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Paediatrics

Childhood obesity in Anderlecht: when to see your GP

BMI charts, warning signs, check-ups and reimbursement: when to talk to your GP about your child's weight, and how your GP can help.

12 January 20264 min readDr. Selim Zenginobesite · enfant · nutrition
Childhood obesity in Anderlecht: when to see your GP

A common concern, to be discussed without blame

In Belgium, around one in five children aged 3 to 17 was overweight, including obesity, in 2022-2023 (measurements by Sciensano). This proportion has risen since 2014-2015 and, among boys, it was highest in Brussels. A child's weight depends on many factors (heredity, sleep, stress, access to healthy food and places to be active): it is not a matter of willpower, nor is it the parents' ‘fault’.

Seeing a doctor early helps to detect possible complications: high blood pressure, high cholesterol, type 2 diabetes, fatty liver, sleep apnoea, joint pain, as well as teasing and low self-esteem.

How can I tell whether my child's weight needs attention?

In children, body build changes with age. The doctor calculates the BMI (weight divided by height squared) and plots it on BMI-for-age charts for boys or girls, such as those in the ONE child health booklet. In Belgium, the international IOTF cut-offs are commonly used: overweight above the curve that reaches a BMI of 25 at age 18, obesity above the curve that reaches 30.

When should you see your GP?

  • Your child's BMI is in the overweight or obesity zone of the chart.
  • The BMI curve rises quickly and crosses lines upwards, even before reaching those zones.
  • Between the ages of 1 and 6, the BMI goes up again instead of falling or staying stable (‘early adiposity rebound’).
  • Your child snores loudly or has pauses in breathing at night, has hip or knee pain, or has dark, thickened skin on the neck or in the armpits.
  • Your child is teased about their weight, withdraws, or seems to lose control around food.

What does the GP do?

The appointment starts with a supportive conversation with the child and parents: family history, meals and drinks, screens, sleep, physical activity, life at school. The examination includes measuring blood pressure, looking for signs of insulin resistance (acanthosis nigricans), checking the joints and assessing puberty.

A blood test is recommended from the age of 10 in children with obesity: lipid profile, fasting blood glucose or HbA1c, and ALT (liver). Depending on risk factors (diabetes in the family, signs of insulin resistance), it may also be offered for overweight or before the age of 10. A hormonal cause (the thyroid, for example) is rare: it is mainly looked for if the child is growing more slowly in height.

The aim is not rapid weight loss: in a growing child, a weight that stays stable or rises more slowly brings the BMI down. Follow-up is built together with the whole family and your GP, through small goals.

Team-based support, and what is reimbursed

For patients registered with Maison Médicale Parc Astrid, GP and nursing consultations are covered by the INAMI flat-rate fee (no payment per consultation). The centre's physiotherapists are contracted (conventionné): their sessions follow your health insurer's usual reimbursement. For other professionals, specific reimbursement schemes exist:

  • Dietitian: for children aged 2 to 17 with overweight or obesity, on a GP's prescription, 10 sessions over two years are reimbursed with no patient co-payment (ticket modérateur) by a dietitian with an INAMI number.
  • Psychologist: primary psychological care through the mental health networks involves no personal contribution up to the age of 23 with a contracted psychologist.
  • Specialist centre: if there are complications, the GP can refer the child to an INAMI-contracted paediatric multidisciplinary obesity centre (CPMO), available in several Brussels hospitals; this care pathway involves no co-payment.

Your health insurance fund (mutualité) can confirm the practical arrangements. See also our obesity clinic. At Maison Médicale Parc Astrid, this follow-up is available in French, Dutch, English and Turkish.

The parents' role in daily life

  • Offer water as the usual drink and keep sugary drinks (fizzy drinks) for special occasions: they are associated with obesity in children.
  • Eat meals together without screens, and limit recreational screen time.
  • Be active every day: the WHO recommends that 5- to 17-year-olds get at least 60 minutes a day, on average, of moderate-to-vigorous activity.
  • Make sure sleep is sufficient and regular: short sleep is associated with a higher risk of obesity.
  • Encourage rather than criticise: comments about weight, including within the family, hurt children and can encourage isolation and binge eating.

Sources

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