Childhood obesity

How to define childhood obesity

Obesity is defined as body mass index(BMI) greater than 25kg/m2, Morbid obesity >40, Super obesity as BMI>60.

BMI=weight in kg/Height in m2

What are the problems with obesity

Obesity could be the starting of many adulthood problems like diabetes, high blood pressure, high cholesterol, Joint problems like osteoarthritis, sleep apnea, etc. Often these children suffer from poor self-esteem. Established obesity can be very challenging and difficult to manage. Early intervention is very helpful in maintaining appropriate weight for age and reducing these problems.

 

What are the causes of obesity

Imbalance between caloric intake and calories spent causes obesity. If the childs parents are overweight/obese there is a high chance the child might be overweight/obese as well. Environmental factors include the family’s food habit, lack of play areas, excess TV viewing, excess junk food etc. It is very rare to have a medical problem as a cause for overweight/obesity(<1%) but should be considered.

What are the complications of obesity

Childhood obesity has many complications which could affect your child’s physical, social and emotional well-being.

Physical complications include

Type 2 diabetes- Body cells cannot use the insulin produced effectively(Insulin Resistance)

Metabolic syndrome- Multiple risk factors that increases the risk of developing heart disease, diabetes or other health problems. The risk factors include high blood pressure, high blood sugar, high triglycerides, low HDL (“good”) cholesterol and excess abdominal fat.

High cholesterol and high blood pressure This cause plaques to develop in the arteries which narrow and harden, leading to heart attack or stroke later.

Sleep problems. Obstructive sleep apnea (breathing repeatedly stops in sleep) could be a serious problem

Increased risk of asthma Obese children are at increased risk of asthma due to many reasons

Early puberty or menstruation. Obesity can cause hormonal imbalances leading to early puberty

Osteoarthritis: The Joints(Hipa and Knee) are subjected to excess wear and tear due to the burden of excess weight placed on them

In addition to the physical problems the child could be a potential victim for bullying at school and may suffer from low self esteem. This may manifest as behavioural and emotional problems of various types.

How do we investigate for childhood obesity

In addition to history with regards to energy intake and energy being spent your child may need few investigations. This includes fasting blood cholesterol and triglyceride level, blood sugar level, and tests to check for any hormone imbalances.

How Can we treat childhood obesity

Obesity once established could be very difficult to treat and prevention is the best option. Treatment depends on the childs age and other problems involved. The usual approach to treatment includes changes in the child’s diet and increasing level of physical activity. If there are additional problems he/she may need medications.

A personalized weight-management program to slow the progress of weight gain might be an option in situations. Loosing weight is usually very slow and it is important to be consistent in whatever approach you are following to loose weight.

How to prevent childhood obesity

We should aim to maintain the childs weight within the normal range for age and height. Obesity can often be prevented by following a healthy eating habit and increasing physical activity.

 

Healthy eating habits include eating more fruits and vegetables(five fruits a day), avoiding sweetened beverages(eg fruit juices, carbonated drinks), Avoiding junk food(Crisps, choclates), and eating appropriate sized meals.

Physical activity can be increased by minimizing TV viewing, IPad/tablets, and encouraging physical activities the child could do eg Cycling, walking, running etc.,

Author:Dr. S.Boopathi MD, DNB, MRCPCH(UK)

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