What Contributes to Childhood Obesity Doc?

Only a few decades ago, childhood obesity was unheard of. Overweight was just a benign shape-shifting of midlife. But today, obesity in children has become a serious public health challenge. 1 in 5 children, between the age of 5 and 10, is found to be overweight. It is still more common among teenagers. Infants and preschool kids are not spared either.

Global Incidence of Childhood Obesity in Year 2019

Obesity is a disease that has threatened child-health. People are aware of the problem. They often ask, “why is my child gaining so much weight Doc”? But the question can seldom be fully addressed in the constrains of a busy clinic.

Childhood obesity is an outcome of increased intake of calorie-rich food along with poor participation in active outdoor games. Following children's weight gain trends, on BMI chart specific for age and sex, would help tweak food choices and lifestyle preferences for healthy living. Optimum energy balance is crucial to keep out of the obesity trap.

Weight gain cycle: A childhood obesity trap

Understanding The Obesity Trap And Its Effects on Well-Being

Energy, by the law of physics, is never lost. If the food consumed is not used up for the day's energy need, the body stores the extra as fat.

Therefore, in its most basic form, the cause of childhood obesity is habitual energy overload. The principle stands strong even for them who have a familial predisposition to gain weight. No one can become fat if the body does not have enough extra calories to convert into fat deposits.

Undesirable weight gain is, no doubt, a complex long-drawn process. But let's make its solution simple:

Say no to empty calories, like in candies, beverages, butter, oil, margarine, and more.
Step up the daily activity level by encouraging outdoor activities, anything from gardening to games.

Outdoor games are crucial for optimal child health

Children are usually apprehensive of new surroundings and new people. To cultivate the habit parents not only need to accompany their children to the playground, but also actively participate in the games.

This imbibes confidence in children; they cherish the company of the parents and perceive outdoor games as source of enjoyment. – After all children learn everything that they see their parents do.

Usual hurdles in developing outdoors sports

Fear of exposure to sunlight:
For developing skin cancers in the western world and for darkening of complexion by the people living in east.
Parents perceive the neighborhoods as unsafe:
Studies show that children of parents who consider neighborhood to be unsafe are 4 times more likely to gain weight excessively.

Family eating habits

Family eating habits that can result in childhood obesity

Eating out
Snacks and tidbits
Drinks and beverages
Health drinks and diet drinks are injurious to child health.

Studies show that marketed fruit juices with “No Extra Sugar Added” label, diet drinks and ice-creams actually lead to Metabolic Syndrome and abnormal fat deposition, predominantly around the waist and on the belly (Truncal Obesity)
Eating while watching TV:
Whereas family meals lower chances of childhood obesity.
May also indicate developing binge eating disorder.

Television viewing

Television viewing time is directly proportional to weight gain. The effect is influenced by -

Sedentary lifestyle.
Low mental activity: When exposed to audio visual media for more than 30 minutes per day, it has an oppressive influence on children’s cognitive development.
Habitual snacking and soft drinks add to calories.
Low inclination to participate in outdoor games.
Poor psycho-social development:
Psycho-social development is dependent on real life time experiences and ability to meet challenges, which are totally lacking while television viewing.
Sleep deprivation leads to increased snacking and fluctuations of hormones.

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Stress

Childhood, though not usually associated with stress, goes through tremendous turmoil. Children experience stress due to:

Sleep deprivation: Late night socialization, television viewing and so on.
Nutritional deficiencies.
Depression.
Coming of a sibling:
The first child goes through a feeling of rejection, which seldom gets any consideration.
Starting at school:
Though taken by adults in child’s environment as a normal childhood curriculum, but it causes severe psycho-social upheaval in children; approval of teachers, high demands on discipline and coping up with peers.

With shrinking family sizes, this has become still more important issue in psycho-social development of middle childhood.
Strict disciplining.
Environmental stressors.
Economical stress in the family.
Disturbed family environment: Death, sickness or disharmony in family.

Medications

Long term use of medications like antipsychotics, high-dose inhaled glucocorticoids, oral glucocorticoids, anticonvulsants are known to cause abnormal weight gain.

Frequent use of antibiotics disturbs gut flora and predispose children to obesity. The micro organisms in our gut work as probiotics. They help in fat metabolism, development of immunity and more.

Hormones' effects on child growth

Hormonal disorders are well known to be a cause of abnormal weight gain that is predominantly central with expanding waistline. However, hormone derangement is confirmed only in about 2 percent of obese children.

Growth hormone deficiency:
It is recognized by discrepancy in height and weight gain on
percentile growth charts (click here to download one for Free) along with abnormal weight gain around the midriff (Truncal obesity).
Cushing syndrome: Recognized by -

i.) Fall in height gain

ii.) Rise in weight gain,

iii.) Abnormal weight gain around the waist .

vi.) Dark linear discoloration of the belly skin (abdominal striae).

v.) These children are usually resistant to insulin.
Polycystic ovarian disease:

i.) Scattered blackish discoloration (acanthosis nigricans) suggests insulin resistance.

ii.) Abnormal hair growth (hirsutism) on face, legs and/or skin of the belly.

iii.) Premature appearance of pubic hair as with onset of puberty (adrenarche).

iv.) Central obesity: abnormal weight gain around the waist.

v.) Discrepancy on percentile chart: Weight gain is more as compared to height gain. - Read more under Growth Variations.

Other predisposing factors

Second hand smoke
Exposure to second hand cigarette smoke and pollution has been associated with childhood obesity.

Genetic predisposition

Obesity in parents
Excessive weight gain by the mother when the concerned child was in the womb is one of the contributing factors to childhood obesity and is associated with weight gain in children during early school years.

However, parents of children who are already victim of overweight cannot do anything about what happened in the past, so I will not elaborate on it. This little information is for future pregnancy.

Abnormalities usually associated with childhood obesity

Delay in achieving milestones.
Hearing and visual impairment.
Sleep apnea: Disturbed sleep, snoring, or daytime sleepiness.
Frequent abdominal pain: Fatty liver disease.
High blood pressure.
Type 2 diabetes: Excessive urination, night time frequent. urination along with excessive water intake.