Childhood obesity has become a pressing global health issue, affecting millions of children across diverse socioeconomic backgrounds.

According to the World Health Organisation, the number of overweight or obese children under the age of 5 was estimated to be more than 40 million in 2019. Additionally, the number of overweight or obese children and adolescents between the ages of 5 and 19 increased from 32 million in 1990 to 124 million in 2016.

The prevalence of childhood obesity varies across regions and countries due to differences in socioeconomic status, cultural factors, dietary patterns, and lifestyle behaviours.

As an example, in the United States, and according to the Centre for Disease Control and Prevention, the prevalence of obesity among children and adolescents between the ages of 2 and 19 was approximately 19.3 per cent in 2018.

What are the causes of childhood obesity?

Genetic factors

Certain genetic variations can influence an individual's susceptibility to fat accumulation and weight gain. Research suggests that genes involved in appetite regulation, metabolism rate, and fat storage may contribute to an increased risk of obesity. However, genetic predisposition alone cannot account for the dramatic increase in childhood obesity tolls, indicating that environmental and behavioural factors also play a critical role.

Environmental factors

The “obesogenic milieu” refers to an environment that promotes unhealthy eating habits and sedentary behaviours. Several environmental factors contribute to childhood obesity:

Availability of high-calorie foods

The widespread availability and aggressive marketing of calorie-dense, nutrient-poor foods, such as sugary snacks and beverages, and fast food, contribute to excessive calorie intake.

Unaffordable

Some communities, particularly in low-income or high cost-of-living areas lack access to affordable and nutritious dietary options like fresh fruits, vegetables, fish and whole grains. This can lead to an overreliance on processed and unhealthy foods.

Sedentary lifestyles

Modern technologies, such as television, video games, smartphones, and computers, have reduced children's physical activity levels. Increased screen time and a decline in outdoor activities contribute to a sedentary lifestyle, resulting in reduced energy expenditure and fat build-up.

Built environment

Urban planning and neighbourhood design can influence physical activity levels. Factors such as lack of safe recreational spaces, sidewalks, and bike lanes, along with increased reliance on motorised transportation, discourage active lifestyles.

Parental influence

Parental practices related to food choices, physical activity, and role modelling significantly impact children's behaviours and weight status. Parental encouragement of healthy eating habits, regular family meals, and sports can help prevent childhood obesity.

Sleep patterns

Inadequate sleep and disrupted sleep patterns have been associated with an increased risk of obesity in children. In fact, lack of sleep can disrupt hormonal regulation of appetite, increase food cravings, and affect energy balance.

Cultural influences

Cultural norms and beliefs related to food and sports can influence dietary patterns and activity levels. For instance, social gatherings centred around high-fat, high-sugar foods can contribute to excessive calorie intake.

What are the health consequences of childhood obesity?

Childhood obesity has numerous health consequences, affecting multiple body systems. It not only impacts physical health but also has psychological and social implications.

Metabolic disorders

Children with obesity are at an increased risk of developing metabolic disorders such as insulin resistance and type 2 diabetes. These conditions arise from the impaired ability of the body to properly regulate blood sugar levels.

Cardiovascular complications

Childhood obesity can lead to high blood pressure, high cholesterol levels, and early signs of atherosclerosis (hardening and narrowing of the arteries). These factors increase the risk of developing heart disease and stroke.

Respiratory issues

Obesity can contribute to respiratory problems such as asthma, obstructive sleep apnoea, and exercise intolerance.

Orthopaedic problems

Excessive weight places stress on the musculoskeletal system, leading to conditions such as joint pain and an increased risk of bone fractures.

Psychological and social consequences

Children with obesity are more likely to experience low self-esteem, depression, anxiety, and social stigmatisation. Negative body image and social isolation can have a detrimental impact on mental wellbeing and overall quality of life.

Increased mortality risk

Obesity in childhood has been linked to a higher risk of premature death in adulthood. The associated health conditions, such as cardiovascular diseases and type 2 diabetes, contribute to this increased mortality rate.

Understanding the health consequences of childhood obesity highlights the urgency of prevention and intervention efforts. New medications are emerging that could, in some children, help with weight loss, but their effect is not yet fully studied in this population, and, if not coupled with lifestyle changes, may not be long-lasting.

Hence, the most effective ways of addressing this rising epidemic imply home-based, school-targeted, and community-directed strategies, in order to minimise the risk of the above-stated health complications and improve the overall wellbeing of children.

• Nisrine Atieh is an American-board certified paediatrician and obesity medicine specialist. Joe Yammine, MD is a consultant cardiologist at the Bermuda Hospitals Board. The information herein is not intended as medical advice nor as a substitute for professional medical opinion. Always seek the advice of your physician.