- by Dr. Saxena's Clinic
- 4 Shares
- Oct 25 2017
OBESITY: A MAJOR HEALTH CONCERN IN CHILDREN
The pervasiveness of childhood obesity has increased dramatically during the past decades all over the world. The majority of obesity in adulthood has its emergence in childhood which makes obesity a paediatric concern.
In the last decade the estimated number of adults with excess weight has increased dramatically, from 200 million to 300 million affected individuals worldwide. Since 1980 obesity rates have risen three-fold or more in some areas of North America, United Kingdom, Eastern Europe, Middle East, The Pacific Islands and Australia (Fima Lifshitz.; 2008).
It has been observed that about 40% of overweight children will continue to have increased weight during adolescence and 75-80% of obese adolescents will become obese adults. A child with a high BMI has a high risk of being overweight or obese at 35 years of life and this risk increases with age. The consequences of this, disease starting in childhood may be more severe as the duration of obesity will be longer. Therefore, child obesity may have a greater inimical impact on health and the rate of morbidity and mortality, than obesity starting in adulthood.
The number of deaths associated with obesity in the US has been reported to be over 430,000 per annum, a number that exceeds that attributed to smoking(5), though others reported a lower death rate, 112,000 of obesity-attributable deaths (Fima Lifshitz.; 2008).
There was a 22% reduction in longevity resulting in 17-20 years less lifespan when obesity occurred by 20-30 years of age. Recently, it has been suggested that in the 21st century, obese children may die before their parents, due to a potential decline in life expectancy.
Obesity results in several modifications that have been linked as co-morbidities of the disease. Hyperinsulinemia is widespread in obesity and is strongly linked with cardiovascular disease, type 2 diabetes mellitus, hyperlipidemia, and hypertension.
Impaired glucose tolerance is highly widespread among obese children and is associated with insulin resistance. Those with insulin resistance often developed type 2 diabetes mellitus over a two year of follow up.
The nonalcoholic liver disease is a major cause of liver-related morbidity and is usually associated to the presence of insulin resistance in individuals with obesity. Cholelithiasis has been reported to be three times more common in morbidly obese people than in normal subjects.
Gallstones may also result while the obese person is on a hypocaloric diet. This may be due to the mobilization of adipose tissue during weight loss. The risk of colorectal cancer and gout was increased among women who had been obese in adolescence. Finally, obesity in adolescence was a more significant predictor of these risks than being overweight in adulthood. It has been shown that the occurrence of obstructive sleep apnea (OSA) in obese subjects is related to the size of the region enclosed by the mandible and sites and sizes of fat deposits around the pharynx, as well as subjects’ weight.
In children, a significant association between excess weight and asthma incidence has been observed. Population surveys do suggest that persons with asthma are disproportionately obese compared with persons who have never had asthma.
Orthopedic disorders such as Blount’s disease (tibia vara) and slipped capital femoral epiphysis are frequently seen in obese adolescents. There has been increasing evidence that maternal obesity is associated with an increased risk of congenital malformations, particularly neural tube defects.
Studies of obese adolescents have demonstrated an obsession with being overweight, passivity, and withdrawal from social contact. Clinical studies generally suggest that obese persons seeking weight loss treatment have elevated rates of mood and binge eating disorders (BED).
The appropriate health-promoting activities include exercising; and eating healthy foods, limiting the amount of food eaten; and avoiding sweets.
Body mass index (BMI) is a widely used method to define the relationship between weight and height. BMI percentiles can be downloaded directly from the Centres for Disease Control (http://www.cdc.gov/nchs/data/ad/ad314.pdf). The BMI provides a practical clinical tool to classify individuals with normal and those with various degrees of obesity.
Adult individuals with a BMI above 27 have a markedly increased risk for hypertension, hypercholesterolemia, and diabetes mellitus.
However, prevention is critical, since effective treatment of this disease is limited. Early recognition of excessive weight gain in relation to linear growth is important and should be closely monitored by pediatricians and health care providers. Food management and increased physical activity must be encouraged, promoted, and prioritized to protect children. Dietary practices must foster moderation and variety, with the goal of setting the appropriate eating habits for life. Advocacy is needed to elicit insurance coverage of the disease.
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