By Evelyn M. Artz, MD
About 17 percent of children and adolescents are obese. Overweight and obese children are at risk for weight-related problems as they grow. Part of providing excellent healthcare for children and adolescents involves discussing weight at doctor’s appointments.
How Do We Define Obesity?
Children and adolescents should have both their height and weight measured. A BMI (body mass index) can then be calculated. This gives an idea of if the child’s weight is appropriate for how tall they are.
This should be calculated and plotted on a growth curve every year at the well-child check:
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- BMI > 85 to 95 percent are considered overweight
- BMI > 95 percent are considered obese
The healthcare provider can assess for things such as increased muscle mass that can lead to a BMI that appears high.
What Should Happen When a Child Is Identified as Overweight or Obese?
Routine labs for a hormone problem are not recommended unless there is concern that child is short or not growing well. Children who are identified as overweight or obese should have fasting labs to look at their blood sugar, liver function and cholesterol. The medical provider should ask about things like snoring or mental health concerns as well.
When Should a Child Be Seen By a Specialist?
A visit with a nutritionist is always appropriate. A child should be sent to a specialist (like a pediatric endocrinologist) if there is early onset obesity (younger than 5 years) or there is concern with excessive appetite or growth concerns. A child may need to see a different specialist if their cholesterol is elevated, blood pressure is elevated or liver function is abnormal.
What Families Can Do?
Try these five suggestions to keep your child at a healthy weight:
- Eat more fruits and vegetables.
- Cut out sugary drinks completely.
- Cook meals at home, and limit eating out and fast food.
- Get adequate sleep and limit screen time (outside of school work) to less than two hours each day.
- Get at least one hour of physical activity a day.
Also, as a parent, be a role model for your kids by following these recommendations.
Evelyn Artz, MD, is a pediatric endocrinologist at Mission Children’s Hospital.
