Great Q&A from the good Doctor!
Obesity in children
Dr. Eduardo G Gonzales I drive my eight-year-old grandson to and from school everyday. I can’t help but notice that many of his classmates – boys and girls, are overweight. I know obese adults are at high risk for many diseases. What about obese children, do they also have health risks? Please write about obesity in children. – Bert A., Quezon City
Obesity has become so increasingly common that it is already considered a global epidemic by the World Health Organization (WHO); and the problem is not limited to first world countries alone. In the Philippines for example, a considerable percentage of the population is overweight.
Particularly alarming is the growing number of children who are overweight. Studies show that children who are fat when they are between four to 11 years old frequently carry the condition to adulthood. If present trends continue, today’s generation will be the first to have a lifespan that is shorter than their parents because overweight children are — as you suspect — susceptible to a myriad of health problems.
What causes obesity in children? Rarely, it is the product of a genetic disease, but in general, it is simply the result of too much intake of fatty and sugary foods coupled with sedentary living over a long period of time. Children need extra nutrients and calories because they are still growing physically. Nevertheless, if they consume more calories than they require for their daily activities and normal physical growth and development, they become overweight.
There are several risk factors that work in concert to bring about obesity in children, the more important are: 1) a diet that is high-calorie and high-fat, the sort that children who regularly eat in fast foods, or are fond of drinking soft drinks or eating candy, ice cream and desserts get; 2) a sedentary lifestyle that is typified by long periods of watching television, playing computer games and surfing the Internet; 3) a family history of obesity; and, 4) psychological and social factors such as emotional stress for which overeating is sometimes used as a coping mechanism.
Obese children have numerous health risks. Many of the chronic diseases of adults such as type 2 diabetes, hypertension, high blood levels of cholesterol, metabolic disease and coronary artery disease actually start to develop in childhood and one of the greatest contributors to the development of these diseases is obesity. Obese children also have a high risk for asthma and other respiratory disease, liver disease, skin infections, sleep and eating disorders and precocious puberty.
In addition, obese children who carry their condition into adulthood have a high risk of developing gallbladder disease, sexual and reproductive problems, sleep apnea and respiratory problems, osteoarthritis; varicose veins and some cancers notably of the breast, uterus, cervix, ovary and gallbladder among women, and colon, rectum, prostate, pancreas and stomach among men.
Obesity in children also entails carrying some social and emotional baggage. Many obese children have low self-esteem; are often teased and bullied; and, are susceptible to depression. Likewise, they have a tendency to be maladjusted and become slow learners.
Obesity, when left untreated, usually worsens, but when treated, it can be corrected. For children under age seven who have no other health concerns, the treatment goal may be simply weight maintenance and just allow the child to grow into his weight. However, for an overweight over seven and obese under seven, the goal may have to include weight reduction.
The safest and most effective way to treat obesity in children is by combining diet and exercise. Remember however, that children can’t change their physical activity level and eating habit by themselves. They need the support and encouragement of their family. To improve the diet and increase the exercise level of an overweight child, the needed dietary and lifestyle modifications must be adopted by the whole family. Parents need to be positive role models.
In some cases, the use of drugs (i.e., appetite suppressants) for a limited period can complement diet and exercise. However, because of their adverse effects, the use of appetite suppressants should be limited to, at most, three to four months, and only as part of a comprehensive weight-reducing program that is supervised by a physician or a trained professional.
In morbidly obese children, surgical procedures designed to either limit the entry of food into the stomach or reduce the amount of nutrients that is absorbed by the small intestines are sometimes carried out. But these procedures are risky and are seldom performed in children.
Address inquiries on health matters to Dr. Eduardo G. Gonzales, DLSU College of Medicine, Dasmariñas, Cavite 4114.
Childhood Obesity
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