Unhealthy eating habits, a lifestyle lacking physical activity, and changes in social habits are contributing to a rapid increase in childhood obesity rates both globally and in our country. This leads to obesity, which begins in infancy and early childhood, leading to numerous health problems later in life. Furthermore, childhood obesity can also lead to psychological problems, making prompt treatment crucial.

Obesity is defined as an excessive amount of body fat that negatively impacts health. The prevalence of childhood obesity is increasing globally, including in our country. For example, in the United States, one in three children is reported to be overweight or obese. The COSI-TUR 2016 study conducted in our country revealed that approximately 24.9% of second-grade elementary school students are overweight or obese, meaning nearly one in four children is overweight. This data highlights the serious health problem of obesity and its importance as a major public health concern for younger generations.

What are the risk factors for childhood obesity?

Many risk factors influence the development of childhood obesity. These factors may include a combination of genetic and environmental factors. Important risk factors include:

• Genetic predisposition: If either parent is obese, the child's risk of obesity increases. If both parents are obese, the risk is even higher. Genetic factors play an important role in a child's body structure and metabolism.
• Eating habits: An unbalanced and unhealthy diet is a significant factor in the development of obesity. Excessive consumption of fast food, processed foods, sugary drinks, and high-fat foods can increase the risk of obesity.
• Lack of physical activity: Lack of regular exercise or physical activity can lead to energy imbalance and weight gain.
• Prenatal and postnatal factors: Factors such as excessive maternal weight gain during pregnancy, low birth weight, lack of breastfeeding, or early initiation of complementary feeding may increase the child's risk of obesity.
• Socioeconomic and cultural factors: Socioeconomic factors such as low income, low education level, availability of unhealthy foods at home, and limited access to physical activity may increase the risk of obesity.
• Psychosocial factors: Psychological factors such as stress, depression, and low self-esteem can contribute to overeating behaviors and obesity.
• Environmental factors: Certain environmental factors, such as industrial chemicals, hormones, and environmental toxins, may contribute to obesity. The effects of these substances on obesity are not yet fully understood, but research is ongoing.

These risk factors may play a role in the development of obesity in children and should be prevented through healthy lifestyle choices and early interventions.

How to diagnose and calculate obesity in children?

Diagnosis of obesity in children is generally based on body weight and height measurements. The diagnostic process proceeds as follows:

Body mass index (BMI) measurement:

A common method for determining obesity in children is measuring body mass index (BMI). BMI indicates the relationship between a child's height and weight. BMI is assessed based on the child's age and gender. BMI is compared to other children within the normal distribution for their age.

BMI percentile evaluation:

A child's BMI is expressed as percentiles using age- and gender-specific reference tables. BMI percentiles are interpreted as follows:

• 5% and below: Poor
• Between 5% and 85%: Normal
• Between 85% and 95%: Overweight (Overweight)
• 95% and above: Obese

Waist circumference measurement:

Waist circumference can help assess fat distribution and metabolic risks. Waist circumference above certain health risk thresholds can increase the risk of obesity and metabolic syndrome.

Progress tracking:

The child's height and weight are regularly monitored, and developmental trends are assessed. Obesity is diagnosed based on the child's long-term growth trends and health risks.

When diagnosing obesity in children, not only the child's BMI is taken into account, but also their general health, family history, eating habits, and lifestyle. All these factors are combined to assess the child's health and potential risks.

How to treat obesity in children?

Treating obesity in children often requires a multifaceted approach that includes lifestyle changes. Here are some methods used to treat obesity in children:

• Healthy eating: A balanced and nutritious diet plays a key role in managing childhood obesity. It's recommended to reduce consumption of fast food, sugary, and processed foods, and increase intake of fruits, vegetables, whole grains, and protein sources.
• Regular exercise: Increasing physical activity helps children lose weight and improve their overall health. At least 60 minutes of moderate- to high-intensity exercise per week is recommended.
• Sleep patterns: Adequate and regular sleep habits can help balance metabolism and control weight. Children should be encouraged to get enough sleep each night.
• Limiting screen time: Limiting the use of television, computers and other electronic devices allows the child to spend more time on physical activity.
• Family involvement: Playing an active role in obesity treatment can help children maintain healthy lifestyle changes. Encouraging healthy eating habits and an active lifestyle within the family is important.
• Psychosocial support: A child's psychosocial needs should also be considered during obesity treatment. Participation in support groups, psychotherapy, and counseling can help children cope with obesity.

