Being "at risk for overweight" really means kids are too fat or obese

Jul 3 2006

Obesity appears to be a problem worldwide affecting millions of people in many developed countries.

According to the the National Center for Health Statistics in the U.S. obesity among adults has risen during the past 20 years to such an extent that now 60 million people over 20 years of age are now considered obese.

That equates to 30 percent of the population.

Of even more concern the percentage of young people who are overweight has more than tripled since 1980.

There are now more than 9 million children and teenagers aged 6-19 years, 16 percent, who are considered overweight.

These significant increases in the rates of those who are overweight or obese is a major concern because it has implications for the health of the American population.

Being overweight or obese considerably increases the risk of many diseases and health conditions such as hypertension, type 2 diabetes, coronary heart disease, stroke, gallbladder disease, osteoarthritis sleep apnea and respiratory problems and endometrial, breast, and colon cancer.

Many experts believe there are a range of reasons why obesity appears to be getting out of control and one of those reasons is that many people do not want to be told they are obese and many doctors are reluctant to tackle what can be a confrontational issue involving the whole family.

Among the medical profession there is debate over the language used to tell to tell children and teenagers they are fat, as labelling a child fat or obese is a sensitive issue.

The Centers for Disease Control and Prevention (CDC) has always favoured a diplomatic approach and refers to such children as "at risk of overweight."

Experts say such indirect terminology only serves to foster denial of a problem which now affects millions of U.S. youngsters.

The American Medical Association and other groups believe that the same terms, overweight or obese, should apply to, and be used with fat children.

British experts say any such move would make sense and would bring the U.S. in line with the rest of the world.

Some view existing U.S. categories as very vague and ironic, as the U.S. leads the world in terms of obesity.

The CDC adopted the current terms in 1998, using weight-to-height ratios and growth charts and say children are "at risk for overweight" if their body-mass index is between the 85th and 94th percentiles, are "overweight" if their body-mass index is in the 95th percentile or higher - or greater than at least 95 percent of youngsters the same age and gender.

The word obese is completely avoided and as a result many doctors translate the first category to mean "overweight" and the second one to mean "obese", and find the current language confusing.

A committee set up by the American Medical Association comprised of obesity experts from 14 professional organizations including the American Academy of Pediatrics are aiming to update the recommendations for prevention, diagnosis and management of obesity in children.

One of the issues debated will be the language used in dealing with overweight and obesity in children and teenagers.

Many experts say despite or maybe because, of the rise in the number of teenagers with eating disorders, there is a tremendous amount of denial by parents and children which possibly perpetuates the problem.