Only a small percentage of childhood obesity is associated with a hormonal or genetic defect, with the remainder being environmental in nature due to lifestyle and dietary factors. Although rarely encountered, hypo-thyroidism is the most common endogenous abnormality in obese children and seldom causes massive weight gain.
Of the diagnosed cases of childhood obesity, roughly 90% of the cases are considered environmental in nature and about 10% are endogenous in nature.
Goals of therapy
The Division of Pediatric Gastroenterology and Nutrition, New England Medical Center, Boston, Massachusetts as well as many child organizations agree that the primary goal of a weight loss program for children to manage uncomplicated obesity is healthy eating and activity, not achievement of ideal body weight. Any program designed for the overweight or obese child should emphasize behavior modification skills necessary to change behavior and to maintain those changes.
For children with a secondary complication of obesity, improvement or resolution of the complication is an important medical goal. Abnormal blood pressure or lipid profile may improve with weight control, and will reinforce to the child and their parents/caregivers that weight control leads to improvement in health even if the child does not approach ideal body weight.
