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Childhood Obesity

Definition


Disease: Childhood Obesity Childhood Obesity
Category: Children diseases
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Disease Definition:

Though all children gain weight as they grow older, childhood obesity is caused by extra pounds that are more than what's needed to support the growth and development of the children.

When a child is well above the normal weight for his/her age and height, childhood obesity occurs, which is a serious medical condition that affects children and adolescents. Because the extra pounds usually start kids on the path to health problems that were once confined to adults, such as high blood pressure, high cholesterol and diabetes, childhood obesity is particularly troubling.

Improving the diet and exercise levels of the entire family, which help protect the health of the child now and in the future, is one of the best strategies to combat excess weight in the child.

Work Group:


Prepared by: Scientific Section

Symptoms, Causes

Symptoms:

None

Causes:

Eating too much and exercising too little is the cause of most excess weight, even though there are also some genetic and hormonal causes of childhood obesity. To fuel the growth and development of children, they need extra nutrients and calories, so they are not like adults in this point. In this way, they add pounds in proportion to their growth if they consume the calories needed for daily activities, metabolism and growth. However, weight beyond what's required to support the growing bodies of children is gained when they eat more calories than needed.

Genetic diseases and hormonal disorders that can predispose a child to obesity are far less common than lifestyle issues. A very small proportion of children are affected by these diseases, which include Cushing's syndrome and Prader-Willi syndrome. Exercise and eating habits play a much larger role in the general population.

A child's risk of becoming overweight may increase due to many factors, which usually work in combination, they include:

Genetics:
A kid may be genetically predisposed to put on excess weight in case he/she comes from a family of overweight people, especially in an environment where physical activity is not encouraged and high-calorie food is always available.  

Diet:
Weight gain may be caused by regular consumption of high-calorie foods, such as vending machine snacks, baked goods and fast food. There are lots and lots of calories in high-fat foods. Weight gain can be caused by loading up on soft drinks, desserts and candy as well, because there is a lot of sugar and calories in foods and beverages like these.

Socioeconomic factors:
Because low-income parents may lack the time and resources to make healthy eating and exercise a family priority, poverty and obesity often go hand in hand. So the risk of becoming obese is greater in children from low-income backgrounds.

Psychological factors:
To deal with emotions such as boredom or stress, or to cope with problems, some children overeat. similar tendencies may be found in their parents.

Inactivity:
Because inactive kids don’t burn calories through physical activity, they're more likely to gain weight. This problem may be caused by inactive leisure activities, such as playing video games or watching television.

Family factors:
Putting healthy foods in the kitchen at home and leaving unhealthy foods in the store is the responsibility of the parents, as most children don't shop for the family's groceries. So parents can control much of their children's access to sweet, salty and fatty foods, especially at home, because children can't be blamed for being attracted to these foods.

Complications

Complications:

Serious health problems, such as heart disease and diabetes can develop in obese children; these conditions are carried into an obese adulthood. Here are some of the conditions that overweight children are at higher risk of developing:

  • Eating disorders
  • High blood pressure
  • Type 2 diabetes
  • Asthma and other respiratory problems
  • Skin infections
  • Sleep disorders
  • Liver disease
  • Metabolic syndrome
  • Early puberty or menarche


The child may be hurt by the social and emotional fallout as well. The following conditions may result due to being overweight:

Depression:
Overwhelming feelings of hopelessness in some overweight children are created by social isolation and low self-esteem. Children are well on the way to depression when they lose hope that their lives will improve. In children, depression is of the same seriousness as in adults. Though some depressed children hide their sadness and appear emotionally flat, others may cry a lot, sleep more than usual or lose interest in normal activities. Parents can talk to their child and share their concerns with the doctor when they think that their child is depressed.    

Low self-esteem and bullying:
Overweight children are often teased or bullied by their peers, which in turn makes them suffer a loss of self-esteem and an increased risk of depression.

