Basics About Childhood Obesity

Child and Teen BMI Calculator

How is childhood overweight and obesity measured?

Body mass index (BMI) is a measure used to determine childhood overweight and obesity. It is calculated using a child's weight and height. BMI does not measure body fat directly, but it is a reasonable indicator of body fatness for most children and teens. A child's weight status is determined using an age- and sex-specific percentile for BMI rather than the BMI categories used for adults because children's body composition varies as they age and varies between boys and girls. CDC Growth Charts are used to determine the corresponding BMI-for-age and sex percentile. For children and adolescents (aged 219 years): Overweight is defined as a BMI at or above the 85th percentile and lower than the 95th percentile for children of the same age and sex.1 Obesity is defined as a BMI at or above the 95th percentile for children of the same age and sex.1

What are the consequences of childhood obesity?

Health risks now

Childhood obesity can have a harmful effect on the body in a variety of ways. Obese children are more likely to have

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High blood pressure and high cholesterol, which are risk factors for cardiovascular disease (CVD). In one study, 70% of obese children had at least one CVD risk factor, and 39% had two or more.2 Increased risk of impaired glucose tolerance, insulin resistance and type 2 diabetes.3 Breathing problems, such as sleep apnea, and asthma.4,5 Joint problems and musculoskeletal discomfort.4,6 Fatty liver disease, gallstones, and gastro-esophageal reflux (i.e., heartburn).3,4 Obese children and adolescents have a greater risk of social and psychological problems, such as discrimination and poor self-esteem, which can continue into adulthood.3,7,8

Health risks later

A Growing Problem

Obese children are more likely to become obese adults.9, 10, 11 Adult obesity is associated with a number of serious health conditions including heart disease, diabetes, and some cancers.12 If children are overweight, obesity in adulthood is likely to be more severe. 13

What causes childhood obesity?

Childhood obesity is the result of eating too many calories and not getting enough physical activity.

Why focus on food and physical activity environments?

There are a variety of environmental factors that determine whether or not the healthy choice is the easy choice for children and their parents. American society has become characterized by environments that promote increased consumption of less healthy food and physical inactivity. It can be difficult for children to make healthy food choices and get enough physical activity when they are exposed to environments in their home, child care center, school, or community that are influenced by

Sugary drinks and less healthy foods on school campuses. About 55 million school-aged children are enrolled in schools across the United States,1and many eat and drink meals and snacks there. Yet, more than half of U.S. middle and high schools still offer sugary drinks and less healthy foods for purchase.2 Students have access to sugary drinks and less healthy foods at school throughout the day from vending machines and school canteens and at fundraising events, school parties, and sporting events. Advertising of less healthy foods. Nearly half of U.S. middle and high schools allow advertising of less healthy foods,2 which impacts students' ability to make healthy food choices. In addition, foods high in total calories, sugars, salt, and fat, and low in nutrients are highly advertised and marketed through media targeted to children and adolescents,3 while advertising for healthier foods is almost nonexistent in comparison. Variation in licensure regulations among child care centers. More than 12 million children regularly spend time in child care arrangements outside the home.4 However, not all states use licensing regulations to ensure that child care facilities encourage more healthful eating and physical activity.5

Lack of daily, quality physical activity in all schools. Most adolescents fall short of the 2008 Physical Activity Guidelines for Americansrecommendation of at least 60 minutes of aerobic physical activity each day, as only 18% of students in grades 912 met this recommendation in 2007.6Daily, quality physical education in school can help students meet the Guidelines. However, in 2009 only 33% attended daily physical education classes.7 No safe and appealing place, in many communities, to play or be active. Many communities are built in ways that make it difficult or unsafe to be physically active. For some families, getting to parks and recreation centers may be difficult, and public transportation may not be available. For many children, safe routes for walking or biking to school or play may not exist. Half of the children in the United States do not have a park, community center, and sidewalk in their neighborhood. Only 27 states have policies directing community-scale design.8

