When is it "baby fat" and when is it a problem? In this article, Peggy Patten offers some information parents may want to consider in determining whether their child is unhealthy and what parts of modern family life contribute to rising rates of children who are overweight or obese.

Definitions

Being overweight or obese should not be confused with a child's body type. In our society, there is a great deal of media focus on excessive thinness that plays a large part in compelling some youth (particularly young women) to develop unhealthy eating habits, serious health problems, and eating disorders such as bulimia or anorexia. A taller, more muscular child might, at first glance, appear to be overweight compared to her shorter, leaner peers. However, it is important to help children realize that healthy body types come in a number of shapes and sizes and that they can be proud of their own unique, healthy looks.

In addition, children go through several developmental stages where a healthy "roundness" is to be expected and is likely not a cause for concern about future obesity. For example, infants and young children should have healthy stores of "baby fat," which is generally lost once the baby becomes more mobile during the toddler years. During pre-puberty, which normally begins between the ages of about 8 and 12, some children will gain weight and get a "round" look just before a major growth spurt.

The terms "overweight" and "obese" have specific meanings. If a parent is concerned that his child is overweight or obese, it may be helpful to consult a physician or growth specialist. The Body Mass Index (BMI) measures percent of the body that is composed of fat by using a mathematical calculation that divides a person's body weight in kilograms by the square of their height in meters (Robinson, 1999, p. 1562). According to the National Institutes of Health, overweight refers to "an excess of body weight compared to set standards," and obesity refers "specifically to having an abnormally high proportion of body fat" (1996, p. 2).

Recent Trends

The number of seriously overweight and obese youth in the United States is increasing. Child obesity is considered by many, including the U.S. Surgeon General and researchers at the Centers for Disease Control and Prevention (CDC), to be at epidemic levels (Corradini, 1999, p. 32; Robinson, 1999, p. 1561; Hill, 2000, pp. 1, 5; Centers for Disease Control and Prevention, 2000, p. 1). The American Obesity Association reports that approximately 25% of American children are considered overweight and about 10-15% are considered obese (Tracey, 2000, p. 2). Furthermore, the CDC reports a 100% increase in obesity in the child and adolescent population between 1980 and 1994 (CDC, 2000, p. 1).

There are many reasons to be concerned about a trend toward higher BMI figures for children. Obesity is linked to a variety of serious health conditions, including heart disease and diabetes. A truly obese child may never outgrow his or her weight problem. Children who are obese as 6- to 9-year olds have a 55% chance of being obese as adults, and the risk for adult obesity increases to 67% for children who are obese at ages 10-14. Respectively, this means that the risk of being obese as adults is 10 to 28 times greater than that experienced by peers of normal weight, according to pediatric obesity expert Dr. Robert Whitaker (2000, Kolata, p. 7). Obese adults are at high risk for a variety of health problems, including diabetes, high blood pressure, heart disease, and arthritis, and may be associated with problems with immune system functions (Kolata, 2000, p. 3; Hill, 2000, p. 5; Nieman et al., 1999, pp. 1-2). There are additional reasons to be concerned about obesity in girls, including a possible link between being very overweight and experiencing early puberty (Lemonick, 2000, p. 69). Finally, obesity may negatively impact children's relationships with their peers, which may in turn contribute to social problems (Summerfield, 1990, p. 2).

What is responsible for the rise in overweight and obese children? Most health and nutrition experts acknowledge heredity's role in childhood obesity. Other health issues, such as a thyroid problem, may cause obesity. There has even been some recent, though inconclusive, evidence to suggest some relationship between obesity and infection with a certain class of viruses ("Viruses", 1997).

However, the trend toward greater numbers of heavier children is largely due to two factors: a diet that is high in calories and includes more fats and sweets, and a lifestyle that is not physically active. Our nation's poor eating habits are related to many factors, including the following:

* reliance on fast food meals
* growing portions of food in restaurants and grocery stores
* increased numbers and marketing of snack foods, specially targeted at children
* failure to take information about the role of calories in weight gain seriously

"To gain 15 pounds in a year, you only have to have an imbalance of 150 calories a day, which is one soft drink," says Dr. Robinson, professor of pediatrics and medicine at Stanford University. "Even a Life Saver is 10 calories. An extra Life Saver a day is a pound a year" (Kolata, 2000, p. 5).

Moreover, exercise and general physical activity among everyone from school age children to adults are at their lowest levels in years, according to the Surgeon General's Report on Physical Activity and Health (Manley, 1996). There are many reasons for children's declining levels of physical activity: physical education classes are increasingly being eliminated or curtailed due to tight school budgets and children are getting less exercise outside of school, in part due to our dependence on the automobile. Children and adults have become "couch and mouse potatoes" (Corradini, 1999, p. 33) as they spend an increasing number of hours watching television and playing computer and video games (Brody, 2000, pp. 1-2; Welk, 1999, pp. 3-4). In research on childhood obesity it was found that boys and girls who viewed four or more hours of television each day had greater body fat and body mass than those who viewed less than two hours a day. ("Television Watching", 1998, p. 4). Writing for the Journal of the American Medical Association, Dr. Robinson reports, "American children spend more time watching television and videotapes and playing video games than doing anything else except sleeping" (1999, p. 1561). Robinson concludes, "reducing television, videotape[,] and video game use may be a promising, population-based approach to help prevent childhood obesity" (1999, p. 1566).

In addition to reducing children's television and computer use, what else can parents do to influence children's activity levels?

Again, it is important that parents not panic at news of the growing concern about childhood obesity. One expert on eating disorders offers parents a word of warning: "I would be concerned about parents who have a preoccupation with appearance and weight. Parents can unwittingly send serious messages to their kids" (Center for Studies of the Family, 1998).

However, parents can encourage and facilitate children's involvement in physical activities and sports. Children are more apt to pursue physical activities when parents also engage in them. Taking family walks, bicycle riding, ice skating, playing catch, hiking, or swimming together are some of the many physical activities parents can enjoy with their children. It is also important for parents to model healthy activity patterns in daily routines while encouraging children to do the same: walking instead of riding, taking the stairs instead of an elevator, and shoveling snow or raking leaves outdoors (Welk, 1999, pp. 1-3; Brody, 2000, pp. 3-4).

The physical, social, and emotional outlook for children who are seriously overweight early in life is not a promising one. Since health habits are often established during childhood, parents would be wise to encourage and to model smart eating and exercise patterns when their children are young.

Sources

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Corradini, Deedee. (1999). Kids and fitness. Our Children, 25(6), pp. 32-33. ERIC Document No. EJ590550

Centers for Disease Control and Prevention (CDC). (2000). Physical activity and good nutrition: Essential elements for good health. Centers for Disease Control and Prevention [Online].
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Lemonick, Michael D. (2000, October 30). Teens before their time. Time, 156(18), pp. 66-74.

Manley, Audrey F. (1996). Physical activity and health: A report of the Surgeon General. Centers for Disease Control and Prevention [Online]. Available: http://www.cdc.gov/nccdphp/sgr/sgr.htm [2001, February 2]

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Summerfield, Liane M. (1990). Childhood obesity. ERIC Digest. Washington, DC: ERIC Clearinghouse on Teaching and Teacher Education. ERIC Document No. ED328556

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Tracey, Elizabeth. (2000, September 13). Parents don't see childhood obesity as serious. WebMD Medical News [Online].
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Viruses may be linked to obesity. (1997). Doctor's Guide [Online].
Available: http://www.pslgroup.com/dg/2369e.htm [2001, February 2]