Childhood obesity

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Overview

Childhood obesity has reached epidemic levels in developed as well as in developing countries. Overweight and obesity in childhood are known to have significant impact on both physical and psychological health. Overweight and obese children are likely to stay obese into adulthood and more likely to develop non-communicable diseases like diabetes and cardiovascular diseases at a younger age. The mechanism of obesity development is not fully understood and it is believed to be a disorder with multiple causes. Environmental factors, lifestyle preferences, and cultural environment play pivotal roles in the rising prevalence of obesity worldwide. In general, overweight and obesity are assumed to be the results of an increase in caloric and fat intake. On the other hand, there are supporting evidence that excessive sugar intake by soft drink, increased portion size, and steady decline in physical activity have been playing major roles in the rising rates of obesity all around the world. Childhood obesity can profoundly affect children's physical health, social, and emotional well-being, and self esteem. It is also associated with poor academic performance and a lower quality of life experienced by the child. Many co-morbid conditions like metabolic, cardiovascular, orthopedic, neurological, hepatic, pulmonary, and renal disorders are also seen in association with childhood obesity.

Symptoms

In addition to excessive body weight, typical signs and symptoms of childhood obesity include:


Shortness of breath

Fatigue

Increased sweating

Sleep apnea and snoring

Joint pain

Dislocated hips

Flat feet and knock knees

Skin rashes and irritation

Stretch marks on hips, abdomen, and back (though these can occur in non-obese children as well)

Acanthosis nigricans, which is dark, velvety skin around the neck and in other areas

Fat tissue in the breast area (which can be particularly challenging for boys)

Constipation

Gastroesophageal reflux (also called acid reflux)

Early puberty in girls

Delayed puberty in boys


Causes

At the most basic level, children—like adults—develop obesity when they eat more calories than their bodies use, called an “energy imbalance.” This can be caused by a variety of factors, including genetics, hormones, metabolic makeup, and medical factors. When a child develops obesity, it’s often through a complex interaction of these and other factors including diet, lifestyle, and environmental conditions.

In other words, certain genetic characteristics may cause a greater tendency to become obese, but if a child eats healthfully and gets plenty of exercise, the gene won’t express itself and the child can maintain a weight in the normal range.

Here is a closer look at various factors that cause obesity in children or are known to increase a child’s risk of becoming obese.

Risk factors

Children who have obesity have a higher risk of developing health problems than their peers who maintain a healthy weight. Diabetes, heart disease, and asthma are among the most serious risks.


Diabetes

Type 2 diabetes is a condition in which your body doesn’t metabolize glucose properly. Diabetes can lead to eye disease, nerve damage, and kidney dysfunction. Children and adults who are overweight are more likely to develop type 2 diabetes. However, the condition may be reversible through diet and lifestyle changes.


Heart Disease

High cholesterol and high blood pressure raise the risk of future heart disease in children with obesity. Foods that are high in fat and salt may cause cholesterol and blood pressure levels to rise. Heart attack and stroke are two potential complications of heart disease.


Asthma

Asthma is chronic inflammation of the lung’s airways. Obesity is the most common comorbidity (when two diseases occur in the same person at the same time) with asthma, but researchers aren’t sure exactly how the two conditions are linked. According to a recent study published in the journal Asthma Research and PracticeTrusted Source, about 38% of adults with asthma in the United States also have obesity. That same study found that obesity may be a risk factor for more severe asthma in some, but not all, people with obesity.


Sleep Disorders

Kids and teens who have obesity may also suffer from sleep disorders, such as excessive snoring and sleep apnea. Extra weight in the neck area can block their airways.


Joint Pain

Your child may also experience joint stiffness, pain, and limited range of motion from carrying excess weight. In many cases, losing weight can eliminate joint problems

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Complications

Childhood obesity can lead to immediate health problems as well as put your child at greater risk of developing medical issues in the future. These are some of the weight-related complications that children with obesity are at increased risk of:


Asthma

Type 2 diabetes

High cholesterol

Heart disease

High blood pressure

Gall stones, fatty liver disease, or kidney disease

Arthritis

Reproductive problems like irregular menstruation and hormonal imbalances

Heartburn, reflux, and other digestive problems

Sleep disorders like sleep apnea

Additionally, children who are obese have an increased risk of being overweight or obese as adults

Prevention

Obesity is a chronic disease affecting increasing numbers of children, teens and adults. Obesity rates among children in the U.S. have doubled since 1980 and have tripled for teens. About 17% of children aged 2 to 19 are considered obese, compared to over 35% of adults who are considered obese.

