Overweight in children: symptoms and therapy

Martina Feichter studied biology with an elective in pharmacy in Innsbruck and also delved into the world of medicinal plants. From there it wasn’t far to other medical topics that still captivate them. She trained as a journalist at the Axel Springer Academy in Hamburg and has worked for NetDoktor since 2007 – first as an editor and since 2012 as a freelance writer.

This text corresponds to the requirements of the medical literature, medical guidelines and current ones studies and has been tested by medical professionals.

In the industrialized nations Overweight in children and adolescents a serious health problem. Those affected usually take the excess kilos with them into adulthood – along with all the complaints and complications that can result from being overweight. Read more about overweight in children here: causes, symptoms, diagnosis and therapy!

Overweight in children: description

In the industrialized nations, more and more people are suffering from obesity. Children are also affected: In Germany, depending on the definition, ten to twenty percent of all children and adolescents are overweight. About a third of them are even obese. Expressed in numbers: in Germany 1.4 to 2.8 million minors are too fat and about 700,000 are obese.

Around the world, around ten percent of children between the ages of five and 17 are overweight. In Europe, every fifth child is too fat. Overweight is particularly widespread among children in the United States, where more than 30 percent of the offspring weigh too many pounds.

Overweight in children: symptoms

Depending on the extent of the excess fat deposits, overweight children suffer from various complaints. They are often less physically resilient and tire more quickly than normal peers when exercising and exercising. Some offspring get shortness of breath and shortness of breath during sleep or even short nocturnal breathing interruptions (sleep apnea) – especially if they are very overweight.

In addition, children who weigh too much often experience increased sweating and orthopedic problems such as back or knee pain. The latter is due to the fact that a large body weight permanently puts a heavy load on the joints (especially spinal joints, hip, knee and ankle joints) and accelerates their wear.

Overweight children are often taller than peers when they reach puberty. The growth spurt that usually occurs during puberty is then less. However, if overweight children are smaller than their peers, this should be checked with a doctor.

Being overweight in children can also have psychological effects. Teasing from other children and constant warnings from parents to eat less can put a lot of strain on those affected.

Obesity in children: causes and risk factors

Obesity in children can have different causes, which mostly occur in combination:


In many cases, being overweight in children means that parents and / or grandparents also weigh too many pounds. Heredity is one of several factors that determine body weight. But that doesn’t mean that overweight parents are necessarily overweight have children. It also depends on other factors such as nutrition.

Large portions during pregnancy

If pregnant women regularly eat "for two", move little and gain a lot of weight or even develop gestational diabetes, the risk increases that the child will later become overweight.


Overweight is very often observed in children whose parents (especially mothers) smoked during pregnancy. Active and passive smoking during pregnancy also pose further health risks for the offspring, such as miscarriage and sudden child death.

Bad nutrition

Diet has a major impact on the development of obesity in children, from birth. Studies show that breastfed children do not become overweight as often as bottle-fed children.

As with adults, the same applies to children and adolescents: Those who consume more energy than they consume in the long term are more likely to become overweight. Regular consumption of fast food (such as burgers, pizza, fries), sweets and sweet drinks (soda, cola, etc.) favors overweight in children.

Children learn a lot about nutrition in the family: if mom and dad eat unhealthy food, the offspring will do it.

lack of exercise

Sitting in front of the television or computer for hours contributes significantly to the development of overweight in children. This applies all the more if the sprouts also sweets, chips & Co. consume. The role model function of the parents also comes into play here: If they spend their free time mostly with the chip bag on the couch, the offspring will soon imitate them.


Anger or excessive demands at school, family disputes, neglect by parents – some children are exposed to stress at different levels and can often be difficult to handle. Many then seek escape and comfort in the food. In addition, stressed offspring are constantly under power and cannot relax. This also contributes to the development of overweight in children.

lack of sleep

Children who sleep little have a higher risk of becoming overweight than sleepy peers.

Obesity in children: examinations and diagnosis

The pediatrician is the first point of contact for clarifying overweight in children. He will first gather important information in conversation with the parents and possibly the children themselves. They mainly affect the child’s eating habits, physical activity, possible complaints, underlying illnesses and psychological stress, as well as taking medication (such as cortisone). The doctor also inquires whether other family members are already overweight or obese.

Then the physical examination follows. It includes, among other things, a blood pressure measurement and the measurement of the child’s height and weight. In adolescents, the ratio of hip to waist circumference is also determined in order to determine the body fat distribution (Android type: fat pad, especially on the trunk, gynoid type: fat pad, especially on the buttocks and thighs).

Overweight in children: how much weight is too much?

Obesity in children is not as easy to determine as in adults. As with adults, the body mass index (BMI) is determined, i.e. the ratio between body weight (in kilograms) and the square of body size (in square meters). However, the calculated value must then be compared with the values ​​of gender and age-specific growth curves (percentile curves) in order to be able to assess whether a child’s BMI means overweight or even obesity:

Accordingly, children and adolescents are overweight if the calculated BMI is above the age- and gender-specific 90th percentile (90th percentile means that 90 percent of all children of the same sex and age have a lower BMI).

