Child Health
Childhood Obesity

​​​​Overview:

  • Obesity in children is especially alarming, given that overweight leads a multiplicity of health problems.
  • Several factors combine to increase the risk of overweight in children.
  • Children should not be enforced to follow a certain diet to lose weight without consulting a healthcare service provider.
  • One of the best strategies to reduce childhood obesity is to improve the eating and exercise habits.
 
Introduction:
Childhood obesity is a serious medical condition, and a global concern. It puts children at risk of medical enduring medical problems, that can affect their health now and in the future.  

Cause: 
Childhood obesity can be attributed to several causes, most notably the imbalance of energy metabolism during childhood and adolescence. When the energy consumed is higher than the energy expended, the extra energy is stored as fat. This is what usually happens in the case of inactive lifestyle and lack of physical activity. Following are the key factors that cause children to become obese:
  • Lifestyle factors: examples of these factors include eating large proportions, eating high-calorie foods, spending much time in front of screens, and lack of physical activity.
  • Environmental factors: including easy access to fast food, limited opportunities for physical activity, and lack safe places to exercise (parks, playgrounds etc.) in some communities.
  • Genetic factors: a child will be at higher risk of obesity if either or both parents are obese. Such a child will not be doomed to obesity, though; measures can be taken to curb that risk.
  • Medications: such as steroids, anti-depressants, etc.
  • Medical conditions: such as hormonal abnormalities, including hypothyroidism, overproduction of glucocorticoid (as in the case of Cushing's syndrome), growth hormone deficiency, Turner syndrome, and Down's syndrome.

Risk factors:
  • Diet: eating high-fat and sugary foods, rather than healthy food;
  • Lack of physical activity;
  • Using electronic devices or playing video games for hours;
  • Eating habits of the family suffering from overweight; and
  • Some rare genetic abnormalities.

Symptoms:
Symptoms of childhood obesity vary greatly, but the most common symptoms are:
  • Increased adiposity of thighs and abdomen;
  • Darkness of the skin around the neck, and other areas of the body;
  • Adiposity of fat in the breast region;
  • Uneven and unhealthy distribution of fat cells in the body;
  • Low self-esteem;
  • Eating disorders;
  • Shortness of breath when exercising;
  • Cessation of breathing during sleep;
  • Constipation;
  • Reflux; 
  • Menstrual disorders and irregularity;
  • Knee arthritis; and
  • Hip dislocation.

Complications:
Following are some of the obesity-associated complications that may affect children in the long-run:
  • High blood pressure (hypertension); 
  • Unhealthy level of blood fat;
  • Metabolic syndrome: it is a condition of insulin resistance, associated with hypertension, high level of triglycerides, and obesity;
  • Type 2 diabetes;
  • Asthma;
  • Obstructive sleep apnea: a disorder in which a child's breathing repeatedly stops and starts during sleep;
  • Skin inflammations: the most common of which are fungal inflammation in the skin wrinkles;
  • Knee, femoral and pelvic pain, often associate with a medical condition called: slipped capital femoral epiphysis;
  • Back pain;
  • Liver diseases;
  • Gallstones;
  • Pancreatitis;
  • Menstrual disorders, causing irregularity of the menstrual cycle, or amenorrhea, usually associated with the so-called polycystic ovary syndrome; and
  • Severe headache, and visual disorders.

Diagnosis:
To determine if a child suffers obesity, the doctor relies on the children's bone mass index (BMI) to get a relative value. BMI is calculated by dividing one's weight in kilograms by one's height in meters squared.
If the BMI is the 95th percentile or above, which indicates that the child is obese, the doctor may conduct one or more of the following examinations:
  • Level of blood sugar; 
  • Blood pressure; 
  • Abnormal fat in the blood, to determine the cause of high cholesterol, high triglycerides, low HDL ("good") cholesterol;
  • Liver fat (to check if the patient suffers from nonalcoholic fatty liver disease); and
  • Psychological problems.
Besides, a child will be overweight, and at risk of obesity, if his or her BMI is between the 85th and 94th percentiles, in which case the following examinations may be conducted:
  • Family history of cardiovascular disease, parental elevated total cholesterol, diabetes, parental obesity; and
  • Conducting the BMI test on a regular basis (once a year).

Treatment:
The following instructions are key for treating obesity:
  • Change the child's eating habits;
  • Help the child acquire healthy eating habits;
  • Avoid using food as a reward or withholding food as a punishment;
  • Discourage sugar-sweetened beverages and soft drinks;
  • Limit eating out, especially fatty, high-calorie meals;
  • Discourage eating in front of a screen (TV, video game or otherwise)—there is a correlation between screens and eating large proportions;
  • Encourage children to adopt healthy habits, and reward them for that;
  • Avoid criticizing kids all the time, and encourage them instead;
  • Set an appropriate schedule for the kid’s meals;
  • If the child likes sweets and candies, you can learn low-fat, low-calorie recipes for cooking them; and
  • Encourage the child to exercise daily (60 minutes of moderate exercise, such as playing football and swimming.
As for childhood obesity conditions associated with genetic causes, three therapeutic options are usually adopted: lifestyle change, drug therapy and surgery. The target of these therapies is to help the child lose weight, as well as maintain healthy weight for a long time.

Prevention:
  • Help the child to maintain a healthy weight;
  • Maintain a balance of calories, by encouraging the child to have a sufficient proportion of food, and in the meantime maintain an appropriate amount of calories. The child should, in other words, strike a balance between the calories he or she consumes (in foods and drinks), and the calories expended through physical activity and natural growth;
  • Develop healthy eating habits;
  • Find ways to make the favorite dishes healthier, and limit reliance on high-calorie food;
  • Encourage children to adopt a healthy diet, by making fruit, vegetables, and whole-grain products always available for them;
  • Serve appropriate portion sizes for children;
  • Encourage children to drink much water;
  • Limit sugar-sweetened beverages;
  • Limit the intake of sugar and saturated fat; and
  • Encourage children to exercise, and avoid inactivity—regular physical activity is essential for maintaining a healthy lifestyle. 
The object of the health care provided for obese children is to reduce the rate of gaining weight, and enabling them to grow naturally. Children, as such, should not be enforced to a specific weight-loss program without consulting a healthcare service provider.

FAQ:
  • What kind of exercise (sport) is suitable for obese children?
Children should have at least 60 minutes of moderate physical activity most days of the week. The suitable exercises include: jogging, rope skipping, swimming and football. It should be noted that children follow the example of their parent. So, be a role model, and add exercise to your daily routine, so that a child is more likely to do the same.
  • Is there a link between genetics and obesity? How?
Yes. The brain controls hunger and satiety by responding to the signals coming from the fat tissue, the pancreas and the digesting system. Those signals are carried to the mind through hormones such as: leptin, insulin, ghrelin, and other tiny particles. The brain coordinates those signals with other inputs, and responds to them by orders the body to get more food and expend less energy, or to the contrary. Genes, as such, are essential for the work of such signals and responses associated with the intake of food. Minor changes in those genes may affect their activity, causing obesity.







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Last Update 21 November 2019 12:31 PM
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