Once thought to be a high-income country-based issue, childhood overweight and obesity was not something that was expected to develop into somewhat of a global pandemic within a 35-year period. Childhood obesity has now grown into a major public health concern and more children are struggling with excessive weight gain, leading to serious long-term health risks. Contributing factors include poor nutrition, lack of physical activity, excessive screen time and the prevalence of sugary, processed foods. The impact on both physical and mental health is devastating, affecting children’s quality of life and their ongoing physical and mental wellbeing. Obesity in children can also lead to lifelong health problems, such as type 2 diabetes.
Obesity is more often associated with adults than children. In a quarter of a century, since 1990, the prevalence of obesity in adults has doubled. What’s worse? It has quadrupled in adolescents, worldwide. Nearly 400 million minors aged five to19 years were described as overweight in 2022, of which a staggering 160 million were considered to be obese, up from 31 million in 1990 (a staggering 316 per cent increase). This means that 40 per cent of overweight children are categorised as obese. This signals an alarming increase in less than 35 years.
Overweight and obesity both refer to excess body weight, but they are classified differently based on the extent of excess fat that is present. Overweight and obesity are diagnosed by assessing an individual’s weight and height, followed by calculating their body mass index (BMI) using the formula: weight divided by height squared. BMI serves as an indicator of body fat, though other measurements, like waist circumference, can provide further insight into the presence of obesity and the extent to which this extra weight will affect an individual.
Overweight in adults is typically defined as having a BMI between 25 and 30, indicating that a person weighs more than what is considered healthy for their height but not necessarily excessively so. Obesity, on the other hand, is characterised by a BMI of 30 or higher, signalling a more significant excess of body fat, where significant short-term and long-term health issues then become increasingly likely. While both conditions increase the risk of health issues, obesity is associated with a higher likelihood of serious conditions such as diabetes, heart disease and hypertension. It can become tricky to translate these variables into childhood. However, one measurement strategy defines a ‘healthy weight’ for children as a BMI falling between the fifth and the 85th percentile. Overweight in children is a BMI between the 85th percentile and the 95th percentile and obesity is signalled by a BMI at the 95th percentile or above.
Circling back to the perceptions of overweight and obesity, in general, being a high-income country issue, one only needs to review statistics to understand that this is not the case at all. Despite the stereotyped reputation of the entire African continent having food supply shortages, the number of overweight children under five years has increased by nearly 23 per cent since 2000. Precise numbers on childhood obesity in Africa are unknown. Asia has also been labelled as a hotspot for childhood obesity and was home to approximately half of the globe’s population of obese children under the age of five.
Childhood obesity is closely linked to mental illness, with various psychological impacts that affect children’s emotional and social wellbeing at a stage at which they are meant to be developing confidence and self-esteem. Obesity can lead to low self-esteem and body image issues, as children often feel stigmatised or bullied by their peers for being overweight. This can cause feelings of anxiety, depression and isolation. The negative emotional toll of obesity can also contribute to the development of eating disorders, as children may turn to food as a coping mechanism for emotional distress, further worsening their condition – the dictionary definition of a vicious circle.
Furthermore, the physical limitations caused by obesity, such as difficulty engaging in physical activities, can exacerbate feelings of frustration and ostracisation. Studies also show that childhood obesity can alter brain function, particularly areas associated with mood regulation. Over time, these psychological struggles can also develop into a vicious cycle, as mental health issues can further hinder efforts to manage or reduce obesity. Addressing childhood obesity involves not only focusing on physical health but also providing emotional support and interventions to improve the mental wellbeing of affected children.
Apart from the mental strain, childhood overweight and obesity have clear physical implications that will generally worsen with time. Excess body weight places additional strain on the heart, increasing the risk of developing cardiovascular diseases such as high blood pressure, high cholesterol and eventually the dreaded heart disease. Obese children are also more likely to develop type 2 diabetes due to insulin resistance. Joint problems are another common consequence, as the extra weight puts pressure on growing bones and cartilage, leading to conditions like osteoarthritis later in life.
Respiratory issues, such as sleep apnea and asthma, are more prevalent in obese children, as excess fat can restrict lung function. Furthermore, childhood obesity is linked to liver disease, particularly non-alcoholic fatty liver disease (NAFLD), which can cause inflammation and even liver damage. These physical health issues not only affect the child’s quality of life but also increase the risk of developing chronic conditions in adulthood. Early intervention and lifestyle changes, such as healthier eating habits and increased physical activity, are essential to mitigate these physical risks and improve overall health outcomes.
“There are a variety of influences that have played a key role in the rapid growth of childhood overweight and obesity. It is often a combination of various factors that lead a child to obesity, as this is considered as an extreme condition, especially in children.”
