Definition:
Obesity has been shown to have a substantial negative effect on longevity, reducing life expectancy by up to 20 years. So serious are the potential repercussions for children that a report published in the New England Journal of Medicine in 2005 determined that this generation of children may be the first that do not outlive their parents.
World-wide, approximately 43 million children under the age of 5 are obese and 1 in 10 children are over-weight. In Australia, over the decade from 1985 to 1995 the number of obese children more than doubled, and the prevalence of obesity has continue d to rise since then. Australia and New Zealand now have amongst the hghest rates of childhood obesity in the developed world, with 25% of our children currently overweight or obese.
Thorough research exists to demonstrate the safety and efficacy of moderate protein, high fat and low carbohydrate diets for overweight and obese children. Such dietary changes produce no adverse outcomes in long term growth or health, which is further highlighted when considering the increasing health risks of being overweight. Furthermore, these dietary modifications have been shown to be the best in regards to both weight management and long term compliance.

Aetiology / Risk factors:
• High energy food intake and lack of physical activity
• Dysbiosis in infanthood (may be a result of diet or antibiotic use)
• Chronic otitis media (may increase preferences for sweeter and saltier ‘junk’ foods)
• Childhood stress
• Parental BMI – overweight parents doubles the risk for overweight children (genes and obesegenic environment)
• Maternal smoking during pregnancy
• Gestational Diabetes
• Nutritional deficiency in pregnancy, especially methylating factors, folic acid and vitamin B12
• Low birth weight
• Not breast feeding. Various theories why, but bottle feeding tends to introduce solids earlier.
• Timing of introduction of solids. Higher BMI trend at 10 years of age if solids introduced before 6 months, and higher still at 7years of age if introduced before 15 weeks.
• Pre - and post-natal toxin exposure, such as BPA, organoclorides, dioxins and heavy metals
• Poor sleep
• High TV and technology use.

Clinical Tips for Patient Compliance How to motivate and inspire an obese child:
• Identify feelings associated with being overweight or obese, and meaningful factors to help to commit to making the dietary and lifestyle changes to achieve weight loss goals. Questions to help identify their inspiration, practitioners migh t ask:
                • What would you do if you were healthier and fitter?
                • If you had a better weight, what new activities would you like to do?     

Some suggestions to support motivation and inspiration:                                                                                                                                       * Plan specific exercise times during the week.
                * Ensure they include incidental activity as a partof their daily routine
                * Add variety to their exercise to avoid boredom
                * Ensure they exercise in a group or with friends
                * Find non-structured exercise activities they enjoy , such as dance classes, team sports, playing with other children.
                * Set realistic goals and record progress together. Regular consultations are vital for this.