With rates of childhood and adolescent obesity skyrocketing in the United States, Dr. Max Coppes explains what families can do and how pediatricians can help.
By Dr. Max J. Coppes, MD, PhD, MBA, physician-in-chief, Renown Children’s Hospital; chair and Nell J. Redfield Professor of Pediatrics, University of Nevada, Reno School of Medicine
A recent study led by Imperial College London and the World Health organization suggests
that in the next five years there will be more children and adolescents who are obese in this world than those that are moderately or severely underweight. If this is not alarming as a pediatrician, I am not sure what is.
In Nevada, 12 percent of 2-4 year-olds are obese (we rank 45/51 states) and 30.5 percent of 10-17 year olds (28/51 states). Why is this a big issue, you may ask?
Well, obesity leads to several serious illnesses, including an increased need to replace hips and knees, along with diabetes, heart issues, high blood pressure, arthritis and cancer. Yes: Obesity contributes to the development of cancer. Extra fat in the body can have harmful effects, like producing hormones and growth factors that affect the way our cells work. About 1 in 20 cancers are attributed to obesity.
Obviously, many of these illnesses will manifest themselves long after the child is seen by a pediatrician, so it’s “some other doctor’s problem,” really. That is not how pediatrics works in this country. Pediatricians are an integral part of the healthcare system. And while in the past, our focus may have primarily been on curing childhood diseases, over the past decades pediatricians have realized their role in promoting childhood health, most notably in providing lifesaving vaccinations.
This role of disease prevention and health promotion is taken very seriously by pediatricians and has led us to insights that I had not considered when training to become a pediatrician in the 80s. It is only more recently that we have evidence of the critical role of socioeconomic factors and literacy on the health and well being of children.
As a result, pediatricians have taken on roles as health advocates for children, realizing the enormous impact of the right policies. The role of pediatricians in managing obesity is so important because the longer a person is obese, the higher the probability of them getting the above-mentioned, obesity-related diseases. Moreover, since treating obesity is quite challenging, prevention is a much better the way to go. And data suggest that early prevention is critical.
The likelihood of an obese child becoming an obese adult is about 20 percent, but the likelihood of an obese teenager becoming an obese adult is 80 percent. So how can we prevent obesity?
First, we need to be clear about definitions. Obesity is determined by calculating one’s body mass index (BMI). Our BMI is calculated by dividing our weight in kilograms by the square of height in meters. For children and teens, the BMI is age- and gender-specific, so we do not use the BMI categories used for adults. BMI levels among children and teens need to be expressed relative to other children of the same age and sex.
Obesity exists when the child’s BMI is ≥95th percentile for children (or teens) of the same age and gender. If a child’s BMI is ≥85th percentile but <95th percentile, that child is overweight and at risk for becoming obese.
So my first question to you is: Do you know your child’s BMI? If you do, do you know whether it has changed over the past few years? A child does not become obese overnight. As parents we have the responsibility to monitor our child’s health and given the long-term ramifications of obesity, knowing your child’s BMI may one of the most important contributions to the health and well-being of you child that you as a parent can make. Early recognition provides the best hope for prevention of an alarming trend in our community.
Dr Max J. Coppes, MD, PhD, MBA, is professor and Nell J. Redfield chair of pediatrics at University of Nevada, Reno School of Medicine. He is also physician-in-chief at Renown Children’s Hospital.