August 15, 2024 Author : Catarina Matos Figueiredo Like in adults, also in children and young people, overweight and obesity are mainly a consequence of dietary excesses and imbalances and a sedentary lifestyle. However, in younger age groups, incorrect diet and lack of physical activity can also have other particular effects: During growth, normal weight gain is distributed across tissues and regions of the body, in order to support the body changes that characterize weight gain and development. Thus, in addition to altering this physiological distribution of weight gain in favor of fat deposition , dietary imbalances also can compromise normal body development . Physical activity during growth has an important contribution to body development and movements coordination, which can therefore be impaired with a sedentary lifestyle . Quantification of obesity in children and young people In children and young people, who have not yet reached adult weight and body development and in whom the variability associated with corpulence and growth rate is high, the analysis of body mass index (BMI) for the purpose of quantifying obesity is not done as in adults. BMI distribution percentiles are considered depending on age and sex, using reference charts. It is considered as follows: Thinness : BMI for age and sex less than the 5th percentile Normal weight : BMI for age and sex between the 5th and 85th percentile Overweight : BMI for age and sex between the 85th and 95th percentiles Obesity : BMI for age and sex greater than the 95th percentile In pediatric age, classification and diagnostic criteria are based on percentiles, according to age and sex and the criteria are different for two age groups: Less than 5 years: overweight ≥ P97 and obesity ≥ P99; 5 years or more: overweight ≥ P85 and obesity ≥ P97. Obesity approach in children and young people Prevention When approaching obesity in children and young people, prevention is the main priority, adopting healthy eating habits and regularly practicing exercise . All actions implemented early and maintained throughout life to control body weight have a more favorable and permanent effect. Treating excess weight When there is excess weight, the measures to be adopted depend on the specificities of each case. As a general rule, younger people (under 7 years old) should not follow weight loss programs, but rather programs with the aim of maintaining their weight . This aims to achieve a situation of balance as height increases. In many cases, this attempt to maintain weight can be as difficult as it is for adults to lose weight. Weight loss programs, always under medical supervision, should be reserved for people over 7 years of age , or for those who , despite not having reached that age, are at increased risk of other serious health problems . The methodologies to be adopted in these weight loss programs also include the adoption of healthy eating habits and the practice of physical activity . Medications and surgery should not be common therapeutic options in children and young people to treat these problems. The long-term risks of using medications to treat obesity have not been completely identified and their role in long-term weight maintenance in non-adult people is still under discussion. With regard to surgery, the irreversible characteristics of some procedures and the associated nutritional deficits, which have important consequences for growth, mean that in most cases it is not an option to consider. Remember Children and young people with BMI values higher than desirable should always be evaluated and guided by the health team that accompanies them. Whenever rapid and significant weight gain occurs in a child or young person, and the problem does not seem to be resolved easily, appropriate medical advice should be sought. This allows to carry out an integrated assessment of the problem, taking into account individual history, family history, background and lifestyle habits, the existence of diseases and the risk factors involved, and determine the need to implement a program weight control/loss and specialized support. All necessary actions concerning eating habits, combating a sedentary lifestyle and practicing physical activity cannot be the sole responsibility of children or young people with overweight problems. Meet the pediatrics clinical team from Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