Earlier onset of type 2 diabetes, heart and blood vessel disease, and obesity-related depression and social isolation in children and teens are being seen more often by healthcare professionals. The longer a person is obese, the more significant obesity-related risk factors become. Given the chronic diseases and conditions associated with obesity and the fact that obesity is hard to treat, prevention is extremely important.

A primary reason that prevention of obesity is so vital in children is because the likelihood of childhood obesity persisting into adulthood increases as the child ages. This puts the person at high risk of diabetes, high blood pressure, and heart disease.

Infants

According to the American Academy of Pediatrics and the CDC, breastfed babies are less likely to become overweight. The CDC also reports that the longer babies are breastfed, the less likely they are to become overweight as they grow older. However, many formula-fed babies grow up to be adults of healthy weight. If your child was not breastfed, it does not mean that he or she cannot achieve a healthy weight.

Children and teens

Young people generally become overweight or obese because of poor eating habits and lack of physical activity. Genetics and lifestyle also contribute to a child's weight status.

Recommendations for prevention of overweight and obesity during childhood and teens include:

Gradually work to change family eating habits and activity levels rather than focusing on a child's weight.

Be a role model. Parents who eat healthy foods and participate in physical activity set an example so that a child is more likely to do the same.

Encourage physical activity. Children should have 60 minutes of moderate physical activity most days of the week. More than 60 minutes of activity may promote weight loss and provide weight maintenance.

Reduce "screen" time in front of the television and computer to less than 1 to 2 hours daily.

Encourage children to eat only when hungry and to eat slowly.

Don't use food as a reward or withhold food as a punishment.

Keep the refrigerator stocked with fat-free or low-fat milk, fresh fruit, and vegetables instead of soft drinks and snacks high in sugar and fat.

Serve at least 5 servings of fruits and vegetables daily.

Encourage children to drink water rather than beverages with added sugar. These include soft drinks, sports drinks, and fruit juice drinks.

Adults

Many of the strategies that produce successful weight loss and maintenance help prevent obesity. Improving eating habits and increasing physical activity play a vital role in preventing obesity. Recommendations for adults include:

Keep a food diary of what you ate, where you ate, and how you were feeling before and after you ate.

Eat 5 to 9 servings of fruits and vegetables daily. A vegetable serving is 1 cup of raw vegetables or 1/2 cup of cooked vegetables or vegetable juice. A fruit serving is 1 piece of small to medium fresh fruit, 1/2 cup of canned or fresh fruit or fruit juice, or 1/4 cup of dried fruit.

Choose whole grain foods, such as brown rice and whole wheat bread. Don't eat highly processed foods made with refined white sugar, flour, high-fructose corn syrup and saturated fat.

Weigh and measure food to be able to learn correct portion sizes. For example, a 3-ounce serving of meat is the size of a deck of cards. Don't order supersized menu items.

Learn to read food nutrition labels and use them, keep the number of portions you are really eating in mind.

Balance the food "checkbook." If you eat more calories than you burn you will gain weight. Weigh yourself on a weekly basis.

Don't eat foods that are high in "energy density," or that have a lot of calories in a small amount of food. For example, an average cheeseburger with and order of fries can have as much as 1,000 calories and 30 or more grams of fat. By ordering a grilled chicken sandwich or a plain hamburger and a small salad with low-fat dressing, you can avoid hundreds of calories and eliminate much of the fat intake. For dessert, have a serving of fruit, yogurt, a small piece of angel food cake, or a piece of dark chocolate instead of frosted cake, ice cream, or pie.

Simply reducing portion sizes and using a smaller plate can help you lose weight.

Aim for an average of 60 to 90 minutes or more of moderate to intense physical activity 3 to 4 days each week. Examples of moderate intensity exercise are walking a 15-minute mile, or weeding and hoeing a garden. Running or playing singles tennis are examples of more intense activities.

Look for ways to get even 10 or 15 minutes of some type of activity during the day. Walking around the block or up and down a few flights of stairs is a good start.