Obesity in children: Information & specialists

Currently, one in five children in Germany is too fat. As in all industrialized nations, not only the frequency but also the extent of obesity is on the rise. This is mainly due to living conditions, but also to genetic factors. Overweight children are not only exposed to the risk of secondary diseases, but also to increased suffering.

Here you will find further information as well as selected specialists and centers for children with obesity.

When is a child/adolescent considered overweight?

Currently, one in five children in Germany is overweight. As in all industrialized nations, not only the frequency but also the extent of overweight is increasing.

The BMI (body mass index) also serves as an indication of overweight or obesity in children and adolescents.

BMI = weight in kg / (height in m)²

Example for calculation:

Weight = 87 kg, height = 169 cm

BMI = 87 kg / (1.69m x 1.69m) = 87 / 2.86 m²) = 30, 5 kg/m²

Using this figure, weight curves can be used to determine whether a child is normal weight, overweight or obese.

The percentile value is important here. One speaks of overweight if the BMI is above the 90th percentile. The 90th percentile means that the BMI of 90% of all children under the age of 15 is below this limit. This definition of overweight is based on cross-sectional analyses of children 15 years ago.

Massive overweight (= obesity) is defined as a BMI above the 97th percentile. A simple calculation is also possible via www.mybmi.de.

What are the causes of extreme overweight in children and adolescents?

There are many reasons for the increasing number of overweight children and adolescents. The causes include

• genetic factors,
• human behavior and
• environmental and living conditions

are involved.

Approximately half of our daily energy consumption is determined by genetically determined metabolic processes. They cannot be controlled voluntarily.

Adipose tissue serves as the body's energy store. It increases when the energy supply (= food intake) exceeds the energy consumption (= exercise, metabolism). Weight gain can therefore be caused by excessive calorie intake and/or physical inactivity.

Food intake is essentially determined by

• Sensation of hunger and satiety,
• external stimuli (e.g. smell),
• taste and
• availability of food

determined.

Fatty foods

The frequency and extent of obesity are directly related to the amount of fat consumed. Fats have the highest number of calories per gram (9kcal/g). At the same time, they are less satiating than proteins and carbohydrates (4kcal/g each).

Foods rich in fat are

• almost all sweets,
• "snacks" and
• many fast food dishes.

Another source of calories that should not be underestimated are sweetened drinks, e.g.

• cola,
• Fanta,
• apple juice etc.

Too little physical activity

The amount of physical activity depends on

• active physical activity,
• movement in everyday life (e.g. walking to school) and
• sedentary activities (television, computer consumption)

depends. The increase in television and computer consumption is directly related to the increase in obesity.

Watching television means physical inactivity. At the same time, it encourages the consumption of high-calorie foods (especially sweets and snacks), also through advertising.

Illnesses are rarely the cause of obesity

Illnesses are only the cause of overweight in less than 1% of children and adolescents. Indications of illnesses as the cause of overweight include

• Short stature, stunted growth
• Sudden rapid weight gain

A pediatrician or pediatric endocrinologist should be consulted for these indications. Endocrinologists are specialists in hormonal disorders. They examine the patient for these diseases, among others:

• Hypothyroidism
• Disruption of the adrenal hormones
• Growth hormone deficiency

Psychiatric illnesses (especially eating disorders) can also cause or contribute to obesity. Indications are

• Consumption of large amounts of food
• vomiting
• Use of laxatives
• sleep disorders
• sad facial expression
• Changing appetite
• many negative self-centered thoughts
• Frequent headaches and stomach aches
• Nightmares, increased anxiety
• drop in school performance
• Stealing, constant disregard for rules
• aggressive behavior, truancy
• drug abuse

Consequences of obesity in children and adolescents

Overweight children usually become overweight adults. Being overweight leads to

• Diseases of the cardiovascular system,
• diabetes mellitus type 2 (diabetes) and
• joint wear and tear(arthrosis), even in childhood and adolescence.

The consequences of being overweight, even in childhood, are

• High blood pressure,
• lipometabolic disorders and
• polycystic ovary syndrome in adolescent girls (a disease that causes menstrual irregularities. It is associated with increased hairiness and later reproductive disorders).

Type 2 diabetes mellitus can also rarely occur in obese adolescents.

In addition to these complications, the following occur relatively frequently

• orthopaedic problems (e.g. bowed foot, bow legs) and
• infections in the skin folds

occur.

In addition to the medical consequences, many of those affected also suffer from the psychological consequences of obesity.

The suffering of overweight children and adolescents results from the reactions of their environment. Society usually sees obesity as the result of laziness and a lack of willpower.

