Obesity
Obesity is a condition where a person has accumulated so much body fat that it puts them at a higher risk for serious diseases, such as Type 2 diabetes, High Blood Pressure, Liver disease, and Metabolic Syndrome, leading to an increase in the risk of heart disease later in life. It also leads to serious psychological problems in some children and increases the risk of PCOD in girls.
Obesity in children is classified as having a Body Mass Index (BMI) greater than the 95th percentile i.e. greater than the upper limit of normal for that age and sex. There are BMI charts available for boys and girls of different ages. BMI is a tool used to measure obesity.
What is Obesity?
Obesity refers to an excess of body fat. The term overweight means an excess weight for the height and when the weight excess is enormous, it is termed obesity.
How do I know if my child is overweight or obese?
A more scientific way of assessing this is by calculating the Body Mass Index (BMI).
Body mass Index = Weight in kilograms / Height in m2
If you know your child’s height and weight, you can calculate the body mass index by using the BMI calculator given. You can plot the BMI against the age on the specific chart for boys or girls.
If Your BMI is within:
- -50th percentile, it is normal
- -85th to 95th percentile, it is overweight
- -Greater than the 95th percentile, it is obese
Children who are overweight or obese should be investigated by their pediatric endocrinologist for abnormalities that may have caused the obesity or resulted from obesity.
What is the reason for my child being overweight?
Deposition of fat in the body and weight gain occurs when you are taking more calories (eating large amounts of food or more fatty foods) utilizing less calories (by physical activity) or both.
You do find some children and adolescents eating almost the same food and exercising the same amount, one may be overweight and the other may seem normal. This is because genetic factors also govern the amount of weight gain. Some people seem to gain weight more easily than others and must watch what they eat.
Occasionally excess weight gain may be due to an under-active thyroid gland or overactive adrenal gland and rarely it may be due to a marked increase in appetite secondary to certain genetic syndromes or tumors.
What are the effects of being overweight?
The effects of obesity depend on the degree of excess weight or BMI. The higher the BMI, the greater the risk of these children or adolescents becoming obese adults and developing diseases such as diabetes mellitus, hypertension, abnormalities of the lipid profile, and coronary (heart) disease later in life. If there is a history of these illnesses in the family, then the risk is even higher.
In the last few years, there has been a marked increase in the development of diabetes in adolescents and it has almost become an epidemic in the developed countries. Even in a developing country like India, a marked increase in obesity has been observed in the last few years, although official statistics are limited. There has also been an increase in the number of children who are developing diabetes, hypertension, and abnormalities of the lipid profile in our population since the Indian population is genetically at a very high risk of developing these diseases.
These children may also develop problems with the joints due to excess weight bearing. Females may develop abnormalities in their menstrual periods and excessive hair on the face etc. because of obesity on hormones. Besides the risk of developing complications, cosmetic problems also affect these young children and may cause psychosocial problems.
Does Lifestyle influence weight gain?
The epidemic of obesity is primarily due to the change in lifestyle. The availability of high fat foods (fast food) is a big temptation for children. Lack of physical activity is rampant because of increased TV viewing & spending time in front of computers. Even in schools the time allotted for physical activity has reduced in the last few years and the pressure of studies has contributed to a relatively sedentary lifestyle for young children and adolescents.
How do I get my child to lose weight?
Management in children and adolescents is aimed at controlling the weight gain so that as the child gains height, the weight will get adjusted. A gradual weight loss may be required in those who have completed their growth or are grossly obese.
Avoiding calorie-dense foods with high-fat content and physical exercise to burn calories form the basis of weight loss. Rapid weight loss or severe dietary restriction is not recommended since good nutrition is required for growth in children and adolescents. The whole family should be involved in weight management and should help in the modification of lifestyle.
Weight management should be done under the supervision of your endocrinologist.
Can I prevent my child from becoming obese?
Yes, you can prevent your child from becoming obese. Preventing obesity is more important and much easier than treating it. Regular monitoring of height and weight by your pediatrician will help to identify those who are gaining excess weight, so this can be prevented before the child becomes obese.
Teaching healthy behaviors at a young age is important since change becomes more difficult with age. Behaviors involving physical activity and nutrition are the cornerstone of preventing obesity in children and adolescents. Families and schools are the two most critical links in providing the foundation for those behaviors.
