Obesity is a very clearly identified health hazard. Childhood obesity is an emerging concern today, world over. It is a condition where excess body fat negatively affects a child’s health or well-being. The diagnosis of obesity is assessed in children by weight for height and body mass index. This covers up the difficulty in assessing normal body weight of persons with different heights. With more than 42 million overweight children around the world, childhood obesity is increasing both in developed and developing countries. With development comes, stability and increased affluence, a factor underlying obesity in adults as well as children.
Obesity carries risk of many problems in children. The first problems to occur are usually emotional or psychological. These children are usually mocked by other children, are unable to participate in active sports and games, hence lose self-confidence and feel depressed.
Overweight children are also more likely to grow up to be overweight adults. Obesity during adolescence has been found to increase mortality rates during adulthood.
Childhood obesity can lead to life-threatening conditions including diabetes, high blood pressure, heart disease, sleep problems, ,cancer, and other disorders. Some of the other disorders that could occur are liver disease, early puberty, menarche, eating disorders such as anorexia and bulimia, skin infections, asthma and other respiratory problems. A study has found that obese children have stiffening of blood vessels in neck, due to fat deposits and also have abnormal levels of cholesterol in blood, which is a risk factor both for stroke and heart attack. Children who are obese are more likely to grow up into obese adults. Thus, they are more at risk of adult health problems such as heart disease, type 2 diabetes, stroke, several types of cancer, and osteoarthritis
The greatest risk factor for child obesity is the obesity in parents. This may be related to family environment and genetics. Psychological factors, likes and dislikes of a child also influence increase in weight. Traditional beliefs also contribute to this problem as in most societies, an obese child is considered, "cute”. Other factors include the increasing use of technology, increase in consumption of high calorie snacks, increase in portion size of meals, and the decrease in the physical activity of children. Studies have shown that children who spend more than 3 to 4 hours per day with electronic devices have higher risk of becoming obese.
Schools can play a large role in preventing childhood obesity by providing a safe and supporting environment with policies and practices that support healthy behavior. At home, parents can help prevent their children from becoming overweight by changing the family diet. They can encourage the child to be physically active and also exercise regularly. If parents set an example of healthy life style, children are bound to pick up the same.
Some children can be obese due to hormonal disorders like hypothyroidism, Cushing’s syndrome, e.t.c. Use of drugs like corticoids for a long time can also cause obesity as adverse effect.
Exclusive breast-feeding is recommended in all newborn infants for its nutritional and other beneficial effects. It also prevents obesity in children. If children were more active physically and less sedentary, the rate of obesity would decrease. Parents should recognize the signs and help prevent obesity in their off spring by appropriate life style changes.
There are no medications currently approved for the treatment of obesity in children. Drugs like sibutramine, metformin, can reduce appetite thus reducing amount of calories consumed. But they have adverse effects as well. Surgery to reduce weight is not considered healthy in adults, much less in children. Reducing excess weight in a natural healthy way is healthier than resorting to drugs or surgery. There is need is for elders to be aware of this problem and take preventive steps to avoid childhood obesity.
Dr Rachna Pande, Specialist, internal medicine
rachna212002@yahoo.co.uk