With a BMI above the 97th or the 99.5. Percentiles, there is even obesity (extreme obesity) or extreme obesity (extreme obesity).

Further investigations

Overweight in children is rarely caused by an underlying condition such as an underactive thyroid (hypothyroidism). Such causative diseases must be excluded when clarifying the increased body weight.

On the basis of specific examinations, secondary diseases of obesity and above all obesity (such as disorders of fat metabolism, diabetes, gallstones) can be discovered early. This is done, for example, by measuring blood lipid levels and blood sugar as well as ultrasound examinations of the liver and gall bladder.

If there is obesity (i.e. severe overweight) in children, psychological, psychosocial and behavioral diagnostics are also recommended. The person affected may have a serious underlying psychiatric illness (such as depression, eating disorder). Sometimes there is also severe psychosocial stress such as behavioral and developmental disorders or extreme stressful situations in the family. These factors must be clarified and taken into account in the therapy.

Obesity in children: treatment

Whether and how overweight is treated in children depends on the extent of excess fat, possible comorbidities and the age of the person affected:

Obesity in children between two and six years old sometimes grows. Therefore a constant weight is recommended here: The sprouts should keep their current weight with a healthy, balanced diet and lots of exercise in order to "grow out" of the fat deposits as they get older.

If there is obesity (severe overweight) in children between two and six years without concomitant diseases, constant weight is also recommended. However, if there are concomitant diseases, those affected should lose weight.

Obesity in children over the age of six and adolescents only requires weight loss if there is a concomitant illness. Otherwise it is sufficient to hold the weight. In the case of obesity in this age group, however, weight loss should always be aimed at – regardless of whether there are concomitant diseases or not.

Overweight in children: what does the treatment look like?

Child obesity should be managed according to a multidisciplinary approach that includes nutritional counseling and change, regular exercise and exercise, and psychological support where appropriate. In certain cases of severe overweight in children, inpatient treatment as part of a long-term therapy program can be useful.


To treat obesity in children, a balanced diet with regular meals is necessary. We recommend the optimized mixed food, which was developed by the Research Institute for Child Nutrition (FKE) for offspring between one and 18 years:

  • Plentiful: low-calorie or low-calorie drinks, plant-based foods (vegetables, fruits, cereals, potatoes)
  • Moderate: animal foods (milk, dairy products, meat, sausages, eggs, fish)
  • Economical: high-fat and sugar-rich foods (edible fats, confectionery, nibbles)

How many calories overweight children Being allowed to eat during the day depends, among other things, on the individual therapy goal.

A specialist (such as a dietician, nutritionist) can help with the change in diet.


Regular physical activity is essential if you want to fight obesity in children. Endurance sports such as swimming, cycling and dancing are particularly suitable. However, many offspring are not motivated enough to carry out their sports program alone. Then sports groups are recommended: If you pedal with other overweight people or splash in the water, it is usually much more fun.

Overweight children should also move around a lot in everyday life, for example by taking the stairs instead of the elevator and using the bike or their own feet to get to school instead of getting into the car or bus.

Therapeutic help

Especially in the case of obesity (i.e. overweight) in children, the therapy should also include psychological support, for example in the form of behavioral therapy or family therapy. For example, the children receive help in changing their eating and exercise behavior as well as any psychological problems (such as depression or inferiority complexes).

Other forms of therapy

If obesity (severe overweight) in children cannot be successfully treated by conventional therapeutic measures or serious concomitant illnesses exist, other forms of therapy can be tried that have not been adequately checked so far. This includes formula diets as well as medications to support weight loss. The decision should be made by a therapist who has experience in the field of childhood and adolescent obesity.

Overweight in children: course of the disease and prognosis

When treating obesity in children, one should strive for realistic goals and not expect rapid success, as these are usually not permanent. The better chances of lasting success result from small steps towards the goal (constant weight or weight loss).

Being overweight in children can affect physical and mental development. This applies especially to those who are extremely overweight (obesity). Possible consequences are:

  • accelerated length growth and earlier skeletal maturity (due to increased levels of a growth factor (IGF), which is increasingly formed in the adipose tissue and in the liver)
  • Tearing of the connective tissue with rapid or strong weight gain ("stretch marks")
  • Insulin resistance (reduced response of the body’s cells to the hypoglycemic hormone insulin) and subsequently diabetes mellitus
  • increased testosterone levels in girls with signs of masculinization (virilization) like male hair; decreased testosterone levels in boys
  • increased estrogen levels in both sexes (this increases breast size in boys, technical term: gynecomastia)
  • earlier onset of puberty (early onset of the first menstrual period, earlier onset of a broken voice etc.)
  • High blood pressure (hypertension)
  • increased blood lipid levels
  • Overuse of tendons, joints and muscles with consequences such as back pain, flat feet and spreading feet, X or O legs, etc.

Especially overweight children can lead to high blood pressure, diabetes and increased blood lipid levels, which together promote arteriosclerosis (arteriosclerosis). This can trigger coronary artery disease (CHD), heart attack and stroke. For this reason, sufferers have a lower life expectancy than normal-weight peers.

Possible psychological consequences of (strong) Overweight in children and adolescents include stress, anxiety and depression.


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