Even kindergarten children seem to have internalized a negative image of overweight people. This is shown by tests in which children are presented with pictures of normal-weight and overweight children as well as children with disabilities. They rate the overweight children as the least popular and would least like to be friends with them.

Overweight children and adolescents often have low self-esteem. They suffer from teasing by their peers and social isolation.

Social and economic disadvantages become apparent in adolescence: Overweight people get worse apprenticeships and earn less. Overweight girls are less likely to find a partner.

How can children and young people reduce their overweight?

Reducing excess weight is often difficult and frustrating. A genetic predisposition to obesity cannot be cured. Measures must therefore focus on changing behavior.

A long-term change in diet and exercise behavior is crucial for success. In growing children, a reduction in overweight can already be achieved by keeping the weight off.

It helps many people to lose weight together with others. This can be the whole family or other affected young people.

It is often helpful to take part in a training course as part of an outpatient program. The costs must be clarified with the health insurance company beforehand. You can recognize a useful training course by the fact that the combination of

• nutritional,
• behavioral and
• exercise course

is offered. Parent training should also be included (for therapy services, see www.obeldicks.de or www.a-g-a.de).

First steps in losing weight: The traffic light system

A simple system for changing your diet is the traffic light system, which can be used to categorize foods and drinks.

The body does not need foods and drinks in the red zone. These are the "fattening foods". You should therefore try to limit this area.

The body needs food from the yellow range, but it should not be in excessive quantities.

Foods and drinks from the green area are preferable.

A healthy diet and sufficient exercise are the best measures against obesity, even in children © M.studio | AdobeStock

Green: Great! Okay when hungry!

Overweight children are allowed to eat the following foods when they are hungry:

• Drinks: mineral water, all types of unsweetened tea, fruit juice spritzer (2 parts water : 1 part juice)
• Bread and cereal products: Wholemeal bread, wholemeal rolls, wholemeal toast, wholemeal crispbread, cereal flakes, muesli without sugar and without nuts, wholemeal pasta, wholemeal rice
• Spreads: mustard, tomato paste
• Potatoes and potato products: Jacket potatoes, baked potatoes, boiled potatoes
• Vegetables and salad: Fresh and frozen, e.g. broccoli, cauliflower, cucumbers, carrots, kohlrabi, tomatoes, peppers, all types of cabbage (white cabbage, red cabbage, Brussels sprouts, etc.), all salads (iceberg, lettuce, lamb's lettuce, etc.), pulses (peas, beans, lentils)
• Fruit and nuts: Fresh or frozen e.g. apples, pineapple, bananas, pears, strawberries, raspberries, nectarines, oranges, plums, grapes, grapefruit, mandarins, canned fruit in water, chestnuts
• Cakes, sweets and snacks: wholegrain rice cakes, chewing gum, homemade ice cream made from juice spritzer
• Ready-made products, fast food: salads with low-fat dressing

Yellow: Not too much!

Overweight children should only eat these foods in moderation:

• Drinks: 100% fruit juices, reduced-calorie sodas and fruit juices, carrot juice, tomato juice
• Bread and cereal products: Grain bread, rye bread, mixed bread, white bread, toast, rolls, raisin rolls, milk rolls, crispbread, pretzel rolls, cornflakes, muesli with sugar, light-colored pasta, white rice
• Spreads: Honey, jam, vegetarian spreads up to 30% fat
• Potatoes and potato products: Mashed potatoes with 1.5% milk with no added fat, chips and croquettes from the oven, gnocchi, potato salad without mayonnaise, prepared low-fat
• Vegetables and salad: ready-made products with additives, e.g. buttered vegetables, creamed spinach
• Fruit and nuts: Dried fruit, e.g. apple rings, apricots, banana slices, dates, figs, prunes, raisins, canned fruit with sugar
• Milk and dairy products: Yoghurt, milk and soured milk up to 1.5 % fat, quark and fruit quark up to 20 % fat, fruit yoghurt up to 1.5 % fat, fruit buttermilk, whey with added fruit, sour cream up to 10 % fat, cheese up to 30 % fat in dry matter, pudding made from milk 1.5 % fat, cocoa with milk 1.5 % fat
• Meat, sausage products, fish: Turkey escalope, turkey breast, chicken breast, skinless chicken, pork fillet, veal steak, shashlik, beef fillet, tartare, poultry sausage up to 15 % fat, poultry sausage up to 15 % fat, chicken sausage up to 15 % fat, chicken sausage up to 15 % fat, chicken sausage up to 15 % fat.sausage up to 15% fat, cooked and raw ham without a fat edge, corned beef, 50% fat-reduced sausage, poultry cold cuts up to 15% fat, roast beef, lean aspic cold cuts, low-fat sea fish (e.g. saithe, cod), sausages with a fat content of up to 15%.e.g. saithe, cod, plaice, haddock), tuna in water, fish sticks cooked in the oven
• Eggs and egg dishes: boiled eggs, fried eggs and scrambled eggs without fat, pancakes prepared low-fat
• Fats and oils: Half-fat margarine, mayonnaise up to 50% fat
• Cakes, sweets and snacks: Yeast cake with fruit without sprinkles, sponge cake with fruit, raisin rolls, yeast dough croissants, Russian bread, After Eight, fruit gums and liquorice, sweets, chewy sweets and lollipops, marshmallows and foam sugar, water ice (Calippo, Capri), pretzel sticks and pretzels, popcorn, grissini
• Ready-made products, fast food: hamburgers, pizza without salami, with vegetables, vegetarian, spring rolls, spaghetti with tomato sauce, tortellini without cream sauce, Chinese food without breading, 5-minute terrine, low-fat soups, tomato ketchup

