Obesity in children and adolescents: prevention and treatment
Obesity in childhood and adolescence is a serious and problematic issue of our time.It is not the first decade that there has been an increase in the number of children who are overweight.
The topic of diagnosis and treatment of obesity in children and adolescents forms separate sections of dietology, endocrinology, surgery, therapy and other branches of medicine, since the presence of excess weight leads to serious health problems.Table of contents: How to determine if obesity is present Causes of obesity in children and adolescents Complications that cause obesity Predisposing factors to obesity Treatment of obesity in children and adolescents Recommended reading:
How to determine if obesity is
Notice : According to WHO statistics, the number of children under 5 years old who are obese is about 42 million.Over the past 20 years, it has increased by 50%.It is expected that in 10 years this figure will grow to 70 million.
Physicians consider 2 age categories: from 6 to 11 years and from 12 to 17( adolescents)
First of all, the appearance of the child is alarming, more reliable data can be obtained from special comparative( centile) tables of growth, weight andPhysique.
Causes of obesity in children and adolescents
In the development of obesity in children, there are two main factors:
- alimentary - caused by nutrition problems and a wrong, sedentary lifestyle;
- endocrine - is the result of thyroid pathology, pituitary diseases, abnormal ovarian function, adrenal diseases.
The doctor-endocrinologist is engaged in revealing the reasons of adiposity.
Reasons for the development of obesity in children and adolescents:
- Overeating - eating high-calorie foods( fancy foods, pastries, confectionery sweets), cult and traditions of "polyglot" in the family, overweight in parents, improper feeding of nursing infantsChildren;
- lack of mobility.Sitting games, lying in the afternoon, watching TV for a long time and being behind a computer monitor;
- Hypothyroidism - thyroid hormone deficiency.In this case, the child lingers in his development, begins later than he should by the age to keep his head, walk, talk.He has a later teething, his face looks puffy-edematous, often stools occur, dry skin is noticeable, in girls during puberty, there are violations of the monthly cycle;
- hereditary and genetic diseases are often accompanied by excessive body weight of the child along with mental inferiority, weakness of the muscular system, visual impairment;
- pathology of the adrenal glands is a disease of Itenko-Cushing, accompanied by hyperproduction of glucocorticoids produced by the adrenal glands.Obesity in this disease in children and adolescents is accompanied by a specific deposition of adipose tissue in the upper half of the trunk.Hands and lower half remain thin;
- trauma, surgical pathology, inflammatory diseases of the brain, leading to disruption of the pituitary and subsequent obesity;
- tumor of the brain, pituitary.In this case, headaches with nausea and vomiting, disorders of the menstrual cycle, enlargement of the mammary glands( consequence of tumors of the pituitary gland) can be attached to obesity in children;
- Adiposis genital dystrophy in this disease in boys underdevelopment of the genitals, an increase in the mammary glands, the lack of development of secondary sexual characteristics( growth of the beard, hair on the genitals, in the armpits);
- polycystic ovarian syndrome - along with obesity in girls there is a violation of the menstrual cycle, excessive growth of hair on the face, chest, seborrhea.
Complications and health problems of children and adolescents that cause obesity
Overweight has a negative effect on the entire body.
- Cardiovascular system - develops hypertension, ischemic heart disease, angina pectoris, atherosclerotic vascular changes, diseases with chronic heart failure.These problems are peculiar to the elderly, but obesity develops in children.
- Gastrointestinal tract - inflammation of the stomach( gastritis), duodenum( duodenitis), gall bladder and duct, pancreas( pancreatitis).At children obesity of a liver with replacement by a fatty tissue of its normal cells develops.Hepatic failure is formed.
- Musculoskeletal system - there are changes in bone tissue, deformation of bones and joints, flat feet develop, "X" or "O" -shaped deformity of the legs.
- Endocrine system - fatty pathological processes in the pancreas lead to the development of diabetes mellitus.
- Nervous and mental systems - with obesity in children there are disorders of sleep, shortness of breath, snoring in a dream.Neuroses, asthenic conditions, inferiority complexes are formed.Against the background of ridicule, depression is formed in sick children and adolescents, which can lead to serious complications from the psyche, stimulate the initiation of alcohol and drug use.
Girls with obesity often develop infertility.
Detection of predisposing factors to obesity in children and adolescents
Diagnosis is based on a conversation with children who are addicted to obesity and their parents.Meeting with a doctor should alert the family and make adjustments to lifestyle, nutrition, understanding of the essence of the disease and its treatment.
In addition to diagnosing obesity, the doctor appoints:
- a biochemical blood test that identifies the possible increase in blood glucose, the cholesterol, triglycerides, protein and its fractions.Important indicators are ALT and AST, with the help of which the activity of the liver, heart and other organs is assessed;
- assays for the maintenance of hormones - the thyroid gland, adrenals;
- X-ray examination, computed tomography, magnetic resonance imaging, ultrasound - methods to detect painful processes in almost the entire body of the child.The need for their appointment is decided by the doctor individually.
Treatment of obesity in children and adolescents
When choosing the tactics of treating obesity in children and adolescents, one should consider the need to influence the cause that caused it.
The complex of therapeutic measures includes:
- adherence to a special diet and diet;
- purposeful curative physical training, metered loads, long and mobile walks in the open air;
- conservative therapy of primary and concomitant pathology;
- surgical treatments.
Please note: treatment for obesity in childhood requires accuracy in adherence to recommendations, perseverance, patience, as the healing process is a long one.
All the subtleties of medical treatment should be discussed by doctors and parents of sick children.
Physical activity does not directly reduce weight, but it helps to normalize metabolic processes and does not allow the body mass to grow even more.
Important: The should be reduced gradually, avoiding its sharp drop, which can only aggravate the severity of the existing pathological process.
When obese children should not use ready-made stamps of diets.Diet, multiplicity, amount of nutrition are chosen individually for each patient-child by a dietitian, who takes into account all the characteristics of the patient's personality.There are a large number of developed methods that support the proper organization of the diet.
Physical activity is also selected individually, taking into account the severity of obesity, the temperament of the child, his interests.One of the children is useful for outdoor games, for other swimming, for training in the gym, and for the third - long hiking trips.It is important that the classes are interesting for the patients.
Very useful half an hour walks before bedtime.
Please note: should have a friendly and mutual psychological background, confidential relations, lack of squabbles, scandals and screams in the family.
Periodical visits by the entire family of a psychologist are useful.
Drug therapy for obesity in children and adolescents
In addition to drug treatment of the main pathology leading to obesity, medicines are used that have the ability to suppress appetite.However, these funds are not appointed in all cases, doctors prefer to work with this group of drugs very carefully.
Surgical methods for the treatment of obesity in children and adolescentsWe recommend that:
Surgical treatment of obesity - baryarthria in children is used only in the case of available life indications.We are talking about cases in which a child without an operation will die.
To date, there are a large number of varieties of this type of surgical intervention.Work on their improvement continues.
Prevention of obesity
Provides for the normalization of lifestyle, the establishment of a correct, balanced diet, exclusion from the diet of fast food, carbonated drinks, physical education of children, prevention and treatment of diseases that can lead to the appearance of excessive body weight.
As we see, obesity of children and adolescents is quite a complex problem and requires close attention from parents, educators, medical workers, as it is about the future of young patients, physical and mental health.
Alexander Lotin, medical reviewer