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What is childhood obesity?
Obesity is a chronic disease. Childhood obesity is diagnosed by calculating the body mass index (BMI). The normal body mass index (BMI) varies depending on age and gender, so it is important for the doctor to calculate it and place it on the child’s BMI curve. If the BMI is higher than 85% of children of the same sex and the same age, then the child is overweight. However, if it is above 95% of children of the same sex and the same age, then the child is obese.

Why should we be concerned about childhood obesity?
Overweight and obesity increase the chances of serious health complications. Complications such as type 2 diabetes, hypertension and hypercholesterolemia can start even in childhood!

Complications:
•    Obesity in adulthood (80% of obese children aged 10-15 will remain obese adults)
•    Type 2 diabetes
•    Hypertension
•    Hypercholesterolemia
•    Acute myocardial infarction, stroke
•    Gestational diabetes
•    Obstructive apnea
•    Liver disease
•    Arthritis
•    Cancer
Obesity can even increase the risk of premature death.

What causes obesity?
Obesity is a complex problem and not simply a matter of will or self-control.
In general, it is the result of excessive food consumption, insufficient physical exercise, but also the genetic predisposition of each individual. In addition, a child may suffer from a specific genetic condition that leads to obesity.
More rarely, however, it can also come from other causes such as endocrine diseases, e.g. hypothyroidism, Cushing’s syndrome.

How do we deal with childhood obesity and the factors that affect a child’s weight?
1. Recognizing the problem: The earlier we deal with the problem of increased weight and obesity, the easier and better the results will be, regardless of the cause. Even if it is due to a genetic syndrome, we can reduce or prevent the problem. Thus, it is important to investigate the cause of the increased weight / obesity in order to establish the most appropriate treatment.
2. Prevention and treatment go hand in hand. Their goal is to help the child have healthy lifestyle habits (along with his whole family):

• Breastfeeding for ideally more than 6 months. Infants who are exclusively breastfed for 3 to 5 months are 35% less likely to be obese when they start school.
• Correct amounts of food.
• Avoid frequent intake of foods that are too high in calories and fat (sweets, skewers, chips, etc.)
• Fruits and vegetables daily.
• Stable meal times, no snacking.
• Physical exercise: organized exercise that he/she enjoys, good habits e.g. use stairs, walk to school/daycare, etc.
• Limit screen time: Do you know how much time your child spends in front of a screen?
• Sleep: Children who go to bed late are more likely to gain weight.
• The child’s psychological support during the weight loss effort is often crucial. We also know that some negative experiences can lead your child to develop obesity, so addressing them is a priority.
• In addition to changes in the child’s daily routine, each case should be carefully studied with the treating endocrinologist in order to discuss possible pharmaceutical intervention in specific diagnoses or when there are comorbidities (e.g. diabetes mellitus).
• Surgical intervention only concerns very serious conditions in older adolescents.

The pediatric endocrinologist helps assess the cause of obesity and possible complications, guides the treatment and monitors its treatment.