Behavior and learning problems:
Acting out and disturbing the classroom at one extreme, and social withdrawal at the other, may be caused by some problems that overweight children tend to have, like more anxiety and poorer social skills than normal-weight children have. Anxiety and stress interfere with learning as well. A vicious cycle, in which ever-growing worry fuels ever-declining academic performance, is created by school-related anxiety.

Treatments:

The child's age and whether he/she has other medical conditions are the things that determine treatment for childhood obesity. Changes in the level of physical activity of the child and in his/her diet are usually included in treatment. Weight-loss surgery or medications could be included in the treatment in certain circumstances.
The goal may be weight maintenance rather than weight loss for children under age 7 who have no other health problems. Causing BMI-for-age to drop over time into a healthier range, this strategy allows the child to add inches but not pounds. However, maintaining weight while waiting to grow taller for an obese child may be as difficult as losing weight for older people.
For children who have related health concerns and who are over the age of 7 or for younger children, weight loss is typically recommended. Depending on the situation of the child, weight loss should be slow and steady, anywhere from 0.45 kilograms (1 pound) a week to 0.45 kilograms a month.
The child needs to increase his/her physical activity and eat a healthy diet, which means that the methods for maintaining or losing weight are the same. Commitment of the parents to helping their child make these changes is the thing on which success largely depends. When considering eating habits, one needs to consider exercise habits as well, and vice versa, as they are two sides of the same coin.

Healthy eating:  
A big difference in the child's health can be made by even small changes. The ones who buy the food, cook the food and decide where the food is eaten are parents. Parents should consider the following procedures:

  • Limiting sweetened beverages, which include those containing fruit juice.
  • Never using food as a reward or punishment, and always having healthy snacks available.
  • Limiting the number of times the family eats out at fast-food restaurants.
  • Choosing fruits and vegetables over convenience foods high in sugar and fat.
  • Discouraging fast eating and lowered awareness of the amount one is eating, which are the result of eating in front of a screen such as a video game, computer or television.


Physical activity:
Physical activity is a critical component of weight loss for children in particular. It builds strong bones and muscles and helps children sleep well at night and stay alert during the day, and it also burns calories. Despite the social influences, rapid growth and hormonal changes that usually lead to overeating, such habits established in childhood, help adolescents maintain healthy weight, so active children, in most cases, can become fit adults.

Medications:
For adolescents, there are two prescription weight-loss drugs; orlistat and sibutramine. The absorption of fat in the intestines can be prevented by orlistat, which is approved for adolescents older than 12. And to make the body feel fuller more quickly, the brain's chemistry is altered by sibutramine, which is approved for adolescents older than 16.
As the effect of taking the medications on weight loss and weight maintenance for adolescents is still questioned, and the risks of taking them for a long term are still not clear, prescription medication is not usually advisable for adolescents. Anyways, the need to exercise and to adopt a healthy diet can't be replaced with weight-loss drugs.
A reduced-strength nonprescription (over-the-counter) version of orlistat named Alli has been approved by The Food and Drug Administration. Alli is not approved for children or teenagers under age 18 although it's  readily available in pharmacies and drugstores.

Weight-loss surgery:
For some severely obese adolescents who have been unable to lose weight using conventional weight-loss methods, weight-loss surgery can be a safe and effective option. However, the long-term effects of weight loss surgery on a child's future growth and development are not really known, and there are potential risks and long-term complications, as the case with any type of surgery.  
If the child's weight poses a greater health threat than do the potential risks of surgery, this surgery may be recommended, even though weight-loss surgery in adolescents is still not common. The meeting between the child that is considered for weight-loss surgery and a team of pediatric specialists including a pediatric endocrinologist is important.
The need for following a healthy diet and regular physical activity program can't be replaced by surgery, which doesn't guarantee that the child loses all of his/her excess weight or that the child keeps it off long term, so surgery is not the easy answer for weight loss.

Prognosis:

Not Available

Expert's opinion

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