# Child obesity: what to know and solutions

#### Child Obesity has been described as severe overweight of a child or Child obesity: an excess of adipose tissue with harmful effects on physical and mental health on a child.

Overweight and obesity are the results of an imbalance in the energy balance; in other words, there is an excessive calorie intake concerning dietary consumption habits, too much sitting, and a lack of exercise are the main culprits.

#### When is Child obesity?

To define child obesity or overweight, you can use curves that show weight as a function of height, or BMI curves that show BMI (Body Mass Index) according to age.

To calculate the BMI, divide your child’s weight (in kg) by the square of his/her height (in m). For example, a 10-year-old girl is 1.38 m tall and weighs 42 kg. Her BMI is 42/(1.38 x 1.38) = 22.05.

Since the weight-to-height ratio changes continuously with age, a different value applies to each age for girls and boys as a limit for overweight and obesity. After calculating your child’s BMI, you can check in the table below whether there is overweight or obesity.

If the BMI figure is lower than the values in the table, your child is at a healthy weight.

### Causes of child obesity

#### A disturbed energy balance

The balance between energy intake and energy expenditure may be disturbed. Growing, playing, learning requires a lot of energy from children. They get them from their diet. But when they absorb more energy than they consume, a disturbed energy balance is created. This could be due to:

#### a. Environmental factors and education

Sugar-rich and high-fat products such as chocolate, chips, and soft drinks increasingly displace fruit and other healthy food products.
Children don’t exercise enough. Children sit too often: in the classroom, in the car, in front of TV or computer games… As a result, they use too little energy and develop too little muscle strength and necessary endurance.

#### b. Hereditary factors.

If both parents are obese, children are more likely to develop obesity. Psychological factors can also influence the eating behavior of children. For example, some children seek comfort in food and eat their emotions away. In rare cases, hereditary diseases, use of certain medications, can cause hormonal problems, etc.

#### Effects of child obesity

80% of overweight children also have weight problems as adults. Being overweight increases the risk of health problems such as diabetes, cardiovascular disease, and joint problems.

Being overweight can also cause mental health problems such as bullying, loss of confidence, social isolation, depression, and sleep disorders.

A large proportion of overweight children do not have to lose so much weight. Their weight must stabilize. Due to the growth, the weight will be more in line with the height. Maintaining weight can often be achieved by taking a critical look at the child’s eating habits. Good organization of how, what, and when we eat is extremely important. It is not always the case that the child overeats. Often the wrong things are consumed, and the snacks are too sweet or too fat.

Healthy body weight has many advantages. Children with a healthy weight not only feel better in their skin, they also have more confidence. Improved movement options can prevent health problems. With advanced motor skills, children can burn more energy, develop better muscles and fitness, and participate in sports activities without pain.

#### Multidisciplinary treatment plan

Target audience: Children from 6 to 15 years old who are overweight or obese.

The aim is to make the overweight child healthy in a healthy way through a change in the child’s life situation: from passive to active action, from unhealthy to healthy eating habits, from negative to positive self-image.

Adopting new lifestyle habits is not always easy. Motivation, patience, and a child-friendly approach are essential elements for success. The health program is a dynamic process where the child is central during the treatments. The procedure is determined individually.

After an initial consultation with the pediatrician, dietician, and psychologist, then a team member that will come together to prepare an individual treatment plan.

Consultations will be held with the collaborating physiotherapists or movement therapists who, if necessary, will draw up an appropriate movement program.

The individual treatment plan is presented to the parents and the child. The feasibility, both practical and financial, is being investigated. The program is adjusted if necessary. The team members meet regularly to re-evaluate both the child and the program.

#### The pediatrician

During the first consultation, the causes and consequences of obesity will be examined based on an extensive history, clinical examination, and possible blood tests. Information is provided on the child’s medical condition and the management of obesity.

After the team consultation, the pediatrician presents the individual treatment plan. The blood results and further medical follow-up are discussed. The additional medical monitoring, as well as the treatment of structural health problems as a result of obesity, can be done by your doctor or by the coordinating pediatrician.

