The Obesity Epidemic

By:   Dr. Lesley Wallace-Berman, MD

Obesity among our children has become a growing problem with an estimated 34% of American children being affected with obesity.  The prevalence of obesity diagnosed in children 6-19 years of age tripled from 2003-2006, while in children ages 2-5 years old it has increased from 5% to 12.4%.  Findings of atherosclerosis are also being found in younger and younger individuals and Type II Diabetes is being diagnosed in children as young as nine.  As a last resort, bariatric surgery is even occasionally being performed in 12 year olds.

Other medical complications of pediatric obesity are numerous. Diseases such as hypertension, high cholesterol, coronary artery disease, sleep apnea, fatty liver disease, reflux, and joint disease are also complications of obesity:  not to mention that the mental health of a child is affected secondary to the social stigma of obesity and the effects it can have on self esteem.  It is essential for us to identify and treat children at risk in order to promote healthy lifestyles and to circumvent the risks of obesity for our children.

One of the ways we identify obesity as pediatricians is to screen a child’s BMI during well visits. The BMI is the Body Mass Index and is an indirect measure of weight status.  It is plotted against age and gender specific populations.  Being overweight is identified as a BMI >85% through 95% while being obese is a BMI >95%.  If a child is obese, their risk of adult obesity increases dramatically as the child ages.

Risks of Adult Obesity

14% chance if obese as an infant

25% chance if obese as a preschool age child

41% chance if obese at age 7 years

75% chance if obese at age 12 years

90% chance if obese in adolescence

It is important to consider the preventive and damaging factors that affect a child’s risk of obesity so that steps can be taken to circumvent the risks.  Protective factors for obesity include: breastfeeding, active families, minimal TV use, and having non-obese parents.  The risk factors are extensive and include: the demise of family dinner, eating fast food, use of prepackaged foods with high fat content, decrease in the intake of fruits/vegetables, sedentary lifestyles, and unsafe areas for exercise around the home.  Excessive TV exposure and media advertisements for unhealthy food are also important risk factors.

As a part of our practice and based on recommendations from the American Academy of Pediatrics and the American Heart Association, if a child has an elevated BMI:  we do screening bloodwork to look for complications of obesity.  Otherwise, in all children between the ages of 9-11 years old and 15-17 years old, we perform cholesterol screening.  We also will check younger children if certain risk factors exist in the child or family.  i.e. If a child’s BMI is >85%, depending on age and risk factors, we will screen for fatty liver disease and diabetes in addition to high cholesterol, if medically necessary.  Beyond the screening tests, we want to work with you to help build a healthier future for your child. This is done in a nonjudgmental atmosphere, and it is our personal goal to ensure the child understands that his/her weight does not define his/her character and that they are a beautiful person inside and out.

Our true mission is to ensure the healthiest and happiest life possible for them. To makes changes, we will discuss working on portion sizes, limiting intake of unhealthy foods, making time for exercise, and eliminating a sedentary life style. We may even involve a local dietician for extra support. We want to work with you to create manageable goals so that the road to a lower BMI and healthier habits is not impossible. However, it is important to remember that the only time when these interventions are successful is when both the parent and child are ready for a change. If you feel this article is speaking to you and your child, we would love to see you in the clinic to help make positive changes.  There is an attached form that can help you get started towards making healthy decisions.

Reference:

Rome, Ellen S. “Obesity Prevention and Treatment.” Pediatrics in Review. 2011;32;363.

   
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