How Should Childhood Obesity be Controlled?

Online Physician By Online Physician, 24th Sep 2011 | Follow this author | RSS Feed
Posted in Wikinut>Health>Exercise & Fitness

Obesity is a common observation among children with the increased availability of fast food and decreased activity in the life-style. Some tips to control and prevent obesity are discussed here.

What is Childhood Obesity?

Obesity (or abnormally high weight for age) is a common observation among children in the developed as well as the developing world. The main factors contributing to this are the increased availability of fast food and decreased activity especially due to the increased number of hours spent in front of the TV and computer . It is important to take measures to reduce obesity in early stages as it can lead to various complications in the childhood as well as in adult life.

How can we control obesity in a child?

Management of a child with obesity is complex and the active participation of the child as well as the family is a must in addition to the primary care physician or paediatric endocrinologist, dietitian, physical training instructor and psychologist or therapist when necessary. The interventions should be initiated as early as possible and the changes should be permanent rather than short term.
1. Being aware of obesity and its complications
2. Undergoing proper screening for possible underlying medical conditions
3. Reduce inactivity
4. Reduce intake of calories
5. Have goals to reduce weight and improve behavior
6. Regular monitoring and evaluation of improvement
7. Psychological support

1. Being Aware of Obesity and Its Complications

The parents and the child (if old enough) should be well aware of the risks of obesity described in the article (Why Should Childhood Obesity be Controlled?). Further information can be obtained from support groups, the health care team and blogs and forums in the internet. The whole family should be motivated to overcome obesity and actively participate in the dietary and physical training (PT) schedules.

2. Undergoing Proper Screening for Possible Underlying Medical Conditions

Any child with obesity should undergo a proper clinical interview and thorough medical examination to exclude secondary causes and complications of obesity. Certain investigations may also be necessary including fasting or random blood sugar level, lipid profile, thyroid profile and X-rays of certain areas to determine the bone age.

3. Reduce Inactivity

Time spent in front of the TV and computer should be limited. The child should be encouraged to be active physically (e.g. – walking or cycling to school, playing with friends). The child may be encouraged to take part in out-door sport activities (e.g. – soccer, basket ball, swimming). It would be beneficial to the child as well as the parents if the whole family could be engaged in at least 30 minutes of activity per day. If the above measures fail, a schedule of exercises may need to be implemented with the help of a physical training instructor.

4. Reduce Intake of Calories

Although restriction of calories is not recommended in childhood as it may adversely affect the growth of the child, the child should not be allowed to take energy dense snacks in between proper meals. The meals should contain high amount of fiber (e.g. – fruits, vegetables) and low amounts of sugar and fat dense food. The concept of food pyramid introduced by the WHO may be useful as a guide to plan the diet of the child. However, failure to reduce weight may indicate the requirement of the advice by a dietitian on the diet.

5. Have Goals to Reduce Weight and Improve Behavior

The child and the family should have clearly defined but realistic goals on reduction of weight (e.g. – to achieve a BMI of 33 in two months and 31 in another two months so that the BMI would be less than 30 after 6 months in a child who has a BMI of 35). Goals may also be implemented to improve behavior (e.g. – increase the time of physical activity from 15 minutes to 30 minutes within 2 months). The child may be rewarded to encourage the achievement of such goals. The healthcare team may also have goals to improve the medical condition of the child (e.g. – lipid profile, blood pressure).

6. Regular Monitoring and Evaluation of Improvement

The child as well as the family may be benefited by the maintenance of records on the interventions and the improvement in the form of diaries or charts. These should be regularly evaluated by a member of the health care team and the family should be advised regarding further improvement.

7. Psychological Support

The family may benefit from joining self help groups and the child may take part in camps and activities held with the participation of children with similar conditions so that the problems can be shared and coping skills improved. Criticism at school and the society should always be avoided and the child should be given the support of a psychologist or a therapist to withstand bullying if unavoidable. The personality of the child should be built-up to prevent low self esteem. your child today itself!

Failure to reduce obesity with the above measures indicates the active involvement of the medical team with the use of drugs (e.g. – Orlistat) and surgical measures (e.g. – gastric by pass surgery) when ever necessary. Although these options are available, they should be left for those who are grossly obese and postponed until the puberty as they may adversely affect the growth of the child if performed early.

Being a condition which can lead to many short term and long term problems physically as well as psychologically, obesity should be reduced as early as possible once it is established. However, as prevention is always better and easier than cure, it is important to maintain an active life- style with a calorie intake only to meet the demands of the body in order to prevent obesity.

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