Understanding the Causes of Obesity in Children and Adolescents

Causes of Obesity in Children & Adolescents: Unraveling the Complex Factors

Recognizing the Growing Epidemic

According to the World Health Organization (WHO), children and adolescents from all walks of life, are increasingly facing the health threat of excess body fat, leading to overweight and obesity.

However, managing weight isn’t a quick fix; it’s a journey that requires lifelong support. The WHO emphasizes the importance of sustainable lifestyle changes that promote long-term well-being, not crash diets or rapid weight loss.

We used to think weight was simply about ‘calories in’ versus ‘calories out’, but science reveals a more complex picture. Genetics, environment, stress levels, emotional well-being, sleep patterns, underlying medical conditions, and even medications can all influence how our bodies store and manage fat.

Recognizing this complexity is crucial.

By addressing these multifaceted factors – behaviour, environment, and genetics – we can create a more effective and holistic approach to childhood weight management, paving the way for a healthier future for all.

Genetic Factors Contributing to Obesity

While we inherit a blueprint (genes) that influences weight, obesity isn’t just about our DNA. It’s a complex mix of factors. Genes can make some people more likely to gain weight, but hormones, metabolism, and even our culture and habits can all play a role in fat storage.

Even early in life, certain factors can increase a child’s chances of becoming obese. A mother’s weight before pregnancy, how much weight she gains while being pregnant, and even gestational diabetes (pregnancy-related high blood sugar) can all play a role. These factors can sometimes lead to a higher birth weight for the baby, which can independently be a risk factor for obesity, later in life. Additionally, a family history of weight issues, diabetes, high blood pressure, or certain hormonal problems can also increase a child’s risk of being overweight.

The good news? …Even with a genetic nudge, healthy choices like diet and exercise can make a big difference.

Dietary Habits and Nutrition

Childhood obesity may be linked to certain dietary habits. One major contributor is the overconsumption of calorie-dense foods that are low in essential nutrients. This includes things like processed snacks, fast food, and sugary drinks. These types of foods are often heavily marketed to children, making them even more appealing. While the research is ongoing on the exact impact of other dietary factors like snacking frequency, meal skipping, or one’s eating speed, it’s clear that an overall healthy diet plays a crucial role in weight management for young people.

Shedding extra kilos through calorie restriction (dieting) may be an effective strategy in the short term, but it’s important to consider how our bodies respond over time. While dieting offers a jumpstart, our bodies adapt to changes in calorie intake. This adaptation can sometimes involve a slowdown in metabolism, making it trickier to maintain weight loss in the long run.

Physical Activity Vs Sedentary Lifestyle

Children tend to become less active as they grow older, with a dip seen around age 6 and another around 13. This is especially more true for girls than boys. Children who are overweight or obese tend to move less throughout the day compared to their thinner peers. There’s also a general trend of children spending more time sitting as they get older.

Catching those Zzzs is important for more than just feeling well-rested! Studies have established a direct link between sleep habits and weight gain in children. Children or adolescents who don’t get enough quality sleep, whether it’s due to shorter sleep duration, restless sleep, or going to bed too late, seem to be at a higher risk for obesity. This might be because insufficient sleep is associated with being less active, having unhealthy eating habits, and even developing insulin resistance.

Screen time could also play a role. Too much screen time can disrupt sleep patterns and potentially mess with hormones that control hunger and fullness. Think of it as a domino effect: less sleep can lead to cravings for unhealthy foods and less energy for exercise, which can contribute to weight gain.

Psychosocial and Economical Factors

Weight stigma, the societal devaluation of people who are overweight or obese, can be a major psychosocial factor contributing to obesity. Negative stereotypes paint them as lazy and lacking willpower, creating a discouraging environment. This stigma manifests as bullying and social rejection, especially for children, impacting their mental health and self-esteem. The stress and negativity can even lead to disordered eating behaviours, making weight management even harder. Feeling ashamed and less motivated to participate in social activities due to weight stigma can further hinder progress. This cycle of negativity and discouragement creates a significant barrier to healthy lifestyle changes for those struggling with weight.

Building on the complex challenges of weight management, obesity also carries a significant cost burden. Not only does it strain healthcare systems financially, but it also has a profound impact on individual and societal well-being. The long-term nature of obesity means managing weight requires sustained commitment and lifestyle changes. This burden, coupled with psychosocial factors like weight stigma, can create a discouraging cycle that makes weight management even more difficult.

Environmental and Socioeconomic Influences

Our surroundings strongly influence how we live and our health. Modern life has become less active. Cars replaced walking, technology replaced exercise, and quick meals replaced healthy cooking. This makes it easy to fall into unhealthy habits like eating poorly and not getting enough exercise. As a result, we consume more calories than we burn, leading to weight gain.

