Controlling weight is not always a matter of proper diet and exercise.
There are many causes of obesity. For some children eating less junk food, making "healthier lifestyle choices," getting more exercise and fewer calories is not enough to maintain a healthy Body Mass Index (BMI). Taking diet medications or undergoing bariatric surgery may be the answer for some, but for many, these are extreme or unrealistic options.

The reasons for the manifestation and proliferation of the childhood obesity problem are many and continue to be the source of constant debate as well as constant research and hypothesizing on the part of many scientists, healthcare practitioners, psychological professionals, clinical nutritionists, registered dieticians, geneticists, endocrinologists and physical fitness experts. We are inundated daily with "news" about the two principal causes of childhood overweight and obesity, and it always seems to center around a recurring theme: "eating too much, and not getting enough exercise." This is, to a great extent true in a substantial percentage of cases - the math is indisputable. Stated very logically, if we take in more calories than we burn (or than are actually required to be consumed as necessary to maintain normal bodily functioning), we accumulate a surplus. And that surplus is stored by the body in the form of fat.

Yes, people will often concede that there may be psychological or social factors that lead to either overeating or a lack or avoidance of sufficient exercise. And in the next breath, they will say that it is really the result of character weakness, or of laziness, or gluttony, or other controllable conduct - perhaps simply a matter of DISCIPLINE. This is somewhat simplistic, and it stigmatizes every overweight or obese child, as well as his or her parents. Yet it is seldom challenged.

While an accumulation of excessive body fat in a youngster might indeed be evidentiary of some element of overeating, or some lack of exercise, its true causality - its root cause - may actually be quite complex, and have very little to do with any unhealthy lifestyle choice. Very few youngsters would choose to be fat. There are many other, more insidious physiological, sociological, societal and economic variables which may be at play behind the scenes; and these may be much more challenging to ascertain and correct. These include, but are not necessarily limited to:

• Endocrine (glandular) problems;
• Response to trauma, anxiety and stress;
• Pervasive environmental (familial or peer group) influences;
• Reactions to many medications, including those used to treat ADHD, depression, and other emotional illnesses, as well as to those used to treat pain and physical conditions or injuries;
• Sensitivities or allergies to certain types of foods and food groups;
• Profound psychiatric responses to sexual abuse, neglect or violence;
• Malnutrition associated with poverty, with its limited, unwholesome menu;
• Genealogical propensities, handed down from generation to generation, and enhanced and accelerated through a sea of change in the gene pool and the selection of partners;
• Some cancers, tumors and other growths;
• The body's vicious and vindictive defense against binge dieting and the "yo-yo" effect of many fad diets involving radical nutritional changes;
• Various diseases, insufficiencies and other conditions of the digestive tract;
• Drug and alcohol abuse; Withdrawal from drugs, alcohol and tobacco...

..and many others, far too numerous to mention here.

The problem of childhood obesity will not disappear and will continue to multiply worldwide unless a dedicated group of multidisciplinary professionals and experts cooperatively and openly combine their efforts and energies to focus on finding all of the root causes, the predictive factors (and possible early-stage interventions), the best treatments, and the most potent social support mechanisms required to deal with the problem causally, holistically and with persistence. We cannot lose sight of the fact, for one single moment, that we are not treating overweight or obesity alone - we are treating and taking care of our children. These innocent children, from infants to teenagers, are often viewed by society with a striking lack of compassion, punished instead of supported, and treated as outcasts.