calories a day, while a very active child of the same age should eat about 1,400 to 1,800 calories. Reading food labels to check the calories per serving size is a good way to monitor calories and portions sizes. Registered Dietitian Natalie Allen, a school and community health educator, suggests serving children small portions at meals. If they ask for seconds, give them nutrient-rich vegetables and fruits so they consume fewer calories. As for snacks in between meals, Allen recommends low-fat yogurt, applesauce or raw carrots.

Get in Motion

Have your child do at least 60 minutes of exercise a day. Seek out age appropriate activities. The Centers for Disease Control and Prevention claims young kids might enjoy unorganized, self-starting activities playing on a jungle gym at the park or climbing trees. More mature kids might respond best to a more structured program that includes team sports, such as basketball or football. The key is to involve kids in some kind of activity to help burn calories and keep the weight off.

Less TV, More Action

Two hours in front of any kind of screen is more than enough for kids according to The American Academy of Pediatrics. It suggests helping your child find an active hobby with gifts like a jump rope, balls, or other toys that promote physical activity. They also suggest scheduling exercise into the child's day, It won't interfere with homework and other scheduled activities that way, and it could become part of her lifestyle pattern she'll carry into adulthood.

Set the Example

The best way to motivate your child to lead a healthier and more active lifestyle is to be a good role model. Healthychildren.org suggests you show the child you're serious by being physically active yourself. The website also recommends helping your child learn new activities by taking part in the games with him.

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Obesity affects close to 36 percent of U.S adults. Experts don't see obesity as a single-cause condition. Most medical experts contend obesity results from a combination of lifestyle and dietary factors that lead to energy imbalance. That said, research indicates the amount of fast food you consume plays a contributing role in developing obesity.

Frequency Factor

Fast food. Photo Credit Stockbyte/Stockbyte/Getty Images

Researchers analyzed data from the Michigan Behavioral Risk Factor Survey and published the results in the July 2011 issue of the journal "Preventing Chronic Disease." The team found a strong link between how often residents consumed fast food and obesity prevalence. Michigan residents who consumed fast food once a month had the least risk. The study found that prevalence of obesity increased significantly for those who consumed fast food three or more times per week.

Portion Size

Fish n' chips. Photo Credit Jacek Nowak/iStock/Getty Images

Researchers from New York University examined the role of fast-food portion sizes in the growing obesity epidemic. The team found fast-food portion sizes exceeded government standards. The team notes bigger that portion sizes encourage people to eat more, and the excess calories make it difficult to balance energy with physical activity. The team concluded the trend toward larger portion sizes contributes to rising obesity rates. The study was published in the February 2002 edition of the "American Journal of Public Health."

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