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Disease of the Day: Childhood obesity

Category

This is an Endocrine; nutritional and metabolic Disease

Overview

 
Childhood obesity is a serious medical condition that affects children and adolescents. It occurs when a child is well above the normal weight for his or her age and height. Childhood obesity is particularly troubling because the extra pounds often start children on the path to health problems that were once confined to adults, such as diabetes, high blood pressure and high cholesterol. Childhood obesity can also lead to poor self-esteem and depression. One of the best strategies to reduce childhood obesity is to improve the diet and exercise habits of your entire family. Treating and preventing childhood obesity helps protect the health of your child now and in the future.

Risks

Many factors — usually working in combination — increase your child's risk of becoming overweight:
 
  • Regularly eating high-calorie foods — such as fast foods, baked goods and vending machine snacks — can easily cause your child to gain weight: Soft drinks containing sugar are a risk factor. Candy and desserts also can cause weight gain. Foods and beverages like these are high in sugar, fat and calories
  • Children who don't exercise much are more likely to gain weight because they don't burn calories through physical activity: Inactive leisure activities, such as watching television or playing video games, contribute to the problem
  • If your child comes from a family of overweight people, he or she may be more likely to put on excess weight, especially in an environment where high-calorie food is always available and physical activity isn't encouraged
  • Some children overeat to cope with problems or to deal with emotions, such as stress, or to fight boredom: Their parents may have similar tendencies
  • If many of the groceries you buy are convenience foods — such as cookies, chips and other high-calorie items — this can contribute to your child's weight gain: If you can control your child's access to high-calorie foods, you may be able to help your child lose weight
  • Foods that won't spoil quickly — such as frozen meals, crackers and cookies — often contain a lot of salt and fats: These foods are often less expensive or an easier option than fresher, healthier foods. In addition, people that live in a lower income neighborhood may not have access to a recreation facility or other safe places to exercise
  • If your child comes from a family of overweight people, he or she may be more likely to put on excess weight, especially in an environment where high-calorie food is always available and physical activity isn't encouraged
  • Some children overeat to cope with problems or to deal with emotions, such as stress, or to fight boredom: Their parents may have similar tendencies

Causes

 
  • Lifestyle issues — too little activity and too many calories from food and drinks — remain a significant contributor to childhood obesity: But there are also some genetic and hormonal factors that likely play a role as well. Recent research has found that changes in digestive hormones can affect the signals that let you know you're full

Symptoms

 
  • Not all children carrying extra pounds are overweight or obese: Some children have larger than average body frames. And children normally carry different amounts of body fat at the various stages of development. So you might not know just by looking at your child if his or her weight is a health concern. Your child's doctor can help you figure out if your child's weight could pose health problems using growth charts and, if necessary, other tests

Treatments

Medications
 
  • Only one prescription weight-loss drug is available in the United States for adolescents: orlistat (Xenical): Orlistat, which is approved for adolescents older than 12, prevents the absorption of fat in the intestines. Prescription medication isn't often recommended for adolescents. The risks of taking a prescription medication long term are unknown, and the medication's effect on weight loss and weight maintenance for adolescents is still questioned. And weight-loss drugs don't replace the need to adopt a healthy diet and exercise regimen. If your child has high cholesterol, it's possible your doctor may recommend giving your child a statin medication. Statins help lower cholesterol, but their use in children remains controversial since it's uncertain what long-term side effects they might have. Because of disagreement in the medical community about treating high cholesterol in children, talk to your child's doctor about what's best for your child
Treatments and drugs
 
  • Treatment for childhood obesity is based on your child's age and if he or she has other medical conditions: Treatment usually includes changes in your child's diet and level of physical activity. In certain circumstances, treatment may include medications or weight-loss surgery
Treatment for overweight or mildly obese children
 