The rise of ultra-processed foods has contributed significantly to the increase in weight problems among minors. These foods are often high in added sugars, unhealthy fats and artificial additives, while being low in essential nutrients. They are designed to be inexpensive, convenient and highly palatable, making them an attractive option for children and teenagers who are not fully educated on the attached health risks. As children consume more of these foods, their calorie intake increases without providing the necessary vitamins, minerals or fibre for proper growth and development, which is most often coupled with a lack of exercise to regulate weight gain. The addictive nature of sugary, fatty and salty foods can also drive overconsumption, making it difficult for children to make healthier dietary choices and also promotes a lack of discipline early in life – which makes it significantly more difficult for obese adults to overcome their condition.
Modern advertising tactics and social media have been identified as key players in influencing the eating habits of minors. John Patterson explains that, although public health authorities have clearly recommended stricter marketing activities, the “lack of action leaves children exposed to pervasive marketing tactics that encourage unhealthy eating habits, making it increasingly difficult for families to make nutritious choices.” The frequent exposure to such content also ‘desensitises’ children to the health concerns that may follow, as they often believe that what is seen on social media is a representation of normality and day-to-day life.
It is also undeniable that the increased access to and use of electronic and digital devices has grown in parallel to the increase of unhealthy weight amongst children. Physical activity, primarily in terms of hobby sports, has decreased as it has become somewhat ‘obsolete’ in the minds of modern children, who are as influenced by electronic means as the current generation. Dr. Panagiota ‘Yiota’ Kitsantas, a professor at FAU Schmidt College of Medicine, explains: “Encouraging organised, enjoyable activities rather than competitive ones can help children achieve necessary physical activity levels.”
Overcoming or limiting obesity in children requires a combination of strategies that address both physical activity, healthy eating and mindset. By making gradual lifestyle changes, children can develop healthier habits that promote long-term wellbeing. However, relative circumstances sometimes declare a gradual lifestyle change as not enough, due to serious and potentially life-threatening conditions that need immediate attention.
SO, what can be done?
One of the most effective (and obvious) ways to prevent and reduce obesity is regular exercise. Schools, communities and families MUST encourage children to be more active. For example, organising family walks, bike rides or playing sports together can make physical activity fun and engaging. Schools can also integrate physical education programmes into the curriculum that focus on teamwork, fun games and fitness. Parents can set screen time limits to encourage more outdoor play or enrol children in after-school sports or other physical extracurricular activities to keep them moving. It must be psychologically understood that children suffering from extreme weight issues are very likely to reject any competitive exercises and so activity that can be gently integrated into life is often the most viable and realistic starting point for a child who is likely to be both physically and mentally compromised to begin with.
A balanced diet is essential for reaching and maintaining a healthy weight. Parents can lead by example, preparing meals with whole, unprocessed foods, such as fruits, vegetables, whole grains, lean proteins and healthy fats. Involving children in meal planning and preparation also helps them to make healthier choices while learning about nutrition. Schools can also offer healthier meal options in the cafeteria/tuck-shop and educate students about making better food choices, where such options are available. An example might be substituting sugary snacks and drinks with healthier alternatives like fruits, yogurt and water.
One of the primary contributors to childhood obesity is excessive sugar consumption, particularly from sugary drinks and snacks. Parents can help by replacing sugary beverages with water, milk or homemade smoothies. Offering healthier snacks like nuts, fruits or vegetables can also curb the craving for processed junk food. Teaching children to read food labels and understand the hidden sugars in everyday products is an essential step in developing long-term healthy habits.
Encouraging children to listen to their bodies and eat until they’re satisfied, not full, can help avoid overeating. Smaller portions can reduce the likelihood of consuming excess calories. Using smaller plates and bowls and offering balanced meals with healthier portion sizes can prevent overindulgence. It’s also important to teach children about mindful eating, allowing them to focus on their food rather than distractions like television and social media.
Support from family and peers plays a crucial role in weight management and should help to create an environment that fosters good habits. Schools can contribute by providing education about nutrition, cooking classes and physical activity programmes, all of which empower children to make healthier choices. Additionally, involving children in cooking and grocery shopping helps them develop a sense of responsibility for their eating habits and overall health. Even in the case of adults, people suffering from obesity are likely to reject any form of condemnation and need to feel inspired and secure in order to make a practical lifestyle change.
By combining these practical approaches, families, schools and communities can help children build a foundation for a healthy lifestyle, preventing overweight, obesity and their associated risks. These steps not only support physical health but also promote mental health and wellness, which will play a critical role in the maintenance of healthy weight once reached.
The rise in childhood obesity is a growing global concern with far-reaching consequences for both physical and mental health. As children face an increasing number of environmental, social and dietary challenges, addressing this issue requires a collective effort from families, schools and communities. Promoting healthier eating habits, encouraging physical activity and creating supportive environments are essential steps toward combating obesity. By prioritising prevention and intervention strategies, we can help ensure that future generations lead healthier, more active lives, ultimately reducing the weight of obesity-related diseases worldwide and proactively improving overall wellbeing.
Statistics: World Health Organisation, 2024
Quotes: Wake Up World, 2024 – Additional Sources of Information:
www.medicalnewstoday.com/articles/are-parents-responsible-for-childhood-obesity
www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2024.1430418/full