The obesity spike in recent times is largely due to the surrounding environment that promotes weight gain.
This can happen at the family level (habits modelled by parents), community level (access to parks, healthy food options, and safe walking areas), or even national policies (government food subsidies or marketing practices). These influences can take advantage of our biological, psychological, social, and economic vulnerabilities.

Prevention Strategies and Early Intervention

Helping children and adolescents with obesity requires a multi-faceted approach. The goal is to reduce excess body fat, improve health problems related to weight, and prevent the development of chronic diseases in the future.

Treatment typically integrates a combination of different components. This may include learning healthy eating habits with the help of a nutritionist, incorporating regular physical activity into the child’s routine, and providing psychological support to address any emotional challenges associated with weight. In some cases, medication might be prescribed to assist with weight management.

Metabolic and bariatric surgery offers the best long-term results for weight loss in severely obese adolescents.
Studies show significant weight reduction (25-40%) even years after procedures like Roux-en-Y gastric bypass or sleeve gastrectomy.

The benefits go beyond weight loss!

Individuals often see improvement in health problems linked to obesity, like cardiometabolic risk factors, musculoskeletal pain, and functional mobility.

References:

showPdf (thelancet.com)

What is obesity? (bomss.org)

Obesity – American Society for Metabolic and Bariatric Surgery (asmbs.org)

https://www.atulpeters.com/blog/obesity-children-adolescents/

Obesity in Metros

Addressing the Growing Concern of Obesity in Metros: Causes and Implications

Obesity is a medical condition when a person carries excessive weight. It increases the risk of various non-communicable diseases like type 2 diabetes, hypertension, etc. For weight maintenance, energy intake should be equal to energy expenditure. Imbalance leads to underweight and obesity.

Adults residing in Metropolitan cities are increasingly becoming obese. Even Childhood obesity is also emerging as a major health concern in metros. The reasons being excess consumption of calorie-dense fast food, processed food, ready-to-eat food, etc. Portion sizes that fast food restaurants offer contribute to excessive energy intake. As most of the fast foods are made of refined cereals, fat, and sugar. There is a drastic decrease in energy expenditure owing to reduced physical activity as people use motorized means of transport and spend most of their awake time sitting glued to Television, mobile phones, and Laptops. The present work culture in the corporate and public sectors is also responsible for obesity in adults. Long working hours, late night shifts, sitting jobs, sleep deprivation, excessive tea and coffee consumption, and unhealthy snacking in offices predispose obesity.

Obesity surgery in India is being performed to facilitate weight loss in children and adults when non-surgical treatment strategies fail. Although GI surgeons and general surgeons in India are performing obesity surgery specially trained bariatric surgeons are now available. Bariatric surgery is growing as a specialty in itself. as surgery constitutes only a small part in overall management. A fully equipped, and well-staffed department is a must for the dedicated follow up which is so essential for good outcomes. A dedicated high-volume Bariatric surgery unit in a tertiary care hospital is your best bet if you are seeking bariatric surgery.

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Can Malnutrition cause obesity?

How Malnutrition Can Cause Obesity: Insights from Top Bariatric Surgeons

Obesity is a multi-factorial disease; it simply means that, no single cause which can be solely attributed to it. It is also well known that scientists do not know exactly what exactly causes weight gain. Often, we all see people who can eat whatever comes their way and they still remain thin. With the exception of these lucky few, we are programmed to gain weight with age.

According to top bariatric surgeons, it is a matter of the balance between what you eat, and how much you spend. If we consume calorie-dense food regularly and don’t burn those extra calories, we are likely to gain weight. But can malnutrition cause obesity?

Surprisingly yes.

Obesity Surgeons who treat obese teens know that children who were underweight at birth are prone to gain too much weight in their childhood and adolescence. Children who faced food shortages during famines later on developed abdominal obesity, the classic Indian Subcontinent profile of thin people with paunch, the so-called thin- obese in medical jargon. As we know that the tummy fat or abdominal obesity is the medically worst. This fat is the harmfully active type that leads to diabetes, heart disease, and cholesterol disorders, the so-called metabolic syndrome.

Malnutrition means not eating right; right food at the right time. People who starve for too long to lose weight are initially successful in losing some weight, but complex hormonal reactions result in weight regain, overshooting the earlier weight. This is known Yo-Yo dieting. Secondly, prolonged fasting slows down our metabolism and stops losing further weight, and starts regaining on the same diet. We tend to lose more muscle mass than fat during the starvation phase and fail to regain our muscle back. So with each dieting cycle of malnutrition, we lose more and more muscle mass and gain more fat.

Starvation or fasts followed by eating calorie-rich low protein food ultimately results in further weight gain and obesity. The best bariatric surgeons know well from their experience that protein-deficient diets after bariatric surgery are counterproductive in the long run and patients may end up regaining all their weight.

