Obesity in Children
Obesity is defined as excess body fat for once own height. Generally, a child is not considered obese until the weight is at least 10 percent higher than what is recommended for the height and body type.
Incidence of childhood obesity and associated problems is increasing all over the world including India. It is one of the most easiest medical condition to recognize but most difficult to manage.
Causes of obesity:
Causes of obesity in children are complex and include genetic, medical, behavioral, and socio-cultural factors. The most common cause of obesity is secondary to consumption of more calories than the body requires complemented by lack of exercise. Obesity runs in families. If one parent is obese there is 50% chance of the children being obese and if both parents are obese the children have an 80% chance for being obese. Less than 1% of all obese children are caused by medical conditions.
The causes of obesity are, poor eating habits, over eating or binging, lack of exercise, family history of obesity, medical illnesses like endocrine and neurological problems, medications like steroids, some psychiatric medications, etc, stressful events like abuse, divorce, separation, deaths etc, family and peer problems, low self esteem and depression or other emotional problems.
Risks and Complications of Obesity :
Many preventable health risks and complications are associated with child hood obesity. They are respiratory problems like asthma, sleep disorders eg, sleep apnea (stopping of breathing),excessive night time arousals etc, Pickwickian syndrome, cardiovascular problems like high blood pressure, abnormal cholesterol level (dyslipidaemia), syndrome X (clustering of risk factors for cardiovascular diseases characterized by dyslipidemia, hypertension, and insulin resistance ), Type 2 diabetes (non insulin dependent diabetes), menstrual abnormalities like early menarche (onset of periods) and sometimes late or absent menstruation. Gall stones, neurocognetive deficits, orthopedic complications like Blounts disease (severe bowing of the legs), slipped capital epiphyses, psychosocial effects resulting in impaired learning, social skills over time, and eating disorders like anorexia nervosa and bulimia .
Management :
Obese children need a thorough medical history and evaluation by a pediatrician to rule out medical cause. In the absence of a physical disorder, Changes in diet, exercise, and lifestyle can help to reduce weight and it should be made as a family activity. Praise your child for each small success. Lasting weight loss can only occur when there is self-motivation.
Diet :
Do not put your child on a diet but help her replace unhealthy food with healthy foods. Diets are short-term to lose weight. Healthy eating should be a life-long goal. Teach your child to chew slowly and enjoy her food. Slow meal times down so your child has time to realize when she is full. Do not force them to eat. Serve meals at regular times. Avoid keeping extra food on the table. Serve your child an appropriate portion on her plate. A portion is about the size of the person's palm on their hand. Prepare healthy foods that are high in nutrients but low in calories. Avoid fatty, greasy food and sweets, drinking too much soft drink, fruit drinks, and chocolate milk. These drinks are high in calories. Water is best to quench thirst.
If your child is over 2 years old, use skim milk or low-fat milk.
Limit high calorie foods and treats. Store them out of sight to decrease temptation. Keep healthy snacks around the house. Avoid buying high-fat snacks, such as chips, cookies, etc. Don't use food as a punishment or reward. Talk to other people (such as daycare staff) about trying to keep your child's diet healthy. Never put a child on a diet without talking to your doctor first. You can consult your doctor or a dietician for nutrition tips.
Exercise
Make exercise a fun activity for the whole family. Exercise improves coordination and helps kids express themselves. Show your child many kinds of physical activities, such as walking, swimming, dancing, biking, and running. Focus on having fun and feeling stronger, not on losing weight. Use the stairs instead of the elevator. Doctors recommend at least 30 minutes of physical activity each day.
Lifestyle
Limit TV time, video games. and computer time and encourage your child to do physical activity such as playing, gardening or walking. Avoid eating in front of the TV. Discourage talk about weight. Focusing too much on weight can lead to other problems, such as not eating enough. Do not allow teasing or use of nicknames that have to do with weight. Obese children are at high risk for depression. Help them find activities and hobbies they enjoy doing and are good at. Teach your child healthy ways to deal with stress. Some children turn to food for comfort. These changes may be hard for children. If they resist, don't force them or scold them. Encourage them and join in! All of these changes work best if the whole family takes part. Children are more likely to adapt to the changes if the rest of the family does, too. Each little change is a small step toward success.
Obese children – obese adults
Obese children can often get better by making changes in their diet, exercise, and lifestyle. A few children will out-grow their obesity. They may get taller without gaining much more weight. Other children may be obese into adolescence and adulthood.
Prevention
• Raise children to have healthy eating habits and adequate exercise before obesity becomes a problem.
• Give healthy meal to the whole family (avoidance of soft drinks, and high calorie foods)
• Be an active family. Let the family be involved in walking, playing or gardening together instead of watching TV.
• Encourage children to take pride in their bodies and in their health.
Consult Doctor
• Consult your doctor if your child has gained a great amount of weight in a short time.
• Weight gain may be the sign of medical problem more than simple obesity.
• Consult your doctor to learn more about nutrition and exercise.
• Always consult your doctor if you have questions or concerns about your child.
