Obesity in children is very much a concern because of its epidemic proportions. Nearly, one-third of the children are either overweight or obese. Childhood obesity treatment becomes important in view of its serious complications on the health of the child and the adolescent. These are the complications that can set in immediately and some that are long-term.

These current high prevalent figures are due to unhealthy eating habits and the lifestyle of children today. Early treatment, which involves advising the right diet and physical activity, gives a better prognosis and outcome.

Management guidelines aim at stopping weight gain and reducing the BMI of the child to healthy levels safely and effectively.

There are various reasons why a child becomes obese. It could be that the child eats the wrong types of foods, or leads a physically inactive lifestyle. There could also be medical reasons for the youngster being obese. For example, certain medications or medical conditions can make him obese. 

Usually, the parents do tend to ignore their child’s obesity hoping that with time and age, the obesity in their child will reduce.

They keep goading their child often and this only adds to the child’s already existing psychological woes. The right approach to reducing the child’s heaviness is important and consulting the doctor for its treatment becomes necessary. Parents play an important role in bringing the child to a healthy weight.

Management of childhood obesity in children under the age of 7 years

No medicines to reduce obesity are safe at this age. The treatment here lies in maintaining the right eating habits and eating the right foods. Physical activity too should be part of the child’s lifestyle. At this age, you should encourage the child to play outdoor games that require physical activity.

You could gift your child a bicycle so that he pedals around. On the other hand, at this age children enjoy swimming. A parent could enroll his/her obese child in a swimming club.

 You could take him or her to the nearby garden for walks. However, see to it that physical activity is an everyday affair. The aim is to engage your child in a physical activity he or she likes.

The aim of treating childhood obesity at this age is to maintain the weight so that as the height increases, obesity and the BMI of the child will reduce.

I have written a post on what foods help to lose weight. Bring him around to stick to those foods in his everyday diet. A brief description of the diet is given below.

Treatment of childhood obesity after 7 years of age

If the child has crossed the age of 7 years, and is obese, then losing weight instead of just maintaining it becomes necessary. This will mean burning more calories than the calorie intake becomes necessary. Childhood obesity treatment becomes that much more aggressive. The child’s physical activity should increase and the food intake should decrease.

Foods and diet

Giving the obese child the right type of foods to eat and incorporating in him the habit of doing the right type of physical activity will bring him around to a healthy weight.

Broadly, you should include the following foods in your child’s diet. Give him only

  • Whole grains and whole-grain products such as whole-grain bread and cereals
  • Skimmed milk and its products – no whole milk
  • Fruits and vegetables should be part of his everyday diet.
  • Cook food preferably in olive oil and canola oil.
  • Your child can eat chicken or turkey without skin
  • The more often he eats fish, the easier it is to lose weight.
  • No red meat
  • He should avoid fried foods. Give him food that is baked or grilled.
  • Avoid sweetened beverages
  • Avoid fast food.
  • Serve suitable portions
  • Encourage the child to drink adequate water. According to healthychildren.org, the recommended daily fluid intake is five glasses (200 ml) for 5 to 8-year-olds, seven glasses for 9 to 12-year-olds, and eight to ten glasses for 13 years old and above.

Psychological care

Due to the psychological effects of being obese, childhood obesity treatment also includes taking the help of a psychologist to bring the child out of poor self-esteem, anxiety, or even depression.

These mental disturbances are more common than we think and recognizing them and showing early concern is essential.

Weight loss pills for childhood obesity

Pills to lose weight are available and you should give them to the obese adolescent only under your doctor’s supervision.

  • Orlistat, brand name Xenical, is prescribed for obese children above the age of 12 years
  • Alli, which contains half the strength of Xenical is available over the counter.
  • Sibutramine, brand name Meridia, is prescribed for adolescents over the age of 16 years.

However, putting your child on weight loss supplements or pills isn’t a good idea. Little is known of their side effects on children.

Weight loss surgery for childhood obesity

Bariatric surgery is the last option reserved for the morbidly obese adolescent or just an obese adolescent who has a health complication due to being obese.

There are various surgical options:

  • Lap Band Weight Loss Surgery or Laparoscopic adjustable gastric banding (LAGB) 
  • Gastric bypass surgery also referred to as Roux-en-Y gastric bypass
  • Gastric sleeve surgery also called the vertical sleeve gastrectomy
  • Duodenal Switch Surgery or Biliopancreatic Diversion with Duodenal Switch – (BPD/DS) 

Your bariatric surgeon will be the best person to take a decision on whether your child is eligible for bariatric surgery or not after considering his age and general health.

The current recommendation is to wait until the child is around 13 years of age for girls and 15 for boys before considering bariatric surgery. That is the age when the child is physically done growing up.

Another key factor required to be eligible for surgery is an adolescent with a body mass index (BMI) >40 kg/m2 with severe comorbidities such as nonalcoholic fatty liver disease, or one with a BMI > 50kg/m2 with milder complications.

Your surgeon will first evaluate the child through a physical exam, blood studies, eating habits, the level of physical activity, and lifestyle. Only then, the healthcare professional will take a call on whether your child is fit for surgery and further what type of surgery.

Presently, the most common bariatric surgeries performed for child obesity are the Roux-en-Y gastric bypass (RYGB), laparoscopic adjustable gastric banding (LAGB), and vertical sleeve gastrectomy.

The prognosis after surgery is good and even any existing comorbidities are controlled provided the obese adolescent sticks to a healthy diet and regular physical exercise.