Childhood obesity: what are the causes and risks in childhood

Diffusion of the phenomenon

Unfortunately, although these tables are updated from year to year, precisely to report the most realistic data possible on the growth of children, there are not rare cases in which the little patient is categorized as overweight or obese.

Childhood obesity is a problem in all respects and has a great social impact. In Europe it is a public health problem and our country tops the charts: it is estimated that about one in four children suffer from obesity. 42% of boys are overweight with 21% of obesity, and in girls the figure changes little because it is about a good 38% who are overweight with 14% of girls being obese. The worrying trend increases every year. in the year, mainly the fault of incorrect lifestyles already in developmental age.

The statistics should make us think: a child who is overweight will be led to be so even in adulthood and furthermore these extra pounds can be associated with serious pathologies in the orthopedic, psychic, metabolic and cardiovascular fields.
This is why it is always recommended to approach a healthy lifestyle from an early age; it serves to keep fit and in these cases it is the main ally to reduce obesity.

Now let's see what can be the causes of obesity in developmental age.

The triggering causes

Pediatric obesity is determined by genetic and environmental factors, an incorrect diet and a sedentary lifestyle. These things can interact with each other, accentuating the problem.

Among these listed, the genetic heritage is certainly the most important cause: if one or both parents are obese, it is a high risk factor for the child.
Obesity manifests itself when a positive energy balance is detected over time: that is, more calories are introduced than those consumed, very often due to an incorrect diet and a low use of these calories through a sedentary lifestyle.
Among the most harmful and widespread eating habits in children is the tendency to eat very often outside the home, preferring fast-food foods and calorie snacks, accompanied by drinks with high percentages of sugar.

To give you an idea, simply take 100 kcal / day more than necessary to achieve an increase of 4.5 kg in weight per year. Provided that these calories are not "burned" with healthy physical activity.

There are rare cases in which obesity is linked to hormonal alterations such as hypothyroidism and adrenal dysfunction or to prolonged treatment of drugs such as cortisone (about 2%), therefore the triggering causes are to be found within the family.

Problems associated with being overweight

Pediatric obesity is associated with various problems, including:

• accumulation of fat in the liver (causing fatty liver);
• increase in insulin with possible evolution towards type 2 diabetes, thus affecting the endocrine system;
• increased cholesterol, triglycerides and uric acid;
• rise in blood pressure and attack of the cardiovascular system, resulting in an increase in mortality in adulthood directly linked to obesity problems in adolescents and in boys between 14 and 19 years (this is the most serious and important risk factor);
• orthopedic and skeletal problems;
• respiratory ailments;
• psychological disorders.

These are very serious complications which, if contracted during childhood, can also have repercussions in adulthood, compromising the well-being of life. As you can see, there are few systems that obesity does not affect, not to mention the psychological aspects. that plague teens or pre-teens: chubby kids are often mocked by peers and this doesn't help with the feelings of shame about their bodies they most likely already have. If we notice that our child or teenager is overweight, it is best to take action and change something in lifestyle.

How to prevent obesity in children

To avoid the onset of the diseases that we have listed above, the best way is certainly to prevent. If your child tends to gain weight, intervene promptly. You will certainly have to review your eating habits and the moments dedicated to physical activity, but there are no pre-established rules. Therefore you can customize the suggestions we are about to give you by adopting small tricks for your family. If specifically your son / daughter suffers from obesity, never let your guard down because the risk of going back is always possible.

Here are some practical advice that is promoted by the Italian Ministry of Health:

• as far as food and diet are concerned, it accustoms the child to take regular meals, avoiding that he eats after hours. The suggested number is 3, that is a generous but substantial breakfast and a moderate lunch plus dinner with the presence of vegetables. Spend the day with two snacks, one in the morning and one in the afternoon. The snacks must still be based on nutritious foods, but no junk food. This will help him not to have holes between meals;
• excessive snacking should be avoided. Do not give him snacks that are too high in sugar or high in calories (especially be careful with snacks, ice cream, fruit juices and carbonated drinks). Instead, opt for fruit-based snacks or yogurt;

• cut down on cured meats, fried foods, and seasonings. Sweet foods with meals are also to be limited. Proteins must be taken in a balanced way, not excessive, therefore alternate the consumption of meat, eggs and cheeses (never together in the same meal). These indications must be followed by the whole family, because children start from an early age to imitate their parents in everything, even in their habits at the table;
• if the child seems full, do not insist: sometimes the desire to make the mother happy is greater than the hunger you have at that moment. Better not to unleash a distorted relationship with food;
• fight a sedentary lifestyle by accustoming the child to playing outside, outdoors. Physical activity outdoors is important both to help him grow properly from a physical point of view and to burn excess calories;
• it respects the rhythms of sleep and wake up in order not to establish bad habits such as night feeding;
• it limits the use of electronic devices to about 2 hours a day at the most. Among these we consider both television and computers and videogames; free time is nice to spend in the company of friends or in the open air! Under 2 years of age, watching TV in general is not recommended.

When to contact the pediatrician

When excess fat is already evident and obesity has now become pathological (ie with a BMI above the 95th percentile or 85th percentile), it is always better to consult a specialist.
The family pediatrician or dietician will have to be the first point of reference for this type of problem, especially when as a parent you have already made the changes mentioned in the previous paragraph, and efforts have not been sufficient to improve the situation.

The pediatrician will intervene not only on the health level, but also on the behavioral one, indicating collaborators and ad hoc paths, based on the individual situation. Initially, a "careful medical history will be required that identifies whether the child is suffering from obesity or overweight and what kind, essential or secondary, and only then will the case history be investigated with any blood tests that confirm the diagnosis.

Subsequently, different approaches are possible, but in order to obtain lasting results over time it will be necessary to carry out a nutritional, physical and psychological rehabilitation path, which first of all involves the child, but also the whole family. The therapy can be set up by starting a routine that includes a constant physical activity or set small goals that will be monitored through a food diary.

In the event that even the advice of a pediatrician and dietician are not sufficient, it may be necessary to resort to taking medications.

Medicines to combat childhood obesity

To date, pharmacological therapy is the last resort, because it has been studied how re-education to good nutrition and sporting activity is more than indicated. It is clear that the decisive factor remains the will of the little patient to change things and to reach the end of the path, as well as the involvement of the members of the family to which he belongs.

There are no more targeted drugs than others that counteract obesity in childhood, except for fibers that would help reduce the sense of hunger and slow down the absorption of nutrients.

For the most severe cases of childhood obesity it is possible to resort to bariatric surgery; but here too it should be pointed out that the effects of these interventions on the long term have not been documented in the pediatric age. Without forgetting that important side effects such as intestinal obstruction, pulmonary embolism or malabsorption are always possible, which do not guarantee a safe recovery.