Red: Stop! Rarely and little!

Overweight children should only eat the following foods as an exception or in small quantities:

• Drinks: fruit juice drinks, fruit nectar, lemonade, iced tea, Capri Sun, cola, Fanta etc., malt beer, alcoholic drinks
• Bread and cereal products: Croissant, chocolate croissant, breakfast cereals with lots of sugar and nuts, e.g. honey pops, smacks, chocolate muesli, crunchy muesli, crunchy nut
• Spreads: Nut nougat cream, peanut cream, almond hazelnut butter, vegetarian spreads over 30% fat
• Potatoes and potato products: Fried potatoes, chips, croquettes, potato pancakes, potato pancakes, potato salad with mayonnaise
• Fruit and nuts: Cashew nuts, peanuts, hazelnuts, almonds, Brazil nuts, walnuts etc., coconut
• Milk and dairy products: Yoghurt, milk and soured milk from 1.5 % fat, quark and fruit quark from 20 % fat, fruit yoghurt from 3.5 % fat, sour cream, sour cream, cream, crème fraiche from 10 % fat, cheese from 30 % fat in dry matter, pudding and cocoa with more than 1.5 % fat
• Meat, sausages, fish: Chicken fricassee, chicken thighs, half chicken, pork steak, pork chops, veal roll roast, breaded meat, minced beef/pork, beef sausage, bratwurst, curry sausage, bacon, bacon, pork belly, meat loaf, meat loafsausage, liver sausage, salami, tea sausage, mettwurst, red sausage, mortadella, lyonnaise, yellow sausage, meat sausage, black pudding, tongue sausage, herring, salmon, smoked fish, tuna in oil, frozen fish with sauces, breaded fish, fish sticks
• Eggs and egg dishes: Eggs fried with fat, scrambled eggs with bacon or sausages
• Fats and oils: Butter, margarine, cooking oil (preferably rapeseed oil and olive oil), mayonnaise, remoulade
• Cakes, sweets and snacks: cream cakes, sponge cakes, puff pastry, pieces, doughnuts, doughnuts, waffles, cookies, chocolate bars, muesli bars, ice cream (e.g. Magnum, Cornetto, Nogger), milk ice cream, fruit ice cream, potato chips, peanut flips etc., Tuc
• Ready-made products, fast food: cheeseburgers, Big Mäc etc., gyros, kebab, pizza with salami etc., fish cakes, Bismark herring rolls, chicken nuggets, hot dogs, crepes

What quantities of food should overweight children and adolescents eat?

It is advisable to weigh the foods that are consumed daily once with a household scale. You can then compare them with the following food recommendations for the respective age.

Well-being tips for overweight children and young people

The feel-good tips help you to change your eating habits so that you know when you are full. The feeling of fullness only sets in 15-20 minutes after the meal. It is therefore important to eat slowly and enjoyably in order to notice the feeling of fullness in good time.

These tricks help you to really enjoy eating and drinking and to feel when you are full.

Remembering to

• eating slowly
• chew thoroughly
• take breaks
• rarely have seconds
• eat and drink regularly
• eat and drink at a fixed place
• only eat and drink and nothing else

Very important: take your time when eating so that you can hear the signals of fullness!

How can more exercise be integrated into the everyday lives of overweight children?

It is very efficient for children to walk or cycle to school. The car or bus is less efficient. This ensures regular exercise in everyday life and helps more than doing sport once a week.

Your child should also not watch television out of boredom. Set limits here and encourage your child to be active outside.