Obesity or over nutrition is a generalized and excessive accumulation of fat in subcutaneous and other tissues.
Obesity in childhood is not a disease but rather a symptom complex having a weak association with adult obesity with its correlates of increased mortality, cardiovascular disease, hypertension, hyperlipidemias, liver diseases, cholelithiasis, and adult-onset diabetes.
Factors related to the occurrence of overweight and obesity are multifactorial in nature with the exception of certain single gene disorders associated with human obesity (Prader-Willi, Bardet-Biedl, and Cohen syndromes).
Some of known factors include:
- Repeated and uncritical offering of a bottle as a method of dealing with a fretful or crying infant may establish a habit that leads the infant to seek food whenever experiencing frustration.
- Uncritical early introduction of high-calorie solid foods may lead to rapid weight gain and obesity
- Heredity has recently been shown to influence fatness, regional fat distribution, and response to overfeeding. Infants born to overweight mothers have been found to be less active and to gain more weight by age of three months when compared with infants of normal weight mothers, suggesting a possible inborn drive to conserve energy.
- Excess fruit juice consumption by preschool-age children has been reported to be associated with obesity.
- excessive intake of high-energy foods
- inadequate exercise in relation to age
- more sedentary life-style
- low metabolic rate relative to body mass
- increased insulin sensitivity
The incidence of childhood obesity relates strongly to family variables, including parental obesity (The risk of becoming obese is greatest among children who have two obese parents), small family size, and family patterns of inactivity. An increased amount of time spent viewing T.V., playing video games, or “surfing” the internet appears to correlate with an increased incidence of childhood obesity.
Complications of obesity:
- Children with obesity experience significant social and psychological stresses and difficulties.
- School children are frequently harassed, intimidated, and excluded from other activities; teachers may treat obese children differently.
- Sleep apnea is increasingly identified in obese children, it is estimated that sleep apnea occurs in 7% of obese children, and it directly diminishes participation and academic performance.
- Glucose intolerance and non-insulin-dependent diabetes (NIDDM) occur in obese children and adolescents.
- Obese children have elevated serum levels of low-density lipoprotein cholesterol and triglycerides and lowered high-density lipoprotein cholesterol.
- Obese children are at increased risk of becoming obese adults.
- The pickwickian syndrome is a rare complication of extreme exogenous obesity, in which patients have severe cardiorespiratory distress with hypoventilation.
Prevention and treatment:
Early attempts to modify behavior commencing in infancy period, my effectively prevent overeating and obesity. Such attempts include;
1. Feeding an infant on demand shortly after birth.
2. Providing food only at signs of hunger in the 1st year of life.
3. Avoiding cueing by showing attractive foods or regimenting feeding times by clock.
4. Teaching the child to eat only when hungry.
After childhood obesity is established, active participation and motivation of both the child and the family is essential to implement an effective plan for weight reduction and maintenance.
Techniques used for fat reduction in adults, such as surgery, gastric balloons and pharmacotherapies are contraindicated in children.
Very low-calorie diets are inappropriate because they may impair growth and development at critical points during childhood.
Successful treatment of childhood obesity requires attention to the following components:
- Modification of diet and caloric content.
- Definition and use of appropriate exercise programs.
- Behavior modification of the child.
- Involvement of the family in therapy.
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