Child Obesity Is A Reality

What is childhood obesity?

Childhood obesity is a serious public health challenge faced globally by many middle- and low-income countries, especially in urban settings. WHO statistics show that there were over 42 million overweight children under the age of 5 across the world in 2010, and close to 35 million of these lived in developing countries like India.

Affecting children and adolescents, childhood obesity is a serious health condition that occurs when a child's weighs above the normal weight for his/her age and height. It is a health concern because childhood obesity puts children at risk of other health problems that were earlier restricted to adults. These include diabetes, high cholesterol and high blood pressure. It also leads to emotional stresses like depression and poor self-esteem.

Good news is that being overweight and obese can be prevented by making positive lifestyle changes like improving diet and including exercise in the child's routine.

What are the causes of the disorder?

Common causes for childhood obesity include:

1. Genetic factors - Weight issues can run in families, though it is not necessary that all children with a family history of obesity will be overweight. Genes may increase the risk to obesity, but it could also be due to shared eating and lifestyle habits.
2. Poor diet - Unhealthy eating habits are a major reason for childhood obesity.
3. Inactivity - Today, children spend a lot of time in front of TV or computer, increasing the hours of physical inactivity. A combination of too little activity and too many calories from the wrong type of food is the biggest cause of obesity in children.

What one needs to know about symptoms or signs?

The most obvious indicator of childhood obesity is excess weight. However, not all children with few extra pounds are obese; some children have above-average body frames or can carry different amount of body fat at different stages of development. A doctor can determine if a child is obese by checking his/her body mass index (BMI) and take into consideration the child's growth pattern.

Which specialist should be consulted in case of signs and symptoms?

A paediatrician or family doctor may be consulted to diagnose childhood obesity.

What are the screening tests and investigations done to confirm or rule out the disorder?

The doctor will make a diagnosis based on the following:

1. Physical exam - Body mass index (BMI) calculation is used to determine if a child is overweight for his or her age and height. In addition to BMI, the doctor also evaluates any family history of obesity or weight-related issues like diabetes, the child's eating habits, and activity levels.
2. Blood tests - If the above tests point towards obesity, the doctor may ask for certain blood tests like those for checking cholesterol levels, blood sugar level and any hormonal imbalances.

What treatment modalities are available for management of the disorder?

Weight maintenance is suggested for mildly obese children, and weight loss is recommended for obese teens and young children. Slow and steady weight loss is targeted, depending on the child's condition. Treatment for childhood obesity is usually focused around including changes in the child's diet and physical activity levels.

Healthy eating: For children, it is the parents who purchase food items, prepare meals and fix meal timings. They can make healthy changes in the child's eating habits and routine to meet the right weight target. Some steps that can help in weight loss and management are:

1. Include fruits and vegetables in diet - Processed foods like cookies and chips are high in sugar and fat. Fruits and vegetables in diet and home-prepared meals are healthier alternatives.
2. Limit consumption of sweetened beverages - Packaged fruit juices and colas contain excessive levels of sugar and calories, and provide very little nutritional value.
3. Make meals a family event - Children should be discouraged from watching television or playing computer or video games during meal times, as it causes a child to eat more in a distracted state.
4. Serve appropriate portion sizes - A child'swill eat less food as compared to an adult. Portion sizes should be adjusted accordingly for them.

Physical activity: Being physically active is especially important for children to not only burn calories but also build strong bones and muscles. Physical exercise and outdoor games also ensure that a child gets a good night's sleep later. These activities and habits play an important role in maintaining body weight in the normal range. Activity levels in children can be increased by:

1. Focusing on activity, not exercise - Being physically active does not have to mean stringent exercises; fun activities and games like hide-and-seek, hula-hoop, a hike, swimming etc. can provide the same benefits.
2. Cultivating hobbies - Participating in hobbies can also keep a child active. These may range from collecting leaves, climbing, visiting local libraries for books, etc.
3. Limiting TV and computer time to two hours or less - Sedentary activities like watching TV or playing games on computer or consoles should be reduced in order to encourage playing outdoors.

Surgery: Weight-loss surgery is kept as an option for severely obese teenage children for whom conventional methods of weight loss prove futile. It is not common in children to undergo surgery for weight loss and is reserved for cases with health threats due to excess weight.

How can the disorder be prevented from happening or recurring?

Preventive measures include going for regular check-ups to keep track of the child's BMI, being physically active, eating a healthy diet, and not using food as reward (for parents).

How can a caregiver give support and help the patient cope with the disorder?

Parents of a child dealing with obesity can help by lending support to the child and help him/her deal with emotional issues that go along with being overweight. Showing acceptance and enabling open conversations can be of great help to a child as s/he deals with weight loss. Lastly, it is important that the whole family adopts a healthy lifestyle habits and the child does not feel singled out.