Everything you need to know to control your child’s weight

« By the spring of 2022, rates of overweight and obesity have reached epidemic proportions and continue to rise as 28 % children are overweight reports the WHO (World Health Organization) in its report on obesity in the European region (source 1).

Controlling your child’s weight without turning it into an obsession is therefore essential to avoid obesity or thinness problems over time.

Prologue: to define the child’s age, we will rely on the definition given by the National Agency for the Safety of Medicines and Health Products to define their age group, specifically from 2 to 11 years (source 2) .

« As in adults, the ideal weight in children does not exist », remembers Dr. Corinne Xicheportiche-Ayache, nutritionist doctor. In fact, rather than a precise weight and height in relation to a certain age, the medical profession (general practitioner, pediatrician, etc.) will rather rely on measurement indicators such as corpulence curves represented by BMI (Body mass index).

Many parents want their child to grow up « normally » and that is…normal! « However, in medical jargon and especially when it comes to children, we prefer to talk about harmonious growth, » explains Dr. Corinne. Xicheportiche-Ayache, nutritionist doctor. Harmonic growth will refer to the evolution of the child’s own curve in relation to the curves present in the clinical history. These charts were made to compare the child’s growth with that observed in millions of healthy children of the same age and sex.

« Before the age of 3, we will pay particular attention to the cranial circumference, weight and height of the child, after this age, we will only be interested in the last two, abandoning the measurement of the cranial circumference, if there are no particular anomalies. by of course they have been diagnosed ».

Relying only on BMI (body mass index) will not allow to characterize overweight or underweight in children. In fact, during growth, corpulence can vary physiologically. « On average, it increases in the first year of life, then decreases until age 6, and increases again until the end of youth growth, » explains Dr. Corinne. Xicheportiche-Ayache, nutritionist doctor.
There are also gender-specific curves (boy O daughter) due in particular to the different development of muscle mass in the two sexes, » explains Dr.

« The growth curves present in the clinical history will be the reference in the medical environment in France, » says Dr. Corinne Xicheportiche-Ayache, nutritionist doctor. And if it is true that there are others on an international scale, given by the WHO in particular, for consistency with our lifestyles (history, social environment, climate…), the French corpulence curves and the thresholds of the International Obesity Task Force (IOTF) will be the most appropriate.

As the name suggests, growth charts are graphs where curved lines are drawn that represent the expected increase in height, weight and head circumference (before age 3) in normally growing children. Each curve represents what is called a « percentile ». But what exactly is a « percentile »? « Let’s take the example of a child whose height is in the 75th percentile. This means that if we compare him to 100 other healthy children, he will be taller than 75 of them and shorter than 25 of them » , explains Dr. Corinne. Corinne Xicheportiche-Ayache, nutritionist doctor.

Just because a child is in a low or high percentile does not mean there is a health problem: “It could be, for example, that their parents were below average height or weight, which could also be the case of the child This is what’s called genetic potential. » Doctors assess growth over time, not just at a specific time. Your doctor will be able to determine whether or not your child’s curve is cause for concern between appointments. with the doctor (monthly appointments).

From the age of 5, the general practitioner or pediatrician will pay special attention to the growth curve to detect a possible increase in BMI curve: this is called early rebound adiposity. « It’s called precocious because it’s usually more apparent during puberty. And the earlier that adiposity rebound is, the greater the risk. obesity in adulthood it will be high, » notes Dr. Corinne Xicheportiche-Ayache, nutritionist doctor. This warning sign will thus allow you to take care of the child in order to limit the risks of future weight gain or obesity.

Weight problems, whether excessive or insufficient, can be explained by different factors, cumulative or not:

• Family predispositions (genetic diseases in parents, brothers or sisters, etc.)
• Feeding behavior unsuitable (sneak snacks, late dinners, poor food selection: too sweet or too salty, not enough fruit and vegetables…
• Emotional impact (arrival of a younger sister or younger brother in the family, parental divorce, family disputes, school problems, etc.)
• Decreased physical activity (related, for example, to increased time spent in front of screens (watching TV, playing console or computer games, making phone calls, etc.)
• Lack of sleep: « Studies have shown that the risk of overweight seems to increase in children who do not get enough sleep. In fact, the bodies of these children produce less hormones that regulate appetite, which are produced during sleep, » reports the Public Health website (source). 3). In addition, the child who sleeps little will be more tired and therefore will have less energy to play sports and therefore exert himself… Then there is the vicious circle.
• Economic and social context (which can explain food options less healthy: fast and cheap industrial products but not necessarily healthy for health)
• Medicines that promote weight gain. Certain medications such as antiepileptics, psychotropics or corticosteroids can also, due to their side effects, promote overweight.
• More rarely, obesity or thinness can be related to a genetic or endocrine disease: thyroid disorder, hormonal problems, polycystic syndrome…
• Not to mention: excessive weight gain during pregnancy. In fact, the corpulence of a child is associated with its birth weight. So the big ones babies (4 kg or more) are more likely than low birth weight newborns (less than 2.5 kg) to be overweight at 5-6 years (20% vs. 8%) (source 3).

« The attitude of parents is a real problem because, in wanting to do well, some can put some kind of extra pressure on their child and accentuate the weight problem in the latter, » says Dr. Corinne. Xicheportiche-Ayache, nutritionist doctor.
It will therefore be a matter of not making weight an obsession but of integrating it as a collective work within the family. « At mealtimes, mothers or fathers can, for example, encourage their child by asking them to correct him if he eats too fast or doesn’t chew enough, for example. All this with the aim of making the child aware of his relationship with food and help him to correct some of these behaviors, » explains Dr. Corinne Xicheportiche-Ayache, nutritionist doctor.
We will also avoid preparing a specific meal for the child with a weight problem, to avoid stigmatizing him. In return, each family member will be able to make a small effort to accompany the latter to a healthier and more balanced diet.
« Finally, food should never be a source of punishment or reward, » insists Dr. Corinne Xicheportiche– Ayache. We will certainly avoid giving our child sweets or products that are too fatty without removing everything from them. Because food should be a real moment of pleasure and exchange within the family. « On the other hand, we encourage the child to move more and find pleasure in physical activity, accompanying it if necessary, » concludes Dr. nutritionist, Corinne. Xicheportiche– Ayache.