Limited access to healthy affordable foods. Some people have less access to stores and supermarkets that sell healthy, affordable food such as fruits and vegetables, especially in rural, minority, and lower-income neighborhoods.9 Supermarket access is associated with a reduced risk for obesity.9 Choosing healthy foods is difficult for parents who live in areas with an overabundance of food retailers that tend to sell less healthy food, such as convenience stores and fast food restaurants. Greater availability of high-energy-dense foods and sugary drinks. High-energy-dense foods are ones that have a lot of calories in each bite. A recent study among children showed that a high-energy-dense diet is associated with a higher risk for excess body fat during childhood.10,11 Sugary drinks are the largest source of added sugar and an important contributor of calories in the diets of children in the United States.12 High consumption of sugary drinks, which have few, if any, nutrients, has been associated with obesity.13 On a typical day, 80% of youth drink sugary drinks.14 Increasing portion sizes. Portion sizes of less healthy foods and beverages have increased over time in restaurants, grocery stores, and vending machines. Research shows that children eat more without realizing it if they are served larger portions.15,16 This can mean they are consuming a lot of extra calories, especially when eating high-calorie foods. Lack of breastfeeding support. Breastfeeding protects against childhood overweight and obesity.17,18 However, in the United States, while 75% of mothers start out breastfeeding, only 13% of babies are exclusively breastfed at the end of 6 months. The success rate among

mothers who want to breastfeed can be improved through active support from their families, friends, communities, clinicians, health care leaders, employers, and policymakers.

Television and media. Children 818 years of age spend an average of 7.5 hours a day using entertainment media, including TV, computers, video games, cell phones, and movies. Of those 7.5 hours, about 4.5 hours is dedicated to viewing TV.19 Eighty-three percent of children from 6 months to less than 6 years of age view TV or videos about 1 hour and 57 minutes a day.20 TV viewing is a contributing factor to childhood obesity because it may take away from the time children spend in physical activities; lead to increased energy intake through snacking and eating meals in front of the TV; and, influence children to make unhealthy food choices through exposure to food advertisemen

pregnancy

Mild cramping and light spotting are normal early in pregnancy when the fertilized egg implants itself in the uterus. But vaginal bleeding could be a sign of something more serious.

What should I do if I am bleeding?

Call your doctor right away. If you have heavy bleeding or severe pain, go to the emergency room.

What causes bleeding during early pregnancy?

Mild cramping and light spotting are normal early in pregnancy when the fertilized egg implants itself in the uterus. But vaginal bleeding could be a sign of something more serious. Some of the most common causes are: Threatened miscarriage (also called threatened abortion).When a threatened miscarriage occurs, there is bleeding from the uterus (also called the womb) but the pregnancy is still normal. Sometimes a blood clot forms in the uterus and increases the risk of miscarriage. However, most women who have a threatened miscarriage will deliver a healthy baby. Ectopic pregnancy. An ectopic (say: eck-tah-pick) pregnancy occurs when the fetus grows outside the uterus, usually in the fallopian tubes. The fallopian tubes are tubes that carry the egg from the ovaries to the uterus. An ectopic pregnancy can also occur on one of the ovaries, on the cervix (the opening of the uterus) or in the abdomen. Signs of an ectopic pregnancy include heavy bleeding, sharp abdominal pain and cramps. Ectopic pregnancies are life-threatening.

Spontaneous abortion (also called miscarriage). A spontaneous abortion is the spontaneous loss of a fetus. Most miscarriages occur because the fetus is not developing normally. Uncontrolled diabetes, infection, thyroid disease and hormonal problems in the mother can also cause spontaneous abortion. Other signs of a miscarriage may include sharp or dull low back or abdominal pain, cramps and tissue passing through the vagina. Other causes of early pregnancy bleeding include infections, swollen veins in your rectum or anus called hemorrhoids (say: hem-roids), cervical cancer and rare pregnancy-related cancers.

How will my doctor diagnose the cause of my bleeding?

Your doctor will probably want to know how much and how long you have been bleeding. He or she will also ask you if you have any cramps or pain. You may need a pelvic exam, an ultrasound, blood tests or urine tests. Sometimes an ultrasound is enough to make sure your pregnancy is healthy. However, if you are very early in your pregnancy, you may need more tests to help your doctor find the cause of the bleeding.

Will I need treatment?

You may need treatment depending on the cause of the bleeding. There is no way to stop a threatened miscarriage with medicines after the bleeding starts. Your doctor will likely recommend that you rest as much as possible until the bleeding stops. You should also avoid traveling, exercise and sexual activity. If you have a miscarriage, your doctor will watch to see if the tissue passes on its own, or if you will need a procedure to help remove it. In some cases, the mother may need to have a procedure done to remove tissue or to stop the bleeding after a miscarriage. This procedure is called suction dilation and curettage (D and C). A doctor will open (dilate) the cervix and gently suction out the tissue from the miscarriage.