What is obesity?
According to the World Health Organization (WHO), obesity is a complex multifactorial disease, defined by an accumulation of excessive fat. It is associated with an increased risk of non-communicable diseases, including cardiovascular diseases, some types of cancer, diabetes, musculoskeletal diseases or chronic respiratory.
Overweight and obesity affect about 50% of adults, and one in three children live as overweight or obese.
Is the severity of the disease the same for adults and children?
Yes, in terms of consequences, obesity in adults and children is both serious. However, a child with obesity may have negative consequences earlier and continue much longer, already into adulthood. Children are also more likely to remain obese in adulthood.
Childhood obesity has reached such an overwhelming dimension that the World Health Organization has classified the problem as one of the most serious public health challenges of the 21st century.
What are the main causes of childhood obesity?
Generally, obesity is the excessive accumulation of fat that results from an amount of calories ingested that exceeds the calories expended. However, the cause of the disease is multifactorial, and can have causes:
- genetic (appear to be associated in 40-85% of cases)
- Environmental
- Endocrine
- among others, such as high consumption of fast food and sugar-rich drinks, less physical exercise, reduced sleep times, excessive screen time, medication, etc.
Thus, some potentially modifiable factors associated with obesity are:
- Inadequate nutrition
- increased sedentary lifestyle and lack of physical activity
- sleeping too little or having irregular sleep schedules
- consumption of sugar-containing beverages and excessive doses of processed food
- Excessive screen time: TV/Phone/Tablet
How is the diagnosis made?
To understand that there is overweight or obesity, it is necessary to evaluate the Body Mass Index (BMI), which compares weight with height. BMI is compared with references for children of the same age and sex. For this, tables (girls and boys) appropriate for the age and sex of the child are used. Body Mass Index is obtained by dividing weight by the square of height (BMI = Weight (Kg) / Height2 (m)).
For example, Laura is 5 years old, weighs 21 kilos and is 1.08 meters tall. In this case, your Body Mass Index is 18. Consulting the BMI percentile tables (below) for females at age 5, Laura is between the 85th and 97th percentile, so she is overweight for her age.
Are there different types of childhood obesity?
yes. According to the child's weight, classified in percentiles, using tables for this purpose, we can consider that there is:
- Underweight: BMI <5th percentile for age and sex
- normal weight: BMI between the 5th and 85th percentiles for age and sex
- overweight: BMI above 85th percentile to 95th percentile for age and sex
- obesity: BMI greater than the 95th percentile for age and sex
- severe obesity: (class II or III): BMI >=35Kg/m2
What are the consequences of childhood obesity?
Among the main consequences of childhood obesity, in the short and long term, we can mention the development of different diseases:
- cardiovascular diseases, such as hypertension, presence of high levels of fats in the blood (dyslipidemia) or premature formation of fatty plaques in the arteries (atherosclerotic disease)
- respiratory diseases, such as asthma and obstructive sleep apnea
- orthopedic diseases, such as joint problems or deformities of the knees
- endocrine dysfunctions, such as diabetes, polycystic ovarian syndrome or excess male hormones (hyperandrogenism)
- nonalcoholic fatty liver disease (nonalcoholic fatty liver) due to fat accumulation
- dermatological changes such as stretch marks or boils
- morbid obesity as adults
In addition to the negative impact on health already mentioned, obesity is often a factor in the development of psychosocial problems, such as bullying, low self-esteem, anxiety, social isolation, depression or eating disorders.
Is it possible to prevent this type of obesity?
In general, yes. The prevention of childhood obesity is, to a large extent, the responsibility of parents, and it is urgent to counter this trend and teach and inform children to adopt healthier lifestyles from childhood.
The bet should start with a healthy and balanced diet and physical exercise, but there are other measures to prevent childhood obesity:
- Do not use food as a reward or punishment
- Establish regular times for meals, which should be taken calmly
- Offer small portions and don't force the child to eat
- Consume soup at the beginning of main meals
- Save sweets and sugary drinks for special days
- Offer children a reusable bottle or institute the moment of the glass of water at home
- Avoid "food junk", in particular hypercaloric snacks, high in salt, sugar and fat - the easiest way is to avoid buying them and replace them with healthy snacks
- avoid prolonged fasting
- encourage the child to try new foods such as fruits or vegetables
- Make breakfast a must-have meal
- Promote outdoor activity and limit time spent gaming, watching TV or using your phone
- Encourage your child to exercise, such as playing soccer or riding a bike
Is there a treatment for childhood obesity?
Prevention is the best way to avoid all the problems caused by obesity, so changing your lifestyle is key to treating the disease.
Thus, overweight and obese children should, in the first place, be evaluated by the attending physician and, if necessary, adopt measures of dietary re-education and physical exercise.
Analyses or other additional tests may be indicated to clarify the causes or sequelae of obesity.
In some cases, medication and/or surgical solutions may be adopted, depending on the degree and risks of obesity.
Is there a program to prevent childhood obesity in Portugal?
Yes. The National Program for the Promotion of Healthy Eating (PNPAS), of the Directorate-General for Health, is considered a national priority health program since 2012 that aims to contribute to the reduction of risk factors related to chronic non-communicable diseases, in particular childhood obesity.
According to this program, "adequate food consumption and the consequent improvement of the nutritional status of citizens has a direct impact on the prevention and control of the most prevalent diseases at the national level".
Source: Directorate-General for Health (DGS)