OBESITY

The facts about childhood obesity are clear. Childhood obesity in the United States is a serious public health problem. According to the CDC, 1 in 5 children and adolescents in the United States has obesity. Children who have obesity are more likely to carry the condition over into adulthood.

Children who have obesity are at a higher risk of developing many health conditions. These conditions include:

• Asthma.
• Sleep apnea.
• Type 2 diabetes.
• High blood pressure (hypertension).
• High cholesterol.
• Heart disease.
• Stroke.
• Musculoskeletal disorders such as osteoarthritis.
• Certain cancers, including colon cancer and breast cancer.
• Fatty liver.

In addition, children who have obesity are at a higher risk of experiencing:

• Bullying.
• Social isolation.
• Low self-esteem.
• Depression.

Childhood obesity is a complex disease that can occur when your child is above a healthy weight for their age and height. The medical definition of childhood obesity is having a body mass index (BMI) at or above the 95th percentile on the Centers for Disease Control and Prevention’s (CDC) specific growth charts. Children’s BMI factors differ from adults. For children, BMI is age- and sex-specific because their body compositions vary as they age. They also vary between children assigned male at birth and children assigned female at birth.

You can calculate your child’s BMI by dividing their weight in kilograms by their height in meters squared (kg/m2). For instance, if your 10-year-old child weighs 102 pounds (46.2 kg) and is 56 inches tall (1.4 m), their BMI would be 23.6 kg/m2. This places them in the 95th percentile for BMI-for-age, which means they have obesity.

Healthcare providers use BMI-for-age growth charts to measure size and growth patterns in children. A high BMI may be a sign of high body fat. BMI doesn’t measure body fat directly. But it alerts your child’s healthcare provider your child may need more tests to see if excess fat is a problem. BMI percentile cutoffs define a level above which your child may be more likely to develop weight-related health issues.

Obesity hypoventilation syndrome symptoms typically occur due to lack of sleep and low blood oxygen levels (hypoxemia). These symptoms may include:

• Shortness of breath.
• Fatigue.
• Lack of energy.
• Daytime sluggishness.
• Headaches.
• Dizziness.
• Depression.

While you’re sleeping, your bed partner may notice the following symptoms:

• Loud snoring.
• Choking or gasping.
• Pauses in your breathing.

Obesity hypoventilation syndrome (OHS) is a breathing disorder that affects some people who have obesity. The condition causes you to have too much carbon dioxide and not enough oxygen in your blood (hypercapnia). Normally, you exhale carbon dioxide and inhale oxygen. But when you’re breathing at a slow rate, you’re not moving enough air in and out of your lungs. This is called hypoventilation.

In addition to hypoventilation, you may also have sleep-disordered breathing due to obstructive sleep apnea. About 90% of the sleep-disordered breathing that occurs with OHS is due to obstructive sleep apnea. Therefore, OHS is typically a combination of three factors:

• Obesity.
• Hypoventilation.
• Sleep-disordered breathing.

Another name for OHS is Pickwickian syndrome. In the 1950s, scientists named the condition after a character in a Charles Dickens novel that had symptoms of OHS.

Obesity hypoventilation syndrome is a serious respiratory complication of obesity. It can cause life-threatening health issues, but it’s treatable.

Is obesity defined by your weight?

Healthcare providers commonly use the Body Mass Index (BMI) to define obesity in the general population. The BMI measures average body weight against average body height. As a generalization, healthcare providers associate a BMI of 30 or higher with obesity. Although BMI has its limitations, it’s an easily measurable indicator and can help alert you to obesity-related health risks.

Examples of limitations include bodybuilders and athletes, who have more muscle and may have higher BMI scores even though their fat levels are low. It’s also possible to have obesity at a “normal” weight. If your body weight is average but your body fat percentage is high, you may have the same health risks as somebody with a higher BMI.

Healthcare providers have also observed ethnic differences in how much extra weight different people can carry before it affects their health. For example, people of Asian descent are more likely to have health risks at a lower BMI, and Black people are more likely to have health risks at a higher BMI.

Another way of assessing obesity is by measuring waist circumference. If you have more body fat around your waist, you are statistically more at risk of obesity-related diseases. The risk becomes significant when your waist size is more than 35 inches for people assigned female at birth or 40 inches for people assigned male at birth.

Obesity affects your body in many ways. Some are simply the mechanical effects of having more body fat. For example, you can draw a clear line between extra weight on your body and extra pressure on your skeleton and joints. Other effects are more subtle, such as chemical changes in your blood that increase your risk for diabetes, heart disease and stroke.

Some effects are still not well understood. For example, there is an increased risk of certain cancers with obesity. We don’t know why, but it exists. Statistically, obesity increases your risk of premature death from all causes. By the same token, studies show that you can significantly improve these risks by losing even a small amount of weight (5% to 10%).