Wednesday, April 16, 2014

Obesity in Childhood - An Overview

Childhood obesity is not a disease because there are few known physical health risks among children who are obese. The concern for childhood obesity is the subsequent obesity during adulthood, which may lead to health problems. Children who are obese are at somewhat increased risk of becoming obese adults. Overweight in a child under three years of age does not predict future obesity unless at least one parent is also obese.
The obese children are at increased risk of orthopedic problems and are also prone to skin disorders. Dyslipidemia, hypertension and insulin resistance are frequently seen in obese children. Psychological problems are common among obese children as they are discriminated against and stigmatized. They are teased and harassed by peers. They have a negative body image and low self-esteem. This is particularly marked among adolescents. They may be depressed, passive and withdrawn. Prevention of overweight and obesity should begin early in life and should involve the development and maintenance of lifelong healthy eating habits and physical activity patterns. The obesity management programs in children are family based, school based and health-care facility based.
To have the child lose weight, a combination of decreased caloric diet and increased caloric expenditure i.e. exercise is recommended so that the child loses not more than half a kilogram a week. The parent and child should maintain a food diary for three to seven days which should include the type and quantity of food eaten, where and when it was eaten.
A diet of 1500 kcal/day is prescribed constituting 25 percent from fat, 25 percent from protein and 50 percent from carbohydrates. Dietary fiber is very useful as it displaces fat in the diet and provides satiety. Increased physical activity is necessary to maintain weight loss and redistribute body fat into muscle. Initial exercise recommendations should be small and increase the level slowly. Nutritional education is aimed at both the child and the family regarding healthy food patterns.
The child should eat at the dinner table and at designated times, with only one serving. The child's eating behavior should be modified i.e. he/she should take smaller bites and chew longer. Sweets should not be offered as a reward for finishing a meal. Parents should limit television viewing and encourage active play. Finally, reinforcements and rewards include verbal praise from the physician and family members.
It is important to involve the entire family as the long-term effectiveness of the weight-control program improves significantly. If the child fails to lose weight, the child should not be blamed. He should be given positive support so that he makes a renewed attempt to lose weight.By
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