Childhood obesity: Overweight kids are likely to be obese as adults
By Dr Ravi Gaur
There is a steep rise in the number of obese children in India. Obesity in childhood is a prelude to obesity in adulthood and is a cause for serious concern. Children with obesity face four times the risk of developing Type 2 diabetes compared to those whose weight fall within the normal range.
In recent years, paediatric obesity has increased dramatically. In 2016, World Health Organisation (WHO) termed childhood obesity ‘an exploding nightmare’ as it finds 41 million under-fives overweight or obese, which increased by 10 million from 1990 to 2016. The number of overweight children in lower middle-income countries like India more than doubled over the same period, from 7.5 million to 15.5 million.
India has the second highest number of obese children in the world after China, according to a study published in The New England Journal of Medicine which found that 14.4 million kids in the country have excess weight. As per the study, globally, over two billion children and adults suffer from health problems related to being overweight or obese, and an increasing percentage of people die from these health conditions.
Four million deaths were attributed to excess body weight in 2015 and nearly 60 per cent occurred among people whose body mass index (BMI) was considered to be obese. Although the prevalence of obesity among children has been lower than among adults, the rate of increase in childhood obesity in many countries was greater than that of adults.
Obesity is rising so much among certain groups of children that it is prudent that children and adolescents aged of six to 18 are screened for obesity. And this occurs mostly due to faulty lifestyles, overfeeding, wrong eating habits and less daily physical activity. With sedentary lifestyles being pursued, children have turned into couch potatoes. It is recommended that BMI of a child should be checked once in six months or at least annually so that a child’s development parameters could be analysed for health. Maintaining the weight and height chart would be helpful to a great extent. On the basis of this chart, paediatricians and parents can easily assess the healthy development of the child.
The causes of excess weight gain in children are similar to those in adults, including factors such as a person’s behaviour and genetic makeup. Childhood obesity is a condition in which a child is significantly overweight for his or her age and height. According to Indian Journal of Endocrinology and Metabolism, nearly 20 per cent schoolchildren in India are obese. Methods to determine body fat directly are difficult; the diagnosis of obesity is often based on BMI. For children and adolescents, being overweight and obesity are defined using age and sex specific normograms for body mass index (BMI). Children with BMI equal to or exceeding the age-gender-specific 95th percentile are defined obese.
It is clearly recognised that obesity triggers Type 2 diabetes which is a progressive disease and the duration of the disease predicts complications and mortality. The chronic complications of diabetes mellitus include accelerated development of cardiovascular diseases, end-stage renal disease, and loss of visual acuity, erectile dysfunction and limb amputations. All of these complications contribute to the excess morbidity and mortality in individuals.
Preventing our children and youth from gaining excessive weight and treating it aggressively should be a public health priority.
Awareness and screening can help enormously. Overweight children who have a body weight greater than 120 per cent of the ideal for height and family history of diabetes and hypertension need to be screened as early as possible. Screening should begin at age 10 or at the onset of puberty whichever comes first. Screening should be done every other year.
Childhood obesity, also known as adolescent obesity usually is self- diagnosable, as the weight of the child increases abnormally. Lab tests or imaging are often required for tracking the condition medically. Maintaining a healthy diet and physical activity levels are important for preventing obesity and consequent diseases.
Schools can play an important role in establishing an environment that supports healthful lifestyle habits to encourage healthy eating and regular physical activity. Schools have the opportunity to both educate students about these behaviors and provide opportunities for them to be practiced. An effort should be made to increase the number of fruits and vegetables served during break time in schools.
Treatment of childhood obesity depends on the child’s age and existing medical conditions. Treatment includes changes in the diet and regular exercise. The goal for obesity treatment is to maintain healthy weight. Depending on a child’s existing health complications, treatment may involve a multidisciplinary team including the family physician, dietitian, counsellor or physical therapist.