Childhood Obesity a Cause for Concern

Childhood Obesity – A cause for concern

Dr. Ravi Bhatia,

MBBS(AFMC),DNB,PGDAP

According to the world health organization Obesity is the most blatantly visible but neglected health problem. It is a modern epidemic which is growing by leaps and bounds everyday. Sadly what previously used to be seen as a disease of the modern world is now commonly being seen in a developing nation like ours also. Obesity among children is on the rise. Obese children tend to be obese adults also.

How does one define obesity?

Obesity is usually defined on the basis of body mass index- or BMI as it is commonly known as in t parlance. The body mass index is expressed as a ratio of weigh in kg divided by square of the height in mtrs. The body mass index of the child is plotted against the age of the child. This is known as the weight stature curve. BMI more than 95th percentile for age and sex is labeled as obese while children having BMI between 85th and 95th percentile are labeled as overweight.

What causes obesity?

Obesity is a multifactorial disease. In simple terms it represents a state of energy imbalance. It’s a state wherein more calories are being taken in than they are being consumed. Genetics, endocrinal , dietary, sedentary lifestyle are the chief causative factors of obesity.

What are the harmful effects of obesity.

There isn’t a single organ system of the body which is not affected by this malady. Obese children are at a higher risk of developing hypertension, cardiac problems, type 2 diabetes mellitus in later life. Orthpaedic complications like joint problems, slipped femoral capital epiphysis are more common among obese children. Most obese children attain puberty early. Poly cystic ovarian disease is more frequently seen among obese females. Obese kids have frequent psycho social problems and often suffer from low self esteem., depression and are a victim of their own negative body image.

How to manage obesity.

Management of obesity requires a multi faceted approach. The first step in managing obesity is recognition of the problem. Both the parents and the child need to accept the fact that the child is obese. Diet: Having a healthy diet remains cornerstone in management of obesity. The various principles of dietary management are;

1. Both the parents and the child need to be educated about having a healthy diet.

2. Energy dense foods and drinks should be avoided.

3. The whole family should adopt a healthy diet. You cannot expect the child to eat healthy without the parents doing the same.

4. Fibres and complex carbohydrates should be taken more in diet.

5. Diet alone without exercise won’t help.

Role of exercise:

1. Increased physical activity in the form of jogging, running, swimming, games should be encouraged. One hour of physical activity daily is recommended.

2. Children should be encouraged to play outdoor games like soccer, basketball, handball which involve the whole body and result in a high calorie burn out.

The big five concept:

1. Limit T.V watching/ computer viewing to less than one hour per day.

2. At least one meal the entire family should have together. During which it should stay away from distractions like t.v.watching, internet etc.

3. Remember what is out of sight is also out of mind. Do not stack up your refrigerator with items you don’t want to eat.

4. At least one hour of physical activity per day should be planned for the whole family. Have a realistic goal the aim should be to target a weight loss of 0.5 kg/week.

5. Involve the child in preparation of one meal every day.

Role of drugs:

Drugs do not have a major role to play in the management of childhood obesity.

Role of surgery: These days its is quite fashionable to talk about surgery as a modality for treatment of obesity. In children bariatric surgery has a very limited role to play, often being limited t o children whose BMI is greater than 40 and have a severely stunted skeletal growth. Role of schools:

Schools have a very important role to play in management of child hood obesity. There should be provision of open spaces, play grounds, sporting kits for children. Physical activity should be stressed on and not limited to one period per week.

A very important role is also played by the school canteen. The school authorities should ensure that only healthy foods are served in the school canteen. Junk foods and Colas are a strict no.

Teachers should ensure that obese children are not discriminated against. Bullying, teasing should be dealt severely.

Role of media:

Media should focus on healthy eating life styles. There should be a regulation on advertisements of junk foods, colas and other energy dense edibles.

Obesity is challenging and often a frustrating problem both for the treating physician as well as the family. Behavior modification and promotion of a healthy lifestyle remains the cornerstone for treatment of obesity.