What are the effects of obesity in children?
The obesity in children is defined by American Academy of Pediatrics as body mass index (BMI) greater than 95th percentile. Over the past three decades, the developed countries have a two to threefold increased incidence of children obesity. An intense research is on to pinpoint the causes of this surge in incidence. It has also been found that children from lower socio-economic status are also affected. Some of the factors brought are unimaginable. An increase in the earning capacity of middle income group has occurred because both parents are working. Because of that they rely on fast foods or industry prepared foods as they are cheaper and ready to eat. These foods are high calorie but of less nutritional value in comparison to the home cooked food. The increased consumption of sweetened beverages results in increased calorie consumption. The outdoor activities of the children have reduced in school due to changed curriculum and reduced stress on physical education. At home also more time is spent indoors due to increased engagement with modern gadgets.
Health effects of obesity in children
Dietary and lifestyle choices of children which result in obesity are difficult to reverse and have adverse implications on health. Morbid obesity is well known to be associated with multiple life threatening medical conditions and the adolescents are no longer immune to these. As the prevalence of obesity increases in adolescents, there is a parallel rise in the prevalence of obesity related diseases like type 2 diabetes mellitus, fatty liver disease, obstructive sleep apnoea and ischemic heart disease.
Type 2 diabetes mellitus: The incidence of diabetes is rising rapidly. It affects the life expectancy and quality of life adversely. Type 2 diabetes is a metabolic disease and is difficult to treat. The insulin which is required for its treatment has anabolic effects and causes further weight gain. This treatment results in a vicious cycle from which it is difficult to come out. Studies have also reported an increased incidence of diabetes related complications like retinopathy which reduces vision, kidney disease and other organ damage. The severity of damage to organs is directly related to the duration of diabetes and hence is an indication for early treatment.
Fatty liver disease: Liver involvement resulting in fatty change is also rising at an alarming rate in obese adolescents. Over a longer duration, it results in hepatitis and then cirrhosis, with failure of liver function. This is commonly called non-alcoholic fatty liver disease and has become a common indication of liver transplantation in young patients.
Obstructive sleep apnoea: There is an obstruction to upper airway at night which results in pauses in breathing, lasting for 20 to 40 seconds. The severity of obesity is related to higher risk of obstructive sleep apnoea. This is also an independent risk factor for ischemic heart disease.
Heart disease: Clinical studies have shown that 75% of obese children in the age group of 15 – 17 years will continue to be obese as adults. The earlier the onset of childhood obesity, higher is the risk of cardio-vascular disease or ischemic heart disease.
Behavioral changes: Obesity results in behavioral consequences in children. Obese children are more likely to be bullied. They are discriminated by their teachers and friends and are viewed as lazy and dull. There is an increase prevalence of depression and a higher risk of not completing their education. In a survey conducted in schools, the obese children were found to have lesser friendship nominations. In severe cases, there is a higher risk of school dropout, suicidal ideation or attempted suicide.
Obesity has become a global burden affecting all age groups, irrespective of socio-economic status. The changing lifestyle of children has resulted in high prevalence of obesity. The complications of obesity are directly related to the duration of obesity. An early intervention can prevent these complications and improve the quality of life.