Obesity in Children

Overview

Obesity is becoming more common in children. Around 20% of children in year 6 (aged 10-11 years old) were obese in 2018/2019.

Causes

Causes include:

• Lifestyle factors:
  • Poor dietary habits
  • Less exercise
  • Increased screen time
  • Socioeconomic factors – children in deprived areas have a higher risk of obesity
• Predisposing factors:
  • Genetics – family history increases its risk
  • Maternal obesity and gestational diabetes are associated with obesity
• Disorders and drugs:
  • Endocrine disorders (hypothyroidism, Cushing’s syndrome, Down’s syndrome Prader-Willi syndrome)
  • Corticosteroid use

Classification

Overview

NICE recommend using the UK 1990 BMI charts which factor in age and sex. Up to the of 4, the World Health Organisation (WHO) growth charts are used, but from 4 years old, UK 1990 charts are used.

• BMI ≥91^st centile – overweight
• BMI ≥98^th centile – obese
• BMI ≥99.6^th centile – severely obese

Management

Overview

Lifestyle changes are advised as usual. NICE recommends tailored clinical intervention if BMI is ≥91^st centile and assessing for comorbidities if the BMI is ≥98^th centile.

Complications

Overview

Complications of childhood obesity include:

• Obesity in adulthood
• Impaired glucose tolerance and type 2 diabetes mellitus
• Cardiovascular disease
• Hypertension
• Slipped capital femoral epiphysis
• Gastro-oesophageal reflux
• Poor self-esteem
• Eating disorders
• Idiopathic intracranial hypertension