Hi, this is Tom, and in this episode I'm going to be going through childhood obesity.

And you can find notes at zero to finals.com slash childhood obesity and in the zero to finals pediatrics book.

And you can find flashcards and questions to train your knowledge at

members.0.0.5.com. So let's jump straight in. Childhood obesity results when energy intake,

specifically calories, exceeds energy expenditure over time.

There has been a steady rise in children becoming increasingly overweight and obese globally.

Contributing factors include easy access to hyper-palatable, high-calorie, highly processed and inexpensive foods,

reduced physical activity and increased sedentary behaviours, for example, screen time,

and family dietary patterns and genetic predisposition to obesity.

Obese children are often tall for their age and they have overweight families.

Short stature, along with obesity, should prompt further assessment for pathological causes,

for example, hypothyroidism or growth hormone deficiency.

Pathological causes are rare and obesity is almost always caused by lifestyle factors.

Let's talk about the criteria. The UK WHO growth charts for age 2 to 18 years contain a BMI centile chart.

The weight centile on the y-axis can be plotted against the height centile on the X-axis,

and this gives the BMI centile. The results are classified as

above the 91st BMI centile is overweight, and above the 98th centile is very overweight or

clinically obese.

The nice guidelines on obesity from January 2025 recommend also measuring the waist to height ratio. A waist to height ratio of 0.4 to 0.49 is healthy, from 0.5 to 0.59 suggests increased central adiposity,

and 0.6 and above indicates high central adiposity, essentially lots of fat stored around

the abdomen.

Let's talk about management.

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