Dear Doctor,

My 5-year-old daughter seems to be chubbier than normal. She has what my sister calls ‘Michelin tires’ around her neck, arms and legs and even looks like she has breasts. The thing is, I try to give her a healthy diet, I only spoil her with ice cream or fast food once in a while.

She eats veggies and fruits and honestly has a great appetite. She also has three meals a day and maybe a fruit snack in between. Am I over feeding her? I’m worried that she will be obese. What can I do to change this and get her to a healthier size?

Olivia

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Dear Olivia,

Childhood obesity is one of the new health-related problems worldwide. Since 1970, prevalence of obese children as young as two to five-year-olds has doubled globally. A chubby child was considered cute or healthy in olden days. But now, studies have shown that an obese child has greater risk of growing as an obese adult and also, acquiring all diseases related to obesity. These include chronic problems like hypertension, heart problems, diabetes, and etcetera.  Hence, this needs to be checked while the child is young.  An obese child also often becomes the target of jokes of playmates which reduces self esteem.

Body mass index (BMI) is used as an indicator for judging whether a child is overweight or not. About 90 per cent child obesity occurs due to modern life style factors just as it is with adults. Lack of exercise and consuming high calorie foods are the two main reasons. Junk food, instant processed foods, chocolate, ice cream, sodas, all these are high in calories but very low or zero in nutrition.

Thus, the child becomes overweight and misses essential nutrition. For a growing child, it is very important to get necessary nutrients because at this age, foundation is laid for his future physical health. Tissues, bones, among others, develop and need specific nutrients. If deprived of them, he may have weak bones, chronic anemia, protein malnutrition, and other problems. Protein deficiency also reduces the immunity of the child, making him more prone to infections.

Among medical conditions, hormonal disorders like thyroid and adrenal gland disorders, uncontrolled diabetes, use of drugs like corticoids, can cause obesity.

You are doing your bit in controlling her weight, regarding diet. Maybe the whole family can stop taking junk food and sodas for some days.  Seeing only healthy foods at meal times will take her mind away from unhealthy foods. Fresh vegetables, fruits, whole grains, healthy milk and meat products all provide few calories and more nutrition. Hence, she should be encouraged to eat them. Snacking in between meals should be discouraged, because munching all day adds on to calories.

Physical activity is very important to burn the calories consumed. Make exercise and physical activities as a compulsory part of her routine. This will keep her weight normal and her body fresh and healthy.

If the problem continues, in spite of all these measures, it is also advisable to get tests done to exclude a potentially treatable medical disorder.

Dr Rachna Pande is specialist internal medicine, Butaro Hospital