The treatment plan is individualized based on the child's age, health status, degree of obesity, and family dynamics. Treating childhood obesity is a long-term process that requires patience, consistency, and family support.

Obesity and child health: Misperceptions and realities

The perception that an overweight child is healthy is a misconception. Simple obesity is the most common type of obesity in childhood and adolescence. Simple obesity results from an imbalance between energy intake and expenditure. These children's eating habits often include large amounts of sugary foods and drinks, fatty or processed foods. Furthermore, large portion sizes or an unbalanced nutritional intake can also contribute to obesity. These children may be taller than their peers during pre-puberty, but their adult height can be negatively impacted by the early onset of puberty and the premature cessation of growth. Furthermore, family members or caregivers' attitudes such as, "They're young, they should eat, they'll lose weight over time," can contribute to the development and exacerbation of obesity. A significant portion of children who are obese in childhood tend to remain obese as adults.

What are the problems that obesity can cause in children?

Obesity can cause a range of health problems in children. These include cardiovascular disease, hypertension, high blood lipids, fatty liver, diabetes, orthopedic problems, sleep disorders, low self-esteem, and social isolation. Additional treatments may be necessary until adolescence, and as obesity progresses, it can increase the risk of cancers such as breast, ovarian, and prostate cancers in adulthood and lead to reproductive disorders. Obesity can also negatively impact the immune system.

What should parents pay attention to regarding childhood obesity?

Parents should pay attention to childhood obesity:

• Teaching healthy eating: Parents should teach their children healthy eating habits at an early age and set an example by demonstrating these habits.
• Developing regular and healthy eating habits: Children should be encouraged to choose healthy snacks instead of packaged foods. Sugary or additive-containing foods should not be offered as rewards.
• Balanced nutrition: Children should be fed with age-appropriate portions that provide them with a balanced intake of carbohydrates, protein, fat, fiber, vitamins and minerals.
• Encouragement to exercise regularly: Children should be encouraged to exercise regularly and adopt an active lifestyle.
• Maintaining a sleep schedule: It's important for children to have a regular sleep schedule. Adequate and regular sleep can reduce the risk of obesity.
• Reducing screen time: It's important to monitor children's screen time and reduce it as much as possible. Physical activity and outdoor activities should be encouraged.
• Spending quality time: Parents should spend quality time with their children by playing, listening to them, and talking to them. This will strengthen family bonds and meet their children's emotional needs.
• Giving responsibility: Giving children responsibility for household chores helps them become self-confident and active.

It is important for parents to help their children adopt a healthy lifestyle by following these guidelines.

Nutritional recommendations for obese children

Obese children should be fed according to a plan recommended by a doctor or nutritionist. Here are some general principles to consider when feeding obese children:

• Consult a doctor: If the child is overweight, a doctor should be consulted and an appropriate nutrition plan should be created after a comprehensive evaluation by experts.
• Balanced diet: Obese children should eat a balanced and varied diet. This is important for their healthy growth and development.
• Portion control: Children's portions should be kept under control and smaller portions should be preferred if necessary.
• Reducing fast food and junk food consumption: Consumption of high-calorie and processed foods such as fast food and junk food should be limited.
• Consume more fruits and vegetables: Children should be encouraged to eat more fruits and vegetables. These are rich in fiber, vitamins, and minerals and can increase feelings of fullness.
• Water consumption: Water consumption should be encouraged instead of sugary drinks. Water provides essential fluids and is low in calories.
• Regular mealtimes: Obese children should be fed on a regular schedule with regular mealtimes. Snacks should also be healthy and regular.
• Healthy eating habits as a family: Family members should choose appropriate foods together and set an example to help children gain healthy eating habits.

The nutrition plan for obese children should be tailored to their individual needs and health status. Therefore, it is crucial to follow professional recommendations.