Childhood Obesity

Childhood Obesity

Childhood obesity is when obesity occurs in children. Overweight and obesity are defined based on body mass index or BMI. BMI represents the ratio between body height and weight.

The number of obese children is higher each year and now we can say that there are millions of obese children worldwide.  In the USA, obesity in children is a huge problem, one out of every three children is overweight or obese. Obesity is an important risk factor for many diseases in childhood. Especially important is link between obesity in childhood and diabetes.

Children Obesity and Diabetes

At the beginning, it was a general opinion that all cases of childhood diabetes are type 1 diabetes. In recent years there are new studies which discovered another important fact. They confirm a strong link between childhood obesity and type 2 diabetes. Over 8 out of 10 obese children will have symptoms of diabetes. As the child gets older the chance of getting diabetes is even higher.

Obesity is the main cause for diabetes mellitus type 2 in children. Obesity can cause the insulin resistance and inflammation of pancreatic tissue. Pancreatic inflammation can occur in obese children and can cause the destruction of pancreatic beta cells which will lead to type 2 diabetes mellitus. Another factor in the development of diabetes mellitus type 2 is a lack of activity. Inactivity causes glucose to remain in the blood instead of being converted to energy. Obese children may have insulin resistant tissues which will prevent them from proper usage of glucose.

Causes and Risk Factors for Children Obesity

Diet, Childhood Obesity and Diabetes

The most important causes of obesity are a high intake of food and low activity levels. If you take a lot of calories in your food and don't spend them in activities they will accumulate in your body like a fat. Fast food, snacks, cakes, soft drinks all contain many calories.

In addition to excessive calorie intake and decreased activity, some children have a genetic predisposition for obesity. Often their parents have problems with weight too. Hormones can also play a role in childhood obesity. In some cases, levels of digestive hormones can change and lead to increased appetite and obesity.

Some children become obese because they cope with problems by overeating.

Signs and Symptoms of Childhood Obesity

In children, obesity causes a number of different signs and symptoms. But it will also have long-term consequences on children's health.

Obesity is a very significant risk factor for diabetes type 2. A majority of obese children will have at least pre diabetes and most of them will eventually develop symptoms of type 2 diabetes mellitus. These children have increased chance of diabetes complications in adulthood.

Obese children are at higher risk for developing hypertension or cardiovascular diseases. They are a high-risk category for heart diseases such as heart attack. Their cholesterol and triglyceride levels may be elevated. Metabolic syndrome, which is a cluster of  diseases such as diabetes, hypertension, excessive abdominal fat, elevated triglycerides and low HDL may be present in this population. 

Most obese children have problems with joints and often complain of pain in knees, hips, ankles or spine. The cause of pain is increased pressure caused by excessive weight. Prolonged pressure may cause osteoarthritis.

Obesity has significant effect on the physical health of children. They are likely to have problems with a low self-esteem which can lead to depression. They are may develop anxiety and have problems with social interaction.

Long-term, obesity in children may cause the child to become obese in adulthood. When that happens, they are at higher risk for diseases such as osteoarthritis, heart diseases, stroke, diabetes, problems with the gall bladder and some cancers.

Complications of Childhood Obesity

Diagnosis of Childhood Obesity

The main diagnostic tool for obesity in children is body mass index BMI. The doctor will calculate it by measuring height and weight of the child. There are some differences between adults and children. For  children, BMI-for-age growth charts are being used. It is used to determine the percentile for the attribute, which is done by comparing the child with other children in the age group. For  example, if the child is on 60th percentile it means that the BMI is higher than 60% of children his age and gender.

Children with percentile between 85th and 94th are overweight. Children with BMI over 95th percentile are obese.  

If the child is obese, other tests like blood glucose levels, cholesterol levels and hormones levels may be done.

Treatment of Childhood Obesity

Therapy options for obese children are sometimes the treatment options for diabetes mellitus. Lifestyle changes which should be implemented as a part of obesity treatment will also have a positive influence on diabetes mellitus. Diet changes with a low intake of calories, low-fat food, low carbohydrates food are recommended. Children should be motivated to be more active and avoid sedentary lifestyle.

Therapy methods depend on the age of children and obesity level. For children older than 2 years of age which are overweight, the main theory method is strict diet. It will allow them to grow but their weight will remain the same. That will lead to a decrease of percentile on the BMI-for-age growth chart.

Obese children which are older than 6 years of age should also start using diet plan which will reduce calories intake. At the same time, they should increase physical activity. For this category of children, it is safe to lose weight slowly. Around 0,5 to 1 kg per month is safe weight loss for them.

Some adolescents can be prescribed with Orlistat. It will help in obesity prevention by reducing absorption of fats in intestines.

For adolescents, the last step in treatment is bariatric surgery, also known as weight-loss surgery. It can be recommended for adolescents which are struggling with pathological obesity and every other treatment method has failed before. It should be the last resort because it is linked with possible complications.

Prevention of Childhood Obesity

The most important step in the prevention of obesity and diabetes in children is implementing healthy diet plan. Fast food and childhood obesity are strongly linked together. Fast food is rich in calories and fat so it should be avoided at all cost. Do not eat calories rich food. Avoid sugar, carbohydrates and fat in your food. Instead, increase intake of fruit and vegetables. Let them be your source of sugar.

Physical activity is important for the prevention of obesity generally and it works the same in children. Physical activity will make you burn calories.60 minutes per day of exercise will be enough to prevent obesity in children. You can sign up children for different sports or find an activity your child likes. Use them to prevent inactivity.

Good school education about the importance of healthy food and activity is an important to step in prevention. There are links between school lunches and childhood obesity. Schools should offer children healthy food and avoid fast food. Family and friends should always be there to offer support for children battling with obesity. It will help them a lot in achieving their goals.

References

American Heart Association, "What is childhood obesity?“, 2014, retrieved from http://www.heart.org/HEARTORG/HealthyLiving/HealthyKids/ChildhoodObesity/What-is-childhood-obesity_UCM_304347_Article.jsp#.WA3jfeV94dU

Mahshid Dehghan, Noori Akhtar-Danesh and Anwar T Merchant, "Childhood obesity, prevalence and prevention“, 2005, Nutrition Journal: 4:24, retrieved from https://nutritionj.biomedcentral.com/articles/10.1186/1475-2891-4-24

Mayo Clinic Staff, "Childhood obesity“, 2015, retrieved from http://www.mayoclinic.org/diseases-conditions/childhood-obesity/basics/definition/con-20027428

Roy Benaroch, "Obesity in Children“, 2016, retrieved from http://www.webmd.com/children/guide/obesity-children#1

Schwartz, M.S.,  Chadha, A., "Type 2 Diabetes Mellitus in Childhood: Obesity and Insulin Resistance“, 2008, The Journal of the American Osteopathic Association, Vol. 108, 518-524., retrieved from http://jaoa.org/article.aspx?articleid=2093727

Steven M Schwarz, "Obesity in Children“, 2016, retrieved from http://emedicine.medscape.com/article/985333-overview


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