Pediatric obesity is now recognized as a major medical and health problem all over the world

Mar 8 2005

A consensus statement on childhood obesity was published today in The Journal of Clinical Endocrinology & Metabolism, one of the four journals of The Endocrine Society.

The consensus statement reflects the conclusions from an international summit held in Israel last year and includes a controversial recommendation to classify obesity as a disease. This landmark statement reviews the available research evidence on the diagnosis, prevalence, causes (including endocrine disorders), risks, prevention and treatment of childhood obesity.

Pediatric obesity is now recognized as a major medical and health problem all over the world. Researchers have found that children who are obese have a higher risk for adult obesity, which is strongly associated with many serious medical complications that impair quality of life and lead to additional increased health risks. Approximately 14-15 percent of all 15-year-olds in the United States can be classified as obese. The statement notes that, between the years 1980 and 2000, the prevalence of overweight children doubled among children aged six to 11 and tripled among those aged 12-17. The U.S. ranked among the highest of 15 countries in the study in terms of prevalence of overweight and obese boys and girls.

"Our goal is to emphasize the safest means for primary care physicians to manage obese patients," says Dr. Henry Anhalt, a participant of the Obesity Consensus Working Group and physician at Saint Barnabas Medical Center in Livingston, New Jersey. "These recommendations should provide incentive for the public and private sectors to mobilize resources to stem the tide of increasing body mass in children and adults."

By classifying obesity as a legitimate disease, the consensus statement paves the way for public funding and insurer's reimbursement for obesity treatment programs and spurring further research to more effectively prevent and treat obesity. With health care costs of patients whose body mass index (BMI) is greater than 35 reaching 44 percent more than those of non-obese patients, the need for a consensus among physicians and health professionals is necessary. These recommendations not only provide a platform for future corrective action but encourage early intervention at the onset of obesity.

Without proper intervention, serious health risks will likely begin to appear in obese adolescents and children as they grow older. These may include diabetes, metabolic syndrome, hyperandrogenism (hormomal perturbations place the obese adolescent girl at a high risk of menstrual disorders and early onset of polycystic ovarian syndrome), heart disease, hypertension, respiratory factors and sleep disorders, among many others. Obese children are also at greater risk of anxiety and depression.

The following is a partial list of recommendations in the statement that can be implemented by parents, schools, healthcare providers and government and regulatory agencies to help prevent the onset of childhood obesity:

• Normalize the mother's body mass index prior to pregnancy
• Maintain moderate exercise during pregnancy
• Breast feed for up to three months
• Eat meals as a family in a fixed place and time
• Do not skip meals, especially breakfast
• Use small dishes and keep serving dishes away from the table
• Eliminate school fundraisers with candy and cookie sales
• Install water fountains in schools
• Give age-appropriate expectations for body weight in children
• Classify obesity as a legitimate disease for treatment and insurance purposes
• Make exercise programs tax deductible

The statement also includes evidence from previous findings that have shown the adverse impact obesity has on existing endocrine and metabolic disorders such as cardiovascular risk, diabetes and hypertension. Including the classification of obesity as a disease in the recommendations is a critical part of helping the medical community better evaluate and determine the best treatment for obese children and lessen their health risks as they grow older.