Malnutrition can really make us obese.

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Obesity in Children and Adolescents

Addressing Obesity in Children and Adolescents: Causes, Risks, and Effective Interventions

The prevalence of obesity is increasing in both children and adolescents, in both sexes and in various ethnic and racial groups.

Many factors, including genetics, environment, metabolism, lifestyle, and eating habits, are believed to play a role in the development of obesity. However, more than 90% of cases are idiopathic; less than 10% are associated with hormonal or genetic causes.

Defining Obesity in Childhood and Adolescence

There is no single definition of obesity in childhood and adolescence.

Consensus committees all over the world have concluded that children and adolescents be considered overweight or obese if the BMI exceeds the 85th or 95th percentiles, on curves generated from the 1963-1965 and 1966-1970 NHANES, or exceeds 30 kg/m² at any age.

Energy Intake and Sedentary Lifestyle

During childhood and adolescence, excess fat accumulates when total energy intake exceeds total energy expenditure. Reduced energy expenditure is attributed to modern-day sedentary lifestyles. This is particularly associated with excessive television viewing, excessive computer use, and insufficient physical activity. Also, this is often seen when feedings are supplemented with additives such as carbohydrates or fat.

Hormonal Dysfunction and Familial Obesity

Some hormonal dysfunction like that in ghrelin leptin hormonal axis may be the causative factor in as many as 10% of obese children, particularly in those who appear to manifest familial morbid obesity.

Race and ethnicity are also associated with increased rates of obesity in children and adolescents.

Childhood Obesity as a Predictor of Adult Obesity

Childhood obesity is predictive of adult obesity such as with 80% of teenagers who are obese continue to be obese as adults.

This is associated with an increased incidence of type 2 diabetes, hypertension, gallstones, and hypercholesterolemia.

Chest Conditions Associated with Childhood Obesity

There are serious chest conditions associated with childhood obesity like reactive airways, poor exercise tolerance, increased work of breathing, and increased oxygen consumption.

They might develop obesity-hypoventilation syndrome and experience right-sided heart failure with right ventricular hypertrophy.

Acute Complications of Childhood Obesity

Acute complications of childhood obesity include hyperlipidemia, accelerated growth and bone maturation, ovarian hyperandrogenism and gynecomastia, cholecystitis, pancreatitis, and pseudotumor cerebri.

There is an increased incidence of fatty liver and they might develop liver cirrhosis and kidney disease.
Obstructive Sleep apnea and sleep-disordered breathing are common in children and adolescents with obesity which might lead to neurocognitive dysfunction.
Excess weight in children can cause numerous orthopedic disorders, including genu valgum, slipped capital femoral epiphysis, with bowing of the long bones.
Emotional and psychosocial sequelae are also widespread in obese children.
Social isolation, peer problems, and lower self-esteem are frequently observed.
Gout and colorectal cancer rates are found to be increased among men who had obesity as adolescents as well as arthritis.

Therapeutic Interventions for Childhood Obesity

Any therapeutic intervention in the child with obesity in aimed to achieve control of weight gain and reduction in body mass index (BMI) safely and effectively and to prevent the long-term complications of obesity in childhood and adulthood.

These might also require psychiatric assistance for unusual eating disorders or severe depression. It involves a team involving nurse educators, nutritionists, exercise physiologists, and counsellors.

Parental Involvement and Lifestyle Changes

Parents must advice children to walk at least 20 to 30 min daily. Limit their television timings and must indulge in vigorous exercise with children. Low-calorie balanced diet, in association with patient and parent education, behavioral modification, and exercise can limit weight gain in many patients with mild or moderate obesity. Reductions in total and saturated fat may be particularly useful in adolescents who consume large quantities of high-fat, snack, and packaged fast foods, including french fries, pizza, chips, and crackers. Also, they might sometimes require and care if evidence of psychopathology or dysfunction is present.

Bariatric Surgery for Childhood Obesity

According to Dr. Atul NC Peters, one of the pioneers of weight loss treatment in Delhi and among the top 10 obesity surgeons in India, various bariatric surgical procedures have been performed in “carefully selected” patients with a body mass index (BMI) >40 kg/m ² who have severe comorbidities such as nonalcoholic fatty liver disease. It is important to consider several other factors before deciding whether a child or adolescent should undergo bariatric surgery like previous attempts at weight loss, and ability to adhere to follow-up care. Laparoscopic sleeve gastrectomy is the most widely performed procedure in childhood obesity nowadays.

Evidence suggests that bariatric surgery can decrease the grade of steatosis, hepatic inflammation, and fibrosis in Non-Alcoholic Fatty Liver Disease. With more and more people opting for various bariatric surgical procedures, weight loss surgery cost in Delhi has been such that it is becoming affordable day by day and several finance and loan schemes are also available in special circumstances.