OBESITY

The term obesity refers to the excess of fat tissue in the body. In simple terms, a child is said to be obese if his weight is 20% more than the standard weight for his age and height. The ideal body weight for height (% IBWH) is the actual weight divided by the median weight for the child’s sex and height multiplied by 100. This may be represented as: 

Obesity is then defined as greater than 120% of IBWH.

Parents of obese children often get worried for the wrong reasons. They wonder if the child has some endocrinal or hormonal disorder. Obese male children seem to have a small penis. Actually, the penis is of the normal size, but it appears small when it gets buried into the fatty tissue at its base. The apparently small size of the penis, coupled with obesity, raises the doubt of a hormonal disorder in the minds of the parents.

Although certain hormonal disorders can give rise to obesity, most cases are not due to any hormonal disturbance.

Children with more fat around the midsection (‘apple-shaped’ children) have more heart disease risk factors later in life than their ‘pear-shaped’ peers who have more fat around the hips and thighs.

CAUSES: The three main causes of obesity are a family history of obesity, inactivity and poor family food habits. Emotionally disturbed children may also eat more. Television viewing adds to inactivity. The problem gets worse if the child is allowed to eat while watching television.

Fortunately, most obese toddlers lose the extra fat around 5 years of age. But a fat school child is likely to remain obese, especially if the parents are fat.

MANAGEMENT: Help your child to adopt healthy food habits and exercise. It is important that the whole family cooperates with the child. Junk foods like cold drinks, ice creams, cakes, pastries, French fries and sweets should not be brought into the house, or the child tempted with them. A minimum of ghee or oil should be used for cooking. More of fruits, vegetables, whole wheat grains, beans, pulses and sprouts should be eaten. Consumption of meat should be restricted. Snacks should consist of fresh fruits and fruit juices, low fat milk and dahi, paneer, khakhra (very thin roasted chapatis from Gujarat), raw vegetables, puffed rice, channa, corn on the cob and popcorn without butter.

Obese children tend to eat fast and at irregular hours. They should be encouraged to eat slowly, chew properly and stick to regular mealtimes as far as possible.


Exercise
This subject is discussed at length in the chapter on HEALTHY HABITS. This is as, if not more important, as diet control for weight reduction.


Encouragement
Discuss the risks of obesity with the child. Tell him that it can cause heart disease and other chronic diseases including hypertension, early artherosclerosis, hyperlipidaemia, and hyperinsulinaemia. Let him feel responsible for his well being. Do not give him appetite-suppressant drugs. Do not starve him, he needs an adequate number of calories. Spend more time with your child and encourage him in his weight-reduction efforts.

11 February, 2013