Obesity in Children

Defining obesity is more difficult in children than adults as body mass index (BMI) varies with age. BMI percentile charts are therefore needed to make an accurate assessment. Recent NICE guidelines suggest to use 'UK 1990 BMI charts to give age- and gender-specific information'

NICE recommend

• consider tailored clinical intervention if BMI at 91st centile or above.
• consider assessing for comorbidities if BMI at 98th centile or above

By far the most common cause of obesity in childhood is lifestyle factors. Other associations of obesity in children include:

• Asian children: four times more likely to be obese than white children
• female children
• taller children: children with obesity are often above the 50th percentile in height

Cause of obesity in children

• growth hormone deficiency
• hypothyroidism
• Down's syndrome
• Cushing's syndrome
• Prader-Willi syndrome

Consequences of obesity in children

• orthopaedic problems: slipped upper femoral epiphyses, Blount's disease (a development abnormality of the tibia resulting in bowing of the legs), musculoskeletal pains
• psychological consequences: poor self-esteem, bullying
• sleep apnoea
• benign intracranial hypertension