Apr 20, 2021
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Hard childhood. What you need to know about obesity in a child?

Overweight in children is no longer the subject of cartoon films, but a very real situation. WHO is sounding the alarm, as the number of children, even quite young, with extra pounds and excess fat mass, is growing markedly. And we are talking about children who have not reached the age of 5 years. WHO experts note that if the situation continues, then these babies will have serious problems with weight in adolescence and later adulthood.

About why excess weight is dangerous for children and how to deal with it, told Tatyana Butskaya, pediatrician, ONF expert, chairman of the All-Russian public movement “Council of Mothers”

“The problem of obesity is relevant for the whole world. In recent decades, it has only worsened and rejuvenated. Russia “epidemic of extra pounds” also did not pass by. However, the situation among children did not deteriorate as quickly as in Europe, and between 2014 and 2018, statistics even began to improve. Over this period of time, according to the WHO, published in May last year, among 11-year-old Russians, overweight girls decreased by 5%, and boys – by 3%, ”Tatyana Butskaya cites statistics.

Perhaps, the pediatrician notes, the indicators would have continued to improve, but a pandemic and a forced lockdown came. All over the world, children diagnosed with obesity have increased by 10-13%. “I think the same figures are relevant for our country. Just the other day, the Russian Ministry of Health published statistics on the cities in which a record number of obese children live. The three leaders included St. Petersburg, Krasnodar Territory and Rostov Region. In these regions, one in five children, mostly boys, are obese. Moscow, which figured in this top last year, dropped out of the list, ”says Tatyana Butskaya.

Our traditions

Childhood obesity is an obvious problem, the expert notes, but it is often ignored. This is partly to blame for our mentality.

“Firstly, many mothers and grandmothers all the time try to ‘fatten their children’: the more plump the beloved child, the calmer the parents. Secondly, many hope that during a period of intensive growth, extra pounds will go away on their own. After all, many children lose weight during adolescence. It really happens, but mainly with children who are overweight, not obese, ”notes Tatiana Butskaya. At the same time, rarely does anyone think that it is not so easy to defeat a neglected disease.

“Every third child with weight problems will remain overweight even at the age of a teenager, and the list of his illnesses will only increase. Do not forget that obesity is a chronic disease that affects the functioning of almost all organs and systems. Overweight people are doomed to dozens of diseases – from diabetes mellitus and hypertension to atherosclerosis and fatty liver disease, ”the specialist emphasizes.

If a child is a preschooler, the pediatrician says, this does not mean that being overweight does not affect his health. He may have early vascular changes (in the future they will lead to atherosclerosis), orthopedic pathology (X-shaped or O-shaped legs), may slow down or, conversely, accelerate puberty. The child suffers not only physically, but also mentally.

“Obese children quickly become overgrown with complexes and often become the object of ridicule. A round face, crooked legs, stretch marks on the body or an overdeveloped chest (in a boy) can turn a child into a victim of bullying, ”says Tatiana Butskaya.

How to fight

A full child is the responsibility of parents, the expert emphasizes. They should pay special attention to the weight of their child at an early age under 3 years of age and in adolescence. The peak of the rapid set of extra pounds usually falls at 11 years old due to hormonal changes.

“If you see that a child is getting fat, you need to show him to the doctor and find out the reason for the excess weight. In 98% of cases, children gain weight due to banal overeating and low physical activity. In the remaining 2%, obesity can be explained by health problems, ”emphasizes Tatiana Butskaya. These problems include:

  • Iatrogenic obesity is caused by long-term medication (eg, glucocorticoids).
  • Hypotolamic obesity occurs when the hypothalamus, the part of the brain that controls hormone production and many functions, including hunger, is disrupted. This type of obesity can be associated with head trauma, brain infection, or tumor development. The child begins to rapidly gain weight, and the fuller he becomes, the more complaints arise. Bedwetting may begin, growth slows down, hearing decreases, and convulsions appear.
  • Endocrine obesity develops due to the pathology of the endocrine glands.
  • Monogenic obesity becomes a consequence of a mutation in a gene.
  • Syndromic obesity occurs with chromosomal and other genetic syndromes.

The doctor will take a history, examine the child, assess his weight, height, sexual development and prescribe:

1. Analysis for hormones (if endocrine disorders are suspected);

2. Glucose tolerance test (detection or exclusion of diabetes mellitus, assessment of carbohydrate metabolism);

3. Biochemical blood test (assessment of fat metabolism, cholesterol levels and liver condition);

4. Ultrasound (to assess the state of internal organs);

5. ECG.

Additionally, if there are problems with the cardiovascular system, the child may be referred to a cardiologist. Based on the results of the examination, the young patient will be prescribed a diet and, if necessary, medications (for example, in case of a violation of carbohydrate metabolism, but provided that the child is over 10 years old). Surgical methods of treating children and adolescents are not practiced in Russia.

“In the