#### The dietician

The sessions include various substantive themes such as the hot meal, breakfast, drinks, importance of the label, the food triangle, … Knowledge about healthy food is imparted through interactive game forms (hot meal and checkerboard, ..)

In addition, by learning problem-solving skills, the opportunity is created to change certain living and eating habits.

#### The psychologist

Together examine the possible psychological factors that can influence obesity. Frequently occurring themes are self-confidence, bullying, emotions, self-esteem, … This is done through various techniques that offer children the space to speak about the difficulties they experience in these multiple domains.

Also, by learning problem-solving skills, the opportunity is created to change certain living and eating habits.

• The physiotherapist or movement therapist
• Motor development is stimulated and evaluated.
• Provide breathing exercises and help control body tensions
• Attention to postural hygiene with muscle strengthening exercises
• The intended goal is to encourage your child to exercise more and to get excited about sports. An (re) integration in a sports club is the icing on the cake.

#### Tips for better eating habits

A child needs structure, even at the table. Make clear agreements about where and how much it eats. Three meals (breakfast, lunch, and dinner) and two snacks a day are ideal. You should eat at regular times and in fixed places.

1. Do not skip meals, especially breakfast.
2. Provide a healthy lunch for school (e.g., a salad or slices of tomato between the sandwich) and give fruit daily in the school bag.
3. Prefer healthy snacks like fruits or raw vegetables.
4. Make sure your child drinks water regularly.
6. Determine portion sizes (e.g., a balanced pot of chips instead of a whole bag during a birthday party, only on Wednesdays).
7. Do not use food as a reward or punishment.
8. Avoid getting your child bored as it will encourage you to eat.
9. Involve your child in preparing healthy meals (e.g., making fruit salad together, cleaning vegetables together).
10. Always eat at a fixed time and at the table.
11. Do not do other things during the meal, such as watching TV, playing games, or reading.
12. Make the meal a family event.
13. Healthy food does not have to be boring. Use your creativity to present food attractively with fun colors, shapes, flavors, scents, etc.
14. Let your child discover new flavors. Getting to know fresh foods is essential for the development of a healthy and varied diet.

### Tips for more exercise

#### Why is regular exercise so good?

1. Exercise ensures that the body functions (digestion, locomotor system, etc.) improve.
2. Exercise makes your child fit and ensures that the physical condition improves.
3. Exercise promotes your child’s physical and mental development.
4. Sport and exercise improve body composition: it converts fat mass into muscle mass.
5. Exercise is not only strenuous but also relaxing.
6. For about 1 hour of moderate physical activity daily, the recommendation is for anyone under the age of 18.
7. With moderate physical exertion, your child will breathe a little deeper and faster than usual, such as walking, cycling, swimming, etc. Exercise should not be spread over one hour but can be spread over the day. For example, you can cycle twice fifteen minutes and walk three times ten minutes. Of course, you can always move more.
8. Integrate movement into everyday life: at school, travel, at home, and during leisure activities. For example, have your child go to school on foot or by bicycle, take the stairs instead of the elevator, etc.
9. Be active parents so that your child has positive role models or examples.
10. Encourage your child to play outside with a ball, skipping rope, roller skates, etc.
11. Try to move together regularly: e.g., swimming, walking, cycling, etc.
12. Find a sport your child likes and motivate membership in a sports club or participation in school sports activities.
13. If your child wishes, you can register with the youth movement.
14. Avoid long periods of inactivity, regularly interrupt with a moment of movement.
15. Make agreements with your child about the duration of viewing screens such as a TV or computer.
16. Be active so that your child has positive role models or examples. It is best not to limit exercise to sports only, but to integrate physical activity into daily life.
17. If you experience difficulties in getting your child to exercise regularly, a movement therapist can help you further. Together with you and your child, he/she sets up an adapted exercise program.
18. Support your child in the (sports) activities that he wants to undertake (let them go to and from the sports lesson safely, provide material, see it now and then, …).
19. Always applicable: the importance of reward and not punishment. Do not reward with food and do not punish by decreasing a sports activity or oblige to exercise.