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Obesity - Children & Teenagers

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Obesity - Children & Teenagers
Summary
  • Obesity is the excessive accumulation of body fat.
  • Obesity is associated with more than 40 different medical or psychological problems, affecting virtually every organ system in the body.
  • Treatment of Obesity in childhood and adolescence should focus on long-term changes to diet and exercise, family support and avoidance of dramatic swings in body weight.
Description

Obesity is the excessive accumulation of body fat.1 The World Health Organisation has declared Childhood Obesity a 'global epidemic'2.

Obesity or being overweight occurs when a child or teenager's total energy intake (the calories consumed) is greater than the total energy expended (the energy the child uses up in physical activity)3.


Complications of Obesity in Children and Teenagers4

Obesity is associated with more than 40 different medical or psychological problems, affecting virtually every organ system in the body5. Examples of these problems include;

  • Increased risk of Obesity in adulthood.
  • Sleep apnoea and sleep-disordered breathing. 
  • Orthopaedic disorders.
  • Liver dysfunction (in 20% of obese children).
  • Gall stones.
  • Pancreatitis.
  • Skin infections and ulcers.
  • Depression, social isolation, eating disorders, anxiety and other psychological disorders.
  • Type II diabetes, high cholesterol levels and high blood pressure.
  • Increased risk of iron deficiency. Low iron levels in children can cause impairment of physical and mental development6.
  • Reproductive dysfunction e.g polycystic ovary sydrome.
  • Increased risk of developing arthritis.
  • Increased risk of developing cancer.
  • Increased risk of death from coronary artery disease.
  • Increased risk of premature death7.  


Cause

The cause of Obesity in children and teenagers is a very important and complex issue. Weight gain and Obesity develops when energy intake (from food and drink) exceeds energy expenditure (from physical activity) over a prolonged period of time. Environmental or lifestyle factors are responsible for the majority of cases of Obesity in children and teenagers. Less commonly, a hormonal problem or genetic factor may predispose a person to Obesity8.

Certain genes have been identified as playing a role in a person's predisposition or resistance to Obesity e.g the leptin gene9. Some genetic conditions such as Down syndrome, Turner syndrome, Prader-Willi syndrome and Cushing syndrome can cause weight gain, as can some medications (e.g. certain antidepressants). Some hormonal conditions such as hypothyroidism and growth hormone deficiency can result in reduced energy expenditure.

It is important to note that, to date, no single lifestyle factor has been shown to be the single cause of the increasing number of children and teenagers with Obesity. Clinical studies have pointed to dietary trends, sedentary lifestyles, decreases in structured physical activity, and psychosocial stressors as likely contributors to the Obesity epidemic. Several dietary factors have been proposed to play important roles. These include:

  • The increased availability and consumption of fast foods,
  • General trends toward consumption of foods that are highly processed and are high in carbohydrates and/or total calories (including sugary beverages),
  • Decreased consumption of fibre and low-density foods,
  • The strong marketing techniques of the fast food industry,
  • Decreased participation in structured physical activity such as group sports,
  • Decreased lifestyle activity (children are being driven in the car instead of walking or riding a bike),
  • Increased sedentary activities (particularly television viewing and computer use)10.
  • Management

    Treatment of Obesity in childhood and adolescence should focus on long-term changes to diet and exercise, family support and avoidance of dramatic swings in body weight.

    • You and your family can receive nutritional counselling to help you adopt a healthier eating pattern. Ask your Doctor for advice.
    • Be aware of your child's psychological health and be alert to signs of depression and eating disorders which can be the cause and result of Obesity11.  


    Lifestyle

    Activity Hints
    • Exercise and physical activity should be encouraged throughout childhood and adolescence and into adulthood. Encourage your child to make exercise and physical activity a part of every single day.
    • Discourage your child from spending too much time on sedentary activities such as watching television and playing computer games.
    • Undertake physical activity yourself to set a good example for your child.
    • Incorporate physical activity into family outings.
    • Consider alternatives to driving such as walking or riding a bike.
    • Encourage and support your child to participate in after-school and weekend sporting activities.


    Diet Hints

    For a child to achieve a healthy weight his/her diet must provide a balance of calories to energy output. Foods should also be high in nutritional value to ensure proper physical and mental development.

    • Encourage your child to eat a balanced diet that is made up of nutritional foods such as wholegrains and cereals, fruit and vegetables, dairy products, meat and fish.
    • Encourage your child to eat a healthy breakfast. This will discourage the consumption of unhealthy foods in the early part of the day.
    • Provide a healthy and interesting lunch for your child.
    • Use low-fat cooking and food preparation methods e.g., grill or steam instead of frying.
    • Eat home-cooked meals together as a family. This will reinforce healthy eating as a positive experience for children.
    • Decrease portion sizes of foods. If you are unsure about healthy portion sizes, ask your Doctor for advice.
    • Discourage eating while watching television.
    • Save sweet and fatty treats for special occasions.
    • Reward your child with things other than food e.g. a favourite toy or a trip to the zoo.
    • Increase water intake and decrease intake of sugary drinks12.  
  • Pharmacist's Advice

    Ask your Pharmacist for advice.

    1. Follow the Diet Hints.
    2. Follow the Activity Hints under the Health Management section of this topic.
    3. An obese child is at increased risk of developing an iron deficiency13. Ask your Pharmacist for advice about a suitable nutritional supplement for your child.


  • Notes

    References

    1. Beers M H and Berkow R. The Merck Manual of Diagnosis and Therapy. 17th ed. Whitehouse Station (N.J): Merck Research laboratories; 1999.
    2. Rugg K. Childhood obesity: its incidence, consequences and prevention. Nurs Times. 2004 Jan 20-26;100(3):28-30.
    3. Freemark M. Obesity. eMedicine Journal. March 15 2002, Vol.3, No.3. [cited 2002 Apr 3]. Available from: URL: http://www.emedicine.com/ped/topic1699.htm.
    4. Freemark M. Obesity. eMedicine Journal. March 15 2002, Vol.3, No.3. [cited 2002 Apr 3]. Available from: URL: http://www.emedicine.com/ped/topic1699.htm.
    5. Hoppin A. Assessment and Management of Childhood and Adolescent Obesity. Medscape.com. 2004.
    6. Bandhu R et al. Effect of iron on growth in iron deficient anemic school going children. Indian J Physiol Pharmacol. 2003 Jan;47(1):59-66.
    7. Ebbeling CB. Childhood obesity: public-health crisis, common sense cure. Lancet. 2002 Aug 10;360(9331):473-82.
    8. Obesity in Australian Children - Consequences, Causes, Prevention and Management. Australasian Society for the Study of Obesity. June 2004.
    9. Montague CT, Farooqi IS, Whitehead JP, et al. Congenital leptin deficiency is associated with severe early-onset obesity in humans. Nature. 1997;387:903-908.
    10. Hoppin A. Assessment and Management of Childhood and Adolescent Obesity. Medscape.com. 2004.
    11. Freemark M. Obesity. eMedicine Journal. March 15 2002, Vol.3, No.3. [cited 2002 Apr 3]. Available from: URL: http://www.emedicine.com/ped/topic1699.htm.
    12. Obesity in Australian Children - Consequences, Causes, Prevention and Management. Australasian Society for the Study of Obesity. June 2004.
    13. Bandhu R et al. Effect of iron on growth in iron deficient anemic school going children. Indian J Physiol Pharmacol. 2003 Jan;47(1):59-66.
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