In recent years, there has been a rapid increase in the number of children and adolescents with problems with excess weight. Excessive deposition of adipose tissue in the body, that is, obesity, is a disease that needs to be treated. Obesity in children can lead to serious health problems: diseases of the gastrointestinal tract (constipation, diarrhea, cholecystitis, pancreatitis, etc.), cardiovascular system (arterial hypertension, heart problems), atherosclerosis, insulin resistance, type 2 diabetes mellitus , disorders of sexual development, endocrine and metabolic disorders, arthrosis, sleep apnea, bulimia, anorexia, etc. And this is not to mention psychological difficulties, problems with self-esteem, complexes, ridicule of classmates... In general, if you suspect your child has excess weight - don’t let things take their course, contact an endocrinologist!
Our consultant: endocrinologist, nutritionist at EuroMed Clinic Natalya Vladimirovna Michurina.
Causes of obesity in children
The development of obesity is usually influenced by both genetic predisposition and lifestyle. Essentially, excess weight occurs when there is an energy imbalance—when more calories are consumed than are expended. That is, simply put, with an unbalanced diet, overeating and low physical activity.
In addition, obesity can develop due to serious pathological conditions and genetic diseases.
Children who are overweight usually do not eat the healthiest food. Their diet is dominated by fast carbohydrates: baked goods, sweets, desserts, juices, carbonated drinks; as well as fats: fast food, fried, fatty foods. At the same time, there is very little protein, fiber and water.
Modern children also do not have enough physical activity: they spend most of the day sitting at a desk at school, doing homework at home, playing computer games, watching TV or a tablet. That is, children have a fairly intense mental load, but there is a catastrophic lack of movement.
If obesity is detected, the doctor will most likely recommend performing a biochemical blood test and a hormonal profile study. The child may need to have an ultrasound of the thyroid gland, an ultrasound of the abdominal organs, an MRI of the pituitary gland, and some other examinations. In addition to the help of an endocrinologist, the child may need consultation with a neurologist, geneticist, gastroenterologist, cardiologist, orthopedist, psychotherapist and other specialists.
Intestinal flora and child weight
Many scientists are of the opinion that the composition of the intestinal microflora affects not only the health and development of the child, but also his weight . If an imbalance occurs between beneficial bifidobacteria and lactobacilli and pathogenic microflora, and the latter begin to “take over”, then under their influence fermentation processes begin. As a result, complex organic substances are broken down and hydrogen is released, which is absorbed by special methane-producing bacteria. Interestingly, obese people, including children, have a higher percentage of such bacteria in their intestinal tract than people with normal body weight. The “solution” is that these microorganisms actively break down indigestible proteins and carbohydrates, which is accompanied by the production of additional energy, which in turn leads to weight gain.
Often the cause of excess weight is the slagging of the child’s body, especially the intestines, which turns into a kind of “garbage heap” of undigested remains of refined food, in which opportunistic microorganisms feel at ease.
Types of obesity
Depending on the causes, there are two forms of obesity: primary and secondary.
Primary may be associated with hereditary predisposition (exogenous-constitutional) and associated with poor nutrition (alimentary). In such cases, the family plays a huge role in the formation of obesity, since the characteristics of nutrition and lifestyle, the desire to play sports, are primarily instilled by parents.
When we talk about hereditary predisposition, we are not talking about the fact that excess weight is inherited - the peculiarities of metabolic processes in the body are genetically determined. That is, how fast a child’s metabolism is and how quickly he will gain weight when overeating depends on heredity.
Nutritional obesity
, most often, occurs during critical periods of development: up to 3 years of age, in early childhood (the risk group for obesity includes children who weigh more than 4 kg at birth, who gain too much weight every month, who are bottle-fed), preschool age , at 5-7 years, and during puberty - at 12-16 years.
Secondary obesity
occurs as a result of various congenital and acquired diseases: endocrinopathies, damage to the central nervous system, psychopathological conditions, etc. Most often, endocrine diseases lead to secondary obesity (problems with the thyroid gland, adrenal glands, pituitary gland, ovaries in girls). Thus, obesity can be a symptom of a disease, but only a doctor can figure it out.