  • For children and teens who are overweight or mildly obese with no other health concerns, the goal of treatment may be weight maintenance rather than weight loss: This strategy allows the child to add inches in height but not pounds, causing BMI-for-age to drop over time into a healthier range. However, for an obese child, maintaining weight while waiting to grow taller may be as difficult as losing weight is for older people
Treatment for obese children
 
  • Weight loss is typically recommended for obese children and teens and for children younger than 6 who have obesity-related health concerns: Weight loss should be slow and steady — anywhere from 2 pounds (about 0.9 kilograms) a week to 1 pound a month — depending on your child's condition. The methods for maintaining your child's current weight or losing weight are the same: Your child needs to eat a healthy diet and increase his or her physical activity. Success depends largely on your commitment to helping your child make these changes
Healthy eating: Parents are the ones who buy the food, cook the food and decide where the food is eaten. Even small changes can make a big difference in your child's health:
 
  • When buying groceries, choose fruits and vegetables: Convenience foods — such as cookies, crackers and prepared meals — are often high in sugar and fat. Always have healthy snacks available. And never use food as a reward or punishment
  • Limit sweetened beverages, including those containing fruit juice: These drinks provide little nutritional value in exchange for their high calories. They also can make your child feel too full to eat healthier foods
  • Sit down together for family meals:  Make it an event — a time to share news and tell stories. Discourage eating in front of a screen — such as a television, computer or video game — which can lead to fast eating and lowered awareness of how much you're eating
  • Limit the number of times you eat out, especially at fast-food restaurants: Many of the menu options are high in fat and calories
  • Serve appropriate portion sizes:  Children don't need as much food as adults do. Allow your child to eat until he or she is full, even if that means they leave food on the plate. And remember, when you eat out, those portion sizes are often significantly oversized
Physical activity
 
  • A critical part of weight loss, especially for children, is physical activity: It not only burns calories but also builds strong bones and muscles and helps children sleep well at night and stay alert during the day. Such habits established in childhood help adolescents maintain healthy weight despite the hormonal changes, rapid growth and social influences that often lead to overeating. And active children are more likely to become fit adults
Physical activity: To increase your child's activity level:
 
  • Limit recreational computer and TV time to no more than 2 hours a day:  A surefire way to increase your child's activity levels is to limit the number of hours he or she is allowed to watch television each day. Other sedentary activities — playing video and computer games or talking on the phone — also should be limited. Don't let your child eat while viewing an electronic screen; it keeps your child from being aware of how much he or she is eating
  • Emphasize activity, not exercise:  Your child's activity doesn't have to be a structured exercise program — the object is just to get him or her moving. Free-play activities — such as playing hide-and-seek, tag or jump-rope — can be great for burning calories and improving fitness. Children should be moderately to vigorously active for at least an hour a day
  • Find activities your child likes to do:  For instance, if your child is artistically inclined, go on a nature hike to collect leaves and rocks that your child can use to make a collage. If your child likes to climb, head for the nearest neighborhood jungle gym or climbing wall. If your child likes to read, then walk or bike to the neighborhood library for a book
  • If you want an active child, be active yourself:  Find fun activities that the whole family can do together. Never make exercise seem like a punishment or a chore
  • Vary the activities:  Let each child take a turn choosing the activity of the day or week. Batting practice, bowling and swimming all count. What matters is that you're doing something active
Weight-loss surgery
 
  • Weight-loss surgery can be a safe and effective option for some severely obese adolescents who have been unable to lose weight using conventional weight-loss methods: However, as with any type of surgery, there are potential risks and long-term complications. Also, the long-term effects of weight-loss surgery on a child's future growth and development are largely unknown. Weight-loss surgery in adolescents is uncommon. But your doctor may recommend this surgery if your child's weight poses a greater health threat than do the potential risks of surgery. It is important that a child being considered for weight-loss surgery meet with a team of pediatric specialists, including a pediatric endocrinologist. Even so, surgery isn't the easy answer for weight loss. It doesn't guarantee that your child will lose all of his or her excess weight or that your child will keep it off long term. It also doesn't replace the need for following a healthy diet and regular physical activity program