The most common problem is psychological. Most children who are obese have a lack of self-esteem and many become chronically depressed. Obesity is a significant risk factor for many life-threatening medical problems including sleep apnea, pulmonary insufficiency, aseptic necrosis, liver fibrosis and cardiovascular disease. Treatment options for obese children include diet, exercise and behavior modification. Diets only moderately deficient in calories are most successful because they help with compliance.
Exercise uses energy, thereby limiting the amount of ingested energy that is stored as fat.
Exercise also increases a person's lean body mass, which means more calories are then used in the resting state. An exercise program should allow children to select activities they enjoy such as rollerblading, bicycle riding, and walking. Behavior modification is the most important part of therapy and is based on self monitoring with a daily food diary that leads to awareness of eating patterns. Behavior therapy also includes recommending activities to divert attention from food and changing negative thoughts to positive thoughts, and building self-esteem. Making obese children feel good about themselves is more important than weight loss.