There are four degrees of obesity in children:
- Obesity I degree - the child’s body weight exceeds the norm by 15-24%.
- Obesity II degree - the child’s body weight exceeds the norm by 25–49%.
- Obesity III degree - the child’s body weight exceeds the norm by 50–99%.
- Obesity IV degree - body weight exceeds the permissible age norm by more than 100%.
Child’s weight: what are its features?
Childhood obesity is understood as a condition when a child’s weight exceeds the age-height standard by 15% . And extra pounds in childhood are considered a more serious problem than a similar condition in an adult. And all because the child’s body is just forming and does not need developmental adjustments that obesity can make. That is, disruptions may occur that, in older age, turn into diabetes, hypertension, and cardiovascular diseases.
But before you start dealing with this problem, you need to find out whether your child has it. It’s just that, unlike adults, children need additional nutrients as they grow and develop. That is, if a child consumes the amount of calories he needs for growth, metabolism and daily activity, then he will gain pounds in proportion to his height . If the energy intake from food exceeds the mentioned needs, then weight gain begins, which is then extremely difficult to get rid of. Therefore, it is important to determine whether your child’s existing kilograms are truly excessive, and where the limit comes when additional calories become too many and they begin to be deposited in fat depots.
Obesity treatment
When treating obesity, the main measures are aimed at reducing body weight and preventing subsequent excess weight gain.
If obesity is secondary, then the doctor will begin by treating the pathology that provokes the development of obesity. But in both primary and secondary obesity, in order to reduce body weight, a change in the child’s lifestyle is necessary: correction of the diet and rational physical activity.
First of all, it is recommended to limit foods containing animal fats and fast carbohydrates in the child’s diet. Meals should be 5-7 times a day. Together with the doctor, the daily calorie intake for the child is calculated, and parents must follow it.
In parallel with changing the diet, it is necessary to change the child’s motor mode. For very young children, long walks and outdoor games are recommended; preschoolers and schoolchildren need to add age-appropriate sports activities (swimming, cycling, athletics, etc.). It is important to understand that a doctor can determine the causes of obesity and give detailed recommendations, but parents must monitor the child’s nutrition and physical activity. And you need to take this as seriously as possible!
The “food promiscuity” factor
Unfortunately, many parents do not notice the point beyond which the excess intake of additional calories into the child’s body begins. In other words, banal overeating occurs. It is provoked by such a widespread factor in our society as “food promiscuity.”
Food has become a real cult for modern people, and our children are adopting this health-damaging trend from adults. Sweets of all kinds, pastries, sweet soda, chips, hamburgers - these temptations are difficult for a child to pass by. The child is also overfed with homemade food. For example, the “good grandmother” syndrome is well known, when feeding a grandson turns into a special ritual. Such grandmothers work their magic every day at the stove, not knowing what other culinary masterpiece to please the little family member who is already so big in size that he barely fits at the dining table. In one of the TV shows, a 38-year-old man admitted that if it weren’t for his grandmother’s obsessive desire to constantly feed him as a child, adult life would have turned out differently. With a height of 180 cm, he weighs 120 kg and experiences serious complexes because of this. The man is still not married, because he is ashamed of himself, his body and therefore does not meet women. Attempts to lose weight invariably ended in failure. Would you really want such a fate for your child?
Obesity prevention
It is easier to prevent any problem than to treat it. Therefore, the task of parents from a very early age of the child is to organize an adequate diet and physical activity for him.
Set a goal to form the right eating habits in your child, instill in him a love of healthy nutrition. You should not overuse fast food and sweets - the later your child gets acquainted with these products, the better. The child's diet should consist of a large amount of vegetables, fruits, complex carbohydrates (porridge, whole grain bread), lean meat, fish, and low-fat dairy products.
Instill in your child a love of movement.
With the little ones you can do gymnastics and visit the pool (children's pools accept babies starting from two months), walk in the fresh air as much as possible. When the baby begins to walk, do not limit him, let him walk, run, fall, get dirty, hit himself - he will learn the world through movement.
When your child grows up, enroll him in a sports section.
Now there are a huge number of clubs for children of various levels of training. Choose with your child what kind of sport he likes: running, dancing, cycling, skiing, figure skating, hockey, football, basketball, swimming, wrestling - there are a lot of options. Be sure to support your child's passion for sports.
Of course, it is important that parents show their children an example of a healthy lifestyle.
, you must admit, you cannot convince your child to eat broccoli and steamed cutlets while you yourself dine on French fries. Yes, and such nutrition is not useful for parents, but physical activity is necessary. So organize a healthy lifestyle for the whole family - and you will avoid serious health problems for both yourself and your child.
Other causes of weight gain
Intestinal flora
One of the factors that reduces the risk of obesity is adequate microbial colonization of the newborn baby's intestines. This process depends on the health status of the mother, the diversity of the maternal microbiota, childbirth (naturally or via cesarean section), the nature of feeding, and the use of antibacterial therapy.
Sleep duration
The next risk factor is a decrease in sleep duration in an infant. It is assumed that reducing sleep time reduces the level of leptin (a hormone that regulates energy metabolism) and increases the concentration of ghrelin (the so-called “hunger hormone”), which is accompanied by an increase in appetite. Another mechanism for the relationship between sleep and excess body weight is an increase in the number of feedings when the child is restless for a long time, especially at night. It is not always necessary to immediately feed the child when waking up at night; it is necessary to take a certain pause, you can offer the child water.
Feeding should not be used as the only means of calming a child, especially when he is older than 2-3 months. This leads to increased food consumption and increases the risk of obesity.
The causes of anxiety are numerous: functional digestive disorders (usually colic), thirst, uncomfortable position of the child, full diapers or wet diapers, fatigue from prolonged wakefulness, desire for communication, etc.
For timely detection of excess body weight gain, all children require monthly monitoring of growth and weight dynamics.
Protein in the diet
The growth rate of a child is determined by the protein content of the diet. Excessive consumption of dairy products increases the risk of obesity. Therefore, it is recommended to introduce non-adapted fermented milk products (cottage cheese, biolact, yogurt, kefir) from 8 months and not to exceed the recommended amount. At the same time, their intake is important for the child, since they are necessary for the growth and development of children and also have a positive effect on the composition of the intestinal microbiota, which changes during the introduction of complementary foods. It is not advisable to use whole cow's milk in a baby's diet in the first year of life. It is important to note that meat puree predominantly increases body length.
How to Diagnose Overweight
For timely detection of excess body weight gain, all children, regardless of the type of feeding, require monthly monitoring of the dynamics of anthropometric indicators (weekly in the first month of life). Currently, it is recommended to use the Child Growth Standards developed by the World Health Organization. You can go to the website and print centile tables: weight for age, length for age and weight for height, taking into account the age and gender of the child. The averages are between the two yellow lines – the 15th and 85th centile curves. Not only the indicators at a given time are important, but also their dynamics. The peculiarities of the child’s constitution should be taken into account. A pediatrician will help you understand the situation.
Clinical recommendations for prevention: what to do?
More precisely, what exactly you shouldn’t do, we tell you in the article Why is it harder for you to lose weight if you were a chubby child? .
Brief conclusions in clear language:
- the number of fat cells is formed before the age of 20;
- if you have a large number of fat cells, it is very difficult to lose weight: the body will influence you with the help of hormones, you will literally be overwhelmed by the desire to eat;
- Excess weight before the age of 20 is a direct road to excess weight in life.
Symptoms
- Fat deposits in the abdomen, thighs, etc.
- Dyspnea.
- Fatigue, weakness, drowsiness.
- Oily skin, acne, excess hair growth, irregular menstruation (in girls).
- Cryptorchidism, underdevelopment of the penis (in young men).
- Constipation.
- Arterial hypertension.
- Dysfunction of the sex glands.
Complications:
hypertension, atherosclerosis, type 2 diabetes mellitus, angina pectoris, pancreatitis, chronic cholecystitis, hemorrhoids, constipation.
Diagnosis of obesity is based on a mandatory examination by an endocrinologist and anthropometry. Additionally, ultrasound and laboratory tests may be prescribed.
