Childhood Obesity and the COVID 19 Pandemic

Low- and middle-income countries had already witnessed a rise in childhood obesity, particularly in urban settings, before 2019. But did you know that several studies around the world have demonstrated a sharp increase in childhood obesity since the COVID-19 pandemic? In particular, children between 5 and 9 years of age were found to be the most affected.

This finding is not unexpected as the responses to the pandemic caused major lifestyle changes. Lockdowns and social distancing forced families and children to remain indoors and reduced the opportunities for physical activity among children, particularly for those living in small quarters in the urban areas. Schools closed and learning occurred online increasing inactivity as well as screen time.  Without friends and other forms of entertainment, children turned to watching more TV, playing computer games, and using tablets or smartphones to keep themselves busy…..all of which further increased screen time and inactivity.  

What is childhood obesity?

Childhood obesity is a complex health issue that occurs when a child is well above the normal or healthy weight for his or her age and height. Since bodyweight depended on height, the Body Mass Index (BMI) is commonly used to identify overweight and obesity. It is calculated by dividing a person’s weight in kilograms by the square of his/her height in meters (kg/m2).

For adults, overweight is defined as BMI greater than or equal to 25 and obesity as BMI greater than or equal to 30 irrespective of the age or gender of the individual.

However, the body composition of children varies as they age and differs between boys and girls.  Hence, BMI levels among children and teens need to be compared with others of the same age and sex, in other words, BMI in children is age- and sex-specific and is often referred to as BMI-for-age.

Growth charts are often used to assess growth in children. In children above 2 years of age the definitions are as follows:

  • overweight if their BMI for age is between the 85th to less than the 95th percentile
  • obese if the BMI for age is greater or at the 95th percentile.

(BMI for age charts are available under the resources section on the home page)

Why is it important to prevent obesity?

Childhood obesity can lead to many other diseases such as:

  • High blood pressure and high cholesterol which are risk factors for heart attacks and strokes
  • Diabetes
  • Breathing problems, such as asthma and sleep apnea
  • Joint and musculoskeletal problems
  • Fatty liver disease, gallstones, and gastro-esophageal reflux (i.e., heartburn)
  • Psychological problems such as anxiety and depression
  • Social problems such as bullying and stigma

What can you do about it?

Usually (as long are there are no risk factors), the initial efforts are aimed at maintaining your child’s weight rather than losing weight. Remember, your child will continue to grow, so if you can keep them from gaining additional weight, they will ultimately grow into their proper weight. If medically advised, the weight loss should be gradual not exceeding one kg per month.

Interventions to prevent or manage childhood obesity are lifestyle changes that are beneficial to not only your child but your entire family.  These include healthy eating, increasing physical activity, and behavioral modification. Be a role model. Your children watch and mimic your habits, and if they see you being physically active and healthy, they’re more likely to be active and stay healthy throughout their lives.

1. Healthy eating

  • Adopt a healthy diet for the whole family…think of it as healthy eating rather than dieting.
  • Encourage fruits, vegetables, whole-grain cereal.
  • Avoid energy-dense fatty and salty food (prepackaged snacks, ice-creams and chocolates) and sugary cold drinks.
  • Eat more home-cooked meals rather than take out.
  • Avoid frequent snacking.
  • Avoid using food as a reward (i.e., celebrating with ice cream, going out to eat) or a punishment (restricting food for bad behavior).
  • Turn the TV off for dinner. Studies have shown that people consume more food when watching TV than those who do not.
  • Do not miss breakfast.
  • Do not force your children to finish up all of the food on their plate if they are already full.
  • Do not talk about “bad foods” or completely ban all sweets and favorite snacks. Kids may rebel and overeat forbidden foods outside the home or sneak them in on their own. Serve healthy foods most of the time and offer treats once in a while.

2. Increase physical activity

  • Make exercise a family habit. Children need 60 minutes a day of physical activity to be healthy.
  • Kids like to have fun, so they’re more likely to keep exercising if they’re doing an activity they enjoy.
  • There are plenty of things to do to increase physical activity even at a time like this:

– turn on the music and have a dance party

– do some yoga

– skip, walk, cycle around, play ball or badminton

– organize an obstacle course or a treasure hunt inside your house

– include kids in age-appropriate household activities or gardening

3. Encourage sound Sleep

  • Encourage good sleeping habits by forming a nighttime routine with small children and regular bedtimes.
  • Remove TVs from bedrooms.

4. Decrease Screen time

  • Although it is not possible to stick to the recommendations of limiting screen time to 2 hours or less per day with online classes, try to decrease it as much as possible.