Childhood and Adolescent Obesity

M. R. Moinfar,. M. D. FAAP
Clinical Professor in Pediatrics, Georgetown University Medical Center
Pediatrician, Georgetown University Children’s Medical Center

Childhood and adolescents overweight and obesity is a serious nutritional problem. Too much eating and too little physical activity are the most essential causes of obesity. Obesity occurs from a failure between energy intake and energy expenditure, the mechanism of this imbalance process is not well explained and understood.Obesity develops in three stages : In uterine and early infancy. Between the age of five to seven, and adolescence.Obese infant at the age of 6 month, carries a 14% chance of becoming an obese adult, and 40% chance if a child is obese at 7 years of age. Obese children at age 10-13, and adolescence respectively have 70%, and 80% chance to become obese adults. 99% of of obese children have no physical abnormalities and the cause of obesity is exogenous, with primary cause and a family history of obesity. Only 1% of obesity is considered endocrine and genetic disorder.Genetic expression of obesity is most likely the result of gene and environmental interaction. Childhood and adulthood obesity are associated with morbidity syndrome as follow: Cardiovascular complications, hypertension, hyperlipidemia and Dyslipidemias(elevated total cholesterol, elevated tryglyceride and low density cholesterol, and decrease high density cholesterol), sleep apnea, type2 diabetes, abnormal liver enzymes, gallbladder disease, and psychosocial problems(depression, poor self-esteem, negative self image and withdrawal from peers),. Obese children must be evaluated by a pediatrician. The presence of morbidity syndrome of obesity should be evaluated . Through a multidisciplinary team by a pediatrician, dietician, exercise instructor, psychologist, and social worker, a weight management program is to be established. Extreme diet are not advisable for children, and children younger than 2 years of age should not have a restricted fat intake, since the nervous system development needs adequate calories and cholesterol. Healthy diet, balancing energy intake and energy expenditure, limiting television viewing, and computer games, modification of eating habits for child and whole family are essential part of program. Parents should be a role models to implement the guide line. Reducing dietary fat, and encouraging to eat mostly vegetables, fruits, bread, rice, and meat are to be emphasized. By observing the recommended diet which reduces 30% to 40% of caloric intake, and compliance to daily exercise, and behavioral modification of eating habits the obese child will reach a desirable weight and the risk of morbidity syndrome associated with obesity can be reversed.