What is it?
The pediatric obesity epidemic among youth in the United States is a major health concern that affects their current and future health. The pediatric obesity prevalence has increased from approximately 5% in 1963 to 1970 to 17% in 2003 to 2004. Pediatric obesity is defined on the basis of age- and gender-specific body mass index normative values.

Causes
Pediatric obesity is influenced by both genetic and environmental causes.

Risk Factors
• Parents who are obese or overweight themselves. • Non-Hispanic black girls in Mexican American girls are more likely to have high BMI for age than non-Hispanic white girls. • Among boys Mexican-Americans are more likely to have high BMI for age than non-Hispanic white boys.

Symptoms
• Obese children may have low self-esteem, negative body image, and depression. • They may be at risk for teasing and bullying, discrimination, social marginalization, and negative stereotyping. • Obese children may have symptoms of high blood pressure, high cholesterol, sleep apnea, asthma, menstrual abnormalities, impaired balance, and orthopedic problems.

Diagnosis
The diagnosis of pediatric obesity is based upon age and gender specific body mass index normative values, and where a child’s BMI category is greater than or equal to 95th percentile.

Treatment
• The mainstay of pediatric obesity treatment is the development of a well-balanced nutrition plan as well as promoting the importance of routine physical activity. • Healthy weight loss should involve losing no more than 1 to 2 pounds per week. • Weight loss efforts should combine changes in athletic training and diet. • Cycles of light weight loss and weight gain should be avoided.

Prevention
• Limit consumption of sugar sweetened beverages. • Encourage consumption of fruits and vegetables. • Limit television and other screen time. • Limit portion size. • Encourage family meals in which parents and children eat together. • Eat breakfast daily. • Promote moderate to vigorous physical activity for at least 60 minutes each day.

AMSSM Member Authors
Mark Riederer, MD and Neeru Jayanthi, MD

References
Anderson SJ and Harris S, eds. Care of the Young Athlete, 2nd ed. Elk Grove Village, IL: American Academy of Pediatrics; 2010.

Prevention and Treatment of Childhood Overweight and Obesity. Retrieved January 29, 2014, from www2.aap.org/obesity.