Excess weight in children can significantly impact their heart health and increase their risk of developing cardiovascular issues later in life.
 
Although many assume that high blood pressure, high cholesterol, and abnormal heart muscle structure,
are only associated with adults, children with obesity can also suffer from these medical issues. 

The good news is a child who has their obesity issues addressed early, can still lead a healthy life. 
 
Raquel Hernandez, M.D. M.P.H., is an associate professor of pediatrics at the Johns Hopkins University School of Medicine and medical director of the Johns Hopkins All Children’s Healthy Weight Initiative. As part of the Johns Hopkins All Children’s Heart Institute, Hernandez provides patients with a multi-tiered approach including innovative clinical care, research and educational efforts targeting pediatric obesity.
 
“We know that obesity is an increasingly common condition,” she says. “By implementing healthy lifestyle and nutritional changes, of children with obesity will often show improvements in heart-related conditions for a vast majority of kids. Parents should know that these are common health problems that are very treatable if found early.”

What is obesity? 

Obesity is determined by Body Mass Index (BMI), a calculation that uses height and weight to estimate how much body fat someone has. BMI percentiles show how a child's measurements compare with others the same gender and age. A child might be considered obese if their BMI is at or above the 95th percentile for age, gender and height. It’s important to note the BMI does not always determine obesity, but it’s a good first indicator that there might be a health issue and give physicians a need to look deeper into that child’s assessment. 

What causes obesity?

According to Hernandez, “Our food environment and exposure to processed foods is the central reason children suffer from obesity. Our bodies are being asked to work harder to digest these highly processed foods and that is actually causing really unhealthy metabolic changes for all of us.

“We have also become a screen-dependent society where everything we do is based in using a screen for prolonged periods. It’s come to the point where we have to think about how we use screens, in the same way we think about nutrition and exercise, and consider using ‘a digital diet,’ as part of a healthy lifestyle. We need to set a cutoff since we and our children are always on our screen, which means our bodies are not moving less and less.”

How do parents know if their child’s heart health might be an issue 

Symptoms can vary, but in general, children who seem to be having shortness of breath, chest pain or difficulty maintaining brief periods of activity, like a modest walk.
 
Sometimes parents might find out their child has a cardiovascular risk during a routine well-child check-up that might show high cholesterol or triglycerides in a blood test. 
 
Families that know they have a history of high cholesterol or heart disease really should be proactive and connect with their pediatrician early so nothing is overlooked with their child.

“Some parents want to believe their child will outgrow their weight risk, but that’s not always the case,” Hernandez says. “By the time we see children with weight-related heart issues, they might be quite severe and already suffering from numerous health issues related to weight. 
 
“Unfortunately, our society has continued to shame people with obesity. We now know that obesity is a complex, chronic condition influenced by many factors including genetics, very similar to other chronic conditions like asthma. We don’t shame asthmatics. Sometimes adults and children don’t want to come for treatment for obesity due to these stigmas, and that makes it a tough problem to address.” 
 
Sometimes our treatment goals are not just getting the weight down, but it is about changing nutrition, activity levels and stabilizing weight.

What about medication? 

While Hernandez says there are medications available that can be life changing, especially for kids with the most severe forms of obesity, she feels strongly that no patient should be started immediately on weight loss medication without a thorough assessment and physical. 
 
“I’ve had some kids come to our clinic looking for a quick fix with a diet pill or other prescribed medications,” she says. “I tell them that’s not what we do, but let me tell you about the treatments we do offer. We are not chasing numbers on the scale. We’re chasing your best physical and mental health.” 

How to get help for your child 

Hernandez says the place to start is with your child. Include them in the discussion about their health, (if they are old enough to understand). Then consult your pediatrician.
 
The Healthy Steps Clinic at Johns Hopkins All Children’s Hospital is designed to help toddlers, children and adolescents, up to 21 years of age, with weight issues including rapid weight gain and unhealthy weight.

“A lot of parents automatically assume we are going to recommend weight loss. We often are just looking for a modest change in weight and diet becomes the predictive factor,” Hernandez says. “If a family starts a healthy diet, the next time I see that patient they are going to be healthier.”