Currently 1 in 4 children in Chennai are either Obese or Overweight. In order to provide a highly specialized care for these children and adolescents with weight problems, we at Kids N Teens Child Speciality Clinics have started this multi-disciplinary clinic lead by our senior Consultant Pediatric Endocrinologist, Dr.Anbezhil Subbarayan. Here are some practical tips to help these children and family to change their lifestyle for healthy future.
Step 1 : Look for cause – Your doctor will do some tests to look for endocrine and genetic cause if clinically suspected.
Step 2 : Your doctor will assess for complications and co-morbidities if
1. Any symptoms suggestive of complications
2. Any signs suggestive of complications like Acanthosisnigricans
3. In all severely obese individuals
4. Patients with strong family history of metabolic syndrome
1. Insulin resistance/ Type 2 diabetes – check fasting glucose, fasting insulin and HbA1C
2. Hypertension –Check BP
3. Dyslipidemia – Fasting lipid profile
4. Non-alcoholic fatty liver disease – Check LFT and USS liver
Step 3 :Lifestyle modifications
This is the main stay of treatment of obesity however this should be individualized based on the assessment.
- Detailed dietary assessment preferably by a Pediatric dietician is a valuable tool to create an insight into the dietary habits.24 hrs dietary recall helps to calculate the total caloric intake and to plan a detailed diet chart with various healthy options of snacks.
- Avoid deep fried and oily foods
- Less sweets and chocolates
- Children should not to be distracted while eating by watching TV/mobile or reading books
- Eat more fruits and vegetables
- The above advice is for each and everyone in the family irrespective of their weight status
- Exercise/ activities should be incorporated in normal day to day life
- Preschool children should be engaged in unplanned activities/play
- Types :
i) Aerobic – brisk walking/ jogging, dancing etc
ii) Endurance/anaerobic– Weight lifting, exercise against resistance
iii) Flexibility - Yoga
iv) Non-exercise activity thermogenesis(NEAT)–energy spent by increasing normal day to day activities by being fidgety
- Combination of these exercises gives as many choices and reduces boredom.
- Minimum of 1 hr/day in total of exercises is strongly recommended
Step 4 :Behavioral modifications
- Most people in our society still believe that being overweight/obese is healthy and wealthy. This attitude should be changed by regular health education.
- Motivation should be encouraged
- Regular exercise and healthy eating should be incorporated within the family and the society
Step 5 : Medications
- Medications should be considered as a last resort when life style modifications fail or in severe obese individuals or obese children with associated complications. Only very few medicines are licensed in children for treatment of obesity and should not be taken without prescription from your doctor.
- It has to be clearly emphasized to the patient and their parents that dietary changes and regular exercise is still the main stay of therapy and these drugs have very modest effect only along with lifestyle changes and not on their own.
Everyone in our society is responsible for this disaster and should take some responsibility to fix this problem.
1. Parents :
Both parents should understand the importance of healthy eating and regular exercise to maintain good health. They should choose healthy foods and engage in different activities as a family as a whole.
2. School :
The school authorities should tailor the curriculum according to the child’s performance and provide adequate time for physical education and sports. As every child is been assessed in every subject, there should also be assessment for cardio-vascular fitness regularly. The height and weight of every child should be measured annually and plotted in appropriate charts to identify the problem early. Also the school should provide only healthy snacks and lunch at the school premises.
3. Doctors :
Doctors/ Pediatricians should grab each every encounter with their Patients and their family members to identify overweight/ obesity at an early stage and give appropriate advice. They also have a duty to ensure that there are no medical reasons like hormonal or genetic cause for the increase in weight.
4. Government :
The local, state and central government should work together to create laws and ensure adequate space are provided for playgrounds, leisure centers with sports facilities, safe roads for walking and cycling, encourage car free zones and days, adequate public transport etc.
5. Food industry :
The food industry should give people healthier choices with the calorie content listed in each and every food item.
It is a collective responsibility of each and everyone to keep our society healthy. Lets change our lifestyle now for good and aim for a healthier future.