Definition of Childhood and Adolescent Obesity

How is BMI viewed during the growth period?

A child's body fat and BMIchange according to growth and puberty. After calculating BMI using height and weight, we determine which percentile they fall into compared to a reference group of the same age and gender. The movement of the growth curve is more important than a single data point.

Adult standards are not applied, nor are simple comparisons made with siblings or friends.

Why is the family environment considered together?

A child's food purchases, meal times, movement, and sleep are heavily influenced by the family and school environment. Forcing a child to eat a separate diet or publicly pointing out their weight can create stigma and eating disorders.

It is best for the family to together reduce sugary drinks, maintain regular meals, and create enjoyable physical activities and Sleep durationhabits.

Is it necessary to lose weight?

Depending on age, degree of obesity, growth rate, and accompanying conditions, the plan may be to maintain weight to allow for height growth or to plan for gradual weight loss. Goals must be determined by pediatric medical professionals.

Rapid weight loss and the exclusion of specific food groups can affect growth, bone health, and pubertal development.

Which health issues are being checked?

blood pressureand blood sugar·Lipids, fatty liver risk, sleep apnea, and joint problems can be checked. Menstruation, mental health, school bullying, and weight stigma are also important.

When explaining the results to the child, focus on health, strength, sleep, and daily functioning rather than appearance.

What should be changed first at home?

Keep water and nutritious snacks easily accessible and reduce the time spent eating while looking at screens. Find play, walking, and sports that can be enjoyed daily, and maintain a consistent bedtime and wake-up time.

Do not use food as a reward or punishment, and respect hunger and fullness signals.

How do I read the growth curve?

During the growth period, look at the curve of height and weight over time rather than a single BMI percentile. Body shape can change during growth spurts and puberty, and the BMI trend may shift simply by slowing the rate of weight gain while height growth continues. Adult standards should not be applied directly to children.

Mark the height and weight from school check-ups or medical records on the same growth chart and check if the percentile is rapidly crossing multiple intervals. Because there are measurement errors and different growth stages, do not conclude obesity or set treatment goals based on a single number.

How should I talk to my child about weight?

Expressions that evaluate body size or appearance can increase shame, secret eating, and avoidance of exercise. Instead of saying 'you need to lose weight,' talk about healthy behaviors and functions, such as getting enough sleep and building the strength to run and play for a long time. Avoid comparing body shapes with siblings, and guardians should also reduce self-critical talk about their own bodies.

The whole family should change eating habits together; do not feed the child a different menu or publicly monitor their portion sizes. Encourage them to express hunger and fullness; a method where adults decide the food and time, and the child decides the amount to eat within those bounds, can be utilized.

Why are screen time, sleep, and school life viewed together?

Mindless eating while looking at screens or late bedtimes can disrupt both eating and activity rhythms. Rather than just reducing the number of screen hours, create a specific environment, such as charging devices outside the bedroom, having screen-free family meals, and establishing a pre-sleep routine.

Check for snoring, daytime sleepiness, avoidance of PE class, bullying, depression, and anxiety. Before concluding that a child dislikes activity, examine whether pain, shortness of breath, lack of confidence in motor skills, or the peer environment are creating difficulties.

In which cases is a professional evaluation further required?

A pediatric evaluation is necessary if rapid weight gain begins at a very early age, if the rate of height growth drops, or if it is accompanied by severe thirst, polyuria, headaches, menstrual irregularities, or developmental issues. Inform the medical staff about medications, sleep problems, and family history.

When severe dietary restriction, vomiting, binge eating, extreme exercise, or depression occurs due to weight, evaluate eating habits and mental health together rather than pushing harder for weight loss. The priority for growth-period management is safe growth and a sustainable environment for the entire family.

Adult BMI standards are not used for children

During the growth period, BMI percentiles or standard scores based on age and gender are used, and the trend of the growth curve is observed. The path of height growth and weight change is more important than a single high value. The timing of puberty, family build, medications, and diseases are also evaluated.

Repeatedly emphasizing weight numbers and appearance to a child can increase stigma and eating problems. The goal is not a punitive diet, but making growth, sleep, activity, and the family eating environment healthy.

What should be changed as a family unit?

Together, adjust the frequency of sugary drinks and eating while looking at screens, family meals, sleep time, and enjoyable activities. It may be more sustainable for the family to change the food brought into the home and the meal structure together rather than making only one specific child eat different food.

Seek prompt medical evaluation if height growth stops, puberty changes differ from expectations, or if there is severe snoring, thirst, joint pain, depression, or bullying. Do not apply arbitrary fasting or adult weight loss drugs and supplements.

What should I prepare for the first evaluation?

Please bring height and weight records from recent years and school health examination results if available. Rather than presenting an idealized diet as if for a test, record actual meals, drinks, sleep, screen time, and enjoyed activities for both weekdays and weekends. Also, document snoring, sleep apnea, thirst, frequent urination, pain, and any medications being taken.

The guardian's diabetes·hypertension·dyslipidemiaand family history of early cardiovascular disease are also helpful for the evaluation. Whether tests are necessary is determined based on age, degree of obesity, physical examination, and risk factors. It is not the case that every child must undergo all tests, nor is it that no check-up is needed just because a child appears healthy.

How schools and families can share roles

At home, you can change the accessibility of drinks and snacks, as well as family meal and sleep environments. At school, school meals, participation in physical education, and the presence of bullying are important. Rather than simply telling a child to increase activity, ensure there is a safe space to participate, people to join them, and check for any pain or shortness of breath.

Do not disclose the child's weight or test results in front of relatives or peers. Guardians and schools should support the same healthy behaviors, but not operate them through surveillance and punishment. If there is teasing about appearance or avoidance of physical education, do not attribute it to the child's lack of will, but find a solution with the school.

How is the intensity of treatment determined?

The same calorie restrictions or weight loss goals are not applied to all children. The content of lifestyle treatment and the frequency of follow-ups are determined based on the growth stage, comorbid conditions, and the environment in which the family can participate. Some may consider specialized programs or other treatments, but guardians must not directly apply methods intended for adults.

During the treatment process, we look at height growth, blood pressure, metabolic indicators, sleep, and quality of life, rather than focusing solely on the BMI percentile. Even if there are weeks when the plan was not followed, the child is not evaluated as a failure; instead, we look for environmental barriers. If medication or supportive therapy is considered, the expected effects, side effects, and long-term follow-up should be confirmed with pediatric specialists.