Childhood obesity

July 9, 2008  |  General

At first glance you might not think childhood obesity has much to do with pediatric critical care, but it does. There are several well-known health risks to an obese child. Many of these, such as type 2 diabetes, high blood pressure, and sleep apnea, were once quite uncommon in children. For example, two decades ago I never saw a child with type 2 diabetes — now I see several each year. Some authorities say one in three children are overweight. Many of us think the ongoing epidemic growth in childhood asthma is partly driven by rising obesity.

For children, what is obesity? After all, children grow and put on weight as they grow. To determine this we use the same measurements as for adults — the body mass index, or BMI. The BMI is your child’s weight in kilograms divided by her height in meters squared (i.e., multiplied times itself). Here is a site that gives easy conversion of pounds and inches to these metric values. For example, a child who is 1.5 meters tall and weighs 50 kg has a BMI of 22 (50/1.5 x 1.5). Here is an even easier way to do it, a BMI calculator. It also has a chart that tells you if your child is at a good weight for age, overweight (BMI at 85th to 94th percentile for age), or obese (BMI greater than the 95th percentile for age).

Why does this matter? Can’t an overweight or obese child just lose the weight later by exercising more and eating less? The answer is that it becomes harder and harder to lose the weight once the child gets to adolescence and beyond. Ingrained lifestyle habits are hard to break. Besides, obesity has heath risks for children now, both physical and psychological. You can read more about them at a very useful National Library of Medicine site here, which also tells you what you can do about it.


  1. Obesity is when excess body fat accumulates in one to where this overgrowth makes the person unhealthy to varying degrees. Obesity is different than being overweight, as it is of a more serious concern. As measured by one’s body mass index (BMI), one’s BMI of 25 to 30 kg/m is considered overweight. If their BMI is 30 to 35 kg/m, they are class I obese, 35 to 40 BMI would be class II obese, and any BMI above 40 is class III obesity. Presently, with obesity affecting children progressively more, the issue of obesity has become a serious public health concern.
    Approximately half of all children under the age of 12 are either obese are overweight. About twenty percent of children ages 2 to 5 years old are either obese are overweight. Worldwide, nearly one and a half billion people are either obese or overweight. In the United States, about one third of adults are either obese or overweight. It is now predicted that, for the first time in about 150 years, our life expectancy is suppose to decline.
    Morbid obesity is defined as one who has a body mass index of 30 kg/m or greater, and this surgery, along with the three other types of surgery for morbid obesity, should be considered a last resort after all other methods to reduce the patient’s weight have chronically failed. Morbid obesity greatly affects the health of the patient in a very negative way. It has about 10 co-morbidities that can develop if the situation is not corrected. Some if not most of these co-morbidities are life-threatening.
    One solution beneficial in many cases of morbid obesity if one’s obesity is not eventually controlled or corrected is what is known as gastric bypass surgery. This is a type of bariatric surgery that essentially reduces the volume of the human stomach in order to correct and treat morbid obesity by surgical re-construction of the stomach and small intestine. Patients for such surgeries are those with a BMI of greater than 40, or a BMI greater than 35 if the patient has comorbidities aside from obesity. This surgery should be considered for the severely obese when other treatment options have failed.
    There are three surgical variations of gastric bypass surgery, and one is chosen by the surgeon based on their experience and success from the variation they will utilize. Generally, these surgeries are either gastric restrictive operations or malabsorptive operations. Over 200,000 gastric bypass surgeries are performed each year, and this surgery being performed continues to progress as a suitable option for the morbidly obese. There is evidence that this surgery is particularly beneficial for those obese patients that have non-insulin dependent Diabetes Mellitus as well.
    So the surgery to correct morbid obesity greatly limits or prevents such co-morbidities associated with those who are obese. Two percent of those who undergo this surgery die as a result from about a half a dozen complications that could occur. However, the surgery reduces the overall mortality of the patient by 40 percent or so, yet this percentage is debatable due to conflicting clinical studies.
    Age of the patient should be taken into consideration, as to whether or not the risks of this surgery outweigh any potential benefits for the patient who may have existing co-morbidities that have already caused physiological damage to the patient. Also what should be determined by the surgeon is the amount of safety, effectiveness, and rationale for a particular patient regarding those patients who are elderly, for example.
    Many feel bariatric surgery such as this should be considered as a last resort when exercise and diet have failed for a great length of time.
    If a person or a doctor is considering this type of surgery, there is a website dedicated to bariatric surgery, which is:,

    Dan Abshear

  2. María Ignacia Molina

    Hello, my name is María Ignacia Molina and i`m medical student from Universidad Católica del Maule, Talca, Chile (South America).

    I think that your blog is very interesting for many people, in especial this post of “Childhood Obesity”, because the prevalence of obesity in children is increased in the last years. Therefore, this topic is very important today.

    Furthermore, obesity in children has many adverse health effects and it is being recognized as a serious public health concern. Hence, educating our children to eat healthy is vital to prevent obesity and, thus, reduce risk factors, such as type 2 diabetes and hypertension.

    Finally, I hope to continue sharing your clinical experiences, because they contribute to the development of medicine.

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