The prevalence of overweight and obese children has steadily increased over the years among both genders, all ages, all racial/ethnic groups, and all educational levels. This is an alarming situation as it indicates an increase in the risk of various serious diseases associated to obesity or being overweight.

Environmental Influences
As with adults, the impact of our environment and the relative high availability of products that lead to poor nutrition and sedentary lifestyles are prevalent for our nation’s children. While there are genetic influences, excess weight and obesity is most often caused by over eating or eating inappropriate foods that contain high, poor quality calories that cannot be utilized by the body’s metabolism and are stored as fat. It is hard enough teaching ourselves proper nutritional values. Our children, who rely on their elders to set examples and establish boundaries, are bombarded by junk food ads and bad eating habits from TV commercials, and rows of sweet and junk food at the grocery store. We are now faced with our children being forced to make choices at school they should not have to make. They either have to explain why they are not allowed to eat junk food and the rules taught them by their parents, or face the pear pressure that forces them to make a bad choice.

According to the organization “Parents Preferred Nutrition Guidelines”:

Over the past ten years school systems have found another way to disregard the nutritional health of our children by joining with large corporations to place vending machines that sell junk food in our public schools. Our schools furnish our children with access to junk food, but not with a physical fitness program.

Vending machines are big business. About half of the nation's schools districts have vending machine contracts with soft drink companies to help fund extracurricular activities. Some school districts receive hundreds of thousands of dollars up front from large corporations just to sign an exclusive contract with a company. This type of big money is not just being paid to big city school districts. Princeton City School District in Ohio received $136,000 up front from Coke-Cola for a 10-year contract, and receives 40 percent of all sales ($18,000 last year) from the machines. Coke and Pepsi are now involved in a court battle over a contract that was signed by a school system then was later broken so the school could sign for more money with another company.

In an effort to combat this trend, the CDC and Council for Physical Education for Children recommended:

• Establish policies that promote enjoyable, lifelong physical activity. These include:
  • Comprehensive, preferably daily, physical education for children in grades kindergarten through 12;
  • Comprehensive health education for children in grades kindergarten

Benefits of Lifestyle Changes
Some of the health benefits of regular physical activity during childhood and adolescence may be realized before adulthood. Studies have shown an association between higher activity levels and lower levels of body fat, increased bone mineral mass, and lower levels of tobacco and alcohol use. Exercise has been successfully used in conjunction with other interventions to treat obesity, hypertension, and other chronic diseases. Some of these programs using exercise or physical activity have been successfully implemented in the school setting.

Negative Impacts Beyond the Physical
The negative physical, psychological and social health impacts suffered by overweight adults are true for children s well. In fact, children may be at higher risk for long-term health consequences as the compounded effects of obesity may effect the physical development and functional proficiency of internal organs.

Obesity can be socially devastating for children as they are marginalized from school and extracurricular activities, especially sports which, ironically, would most benefit their health. As children develop socially, they tend to compete for positions of dominance within their peer groups. Typically, those seen as being ‘different’ or less than ideal are targeted for psychological and verbal abuse by their peers. While this is not to say that children, or adults, should always strive to blend in or be part of the pack, it is worth considering the long term psycho-social impact such abuse may have on our children.

Social inadequacy can lead to further socialization issues in adulthood, depression, withdrawal, poor academic performance, and even suicide.

An estimated 75% of obese adolescents will continue to be obese in adulthood.

Bariatric Surgery and Children
Bariatric surgery has become one of the most commonly-used operative procedures in the United States today, and while once considered a rarity for the treatment of obesity, bariatric procedures are now well-recognized. But moist of these procedures are performed on adults whose organs, bones, connective tissues and neurology have fully developed. Furthermore, the same is true of their psychological development. The onset of childhood obesity in epidemic proportions is new and it is argued that not enough id known about the effects of bariatric procedures on the physiology of children. Obese adolescents are different; they are not just large adults. The obese adolescent presents a unique array of issues, many of which may be impacted by these surgical procedures in ways we do not understand yet: What will be the psychosocial impact of significant weight loss, the metabolic consequences, and the long-term efficacy of these operations?

In extreme cases, as with that of Billy Robbins, a super-morbidly obese 19-year-old adolescent, bariatric surgery was deemed a necessity if he were to make it to his next birthday. Billy weighed in excess of 800 pounds when he first presented to Dr. Nowzaradan. His situation was so extreme, that Dr. Nowzaradan, Billy and his family decided, after weighing the risks and benefits, to undergo a 2-stage procedure involving an initial Sleeve Gastrectomy, followed by a malabsorptive bariatric procedure. In extreme cases, surgery may certainly be considered for an adolescent; however, this situation should not be entered into lightly. Intense scrutiny of all health and psychological variables is necessary prior to surgery.

Solutions at Home
You cannot account for your child’s whereabouts every minute of the day; therefore, you cannot fully police what he or she eats or what activities he or she engages in. But you are in control at home. You control what foods you purchase at the store and what foods enter your house.

Make sure healthy foods are readily available, and remove high-calorie, high-fat foods, such as chips, cakes, ice cream and soda from the home. Many parents are just as taken in as children when it comes to creative marketing. A Fruit Roll Up is NOT the same as an apple. Today, television, video games, and computer activities have become the babysitter for our children, resulting in kids living a couch potato lifestyle, thus making physical activity less common. Creating new family habits around healthy eating and increased physical activity can help children lose weight and gain self-confidence. This will also improve the health of other members of the family including yourself, by setting good examples of a healthy lifestyle. Physical activity can be a great way to spend quality time with your children: A walk at the park, playing with your child on the playground, riding bikes, playing a game of freeze tag, running a race up a hill, or playing a game of baseball. Just get your kids moving! It is so important for the health of your entire family.