In 2010, almost 18% of children aged 6 to 11 were obese, and in 2010, more than one-third of children and adolescents were considered overweight or obese.
How the problem of excess weight is treated in children varies depending on a child’s age and how overweight they are compared to children of comparable age and build. For example, in overweight children under age 7 who have no other health concerns, the goal may be maintaining weight until natural growth in height causes the child to “catch up” to his or her weight. But in children who are obese, sometimes weight loss must be pursued more aggressively.
How Childhood Obesity Is Defined
Researchers at the University of Minnesota Medical School define severe obesity based on body mass index, which measures weight relative to height. This measurement is not as straightforward in children as it is in adults, because children grow in height at different rates and different ages. Therefore, BMI in children must take into account weight ranges in a child’s age group. Severe obesity in children is diagnosed when a child’s BMI is
- At least 35, or
- Greater than or equal to 120% of the 95th percentile for his age (whichever is lowest)
Researchers believe that this method of defining obesity in children is workable for general clinical and research settings, because it identifies the children with the most severe weight problems.
Health Risks for Severely Obese Children
Children who are severely obese face many of the same health problems as adults with severe weight problems. In the short term, obesity in children raises risk factors for cardiovascular disease, like high blood pressure and high cholesterol. In one population-based sample of children ages 5 to 17, 70% had at least one risk factor for cardiovascular disease. Obese children are also at greater risk for pre-diabetes, bone and joint problems, sleep apnea, and psychological and social problems due to low self-esteem and the social stigma attached to obesity. In the long term, obese children are likely to become obese adults, who are at greater risk of heart disease, diabetes, stroke, and osteoarthritis.
Severely obese children will not necessarily become severely obese adults, however. Obesity, says Dr. Stephen Pont, chair of the American Association of Pediatrics’ Section on Obesity, is “not a fixed condition; it’s potentially reversible.” Lifestyle modification and behavioral therapy are tried first, and in some cases, these changes lead to good weight management, particularly if family-based behavioral changes are adopted. Unfortunately, such interventions may not be readily available or affordable to many families.
Medical Weight Loss for Severely Obese Children
Medications may be used in some cases, including anti-diabetes drugs like metformin, though this drug is not specifically approved by the US Food and Drug Administration (FDA) for treating obese children.
Bariatric, or gastric bypass surgery, is highly effective for weight loss, but long-term effects on children and adolescents are not currently known; risks of surgical complications also keep many pediatric specialists from recommending the surgery for children under 18.
Currently, Xenical is the only medication approved by the FDA for use in children 12 or older. This prescription medication blocks absorption of fats from foods, thereby reducing the number of calories taken in by the body. Other prescription weight loss drugs used in adults work differently, by targeting various brain chemicals associated with appetite, and none are approved for use in children.
Xenical Track Record for Helping With Weight Loss
Studies of the effectiveness of Xenical have shown that a majority of patients who take the drug for one year lose 5% or more of their body weight. Studies also showed a statistically significant difference between weight loss results for those who took the drug and those who were given a placebo. Furthermore, after the trial ended, the people who stopped taking the drug gained back an average of 35% of the weight they had lost while taking it.
Xenical is effective and is approved for long-term use, but it requires certain dietary changes to curb side effects. It is the only prescription weight loss drug approved for long-term use, and the only one the FDA approves for weight loss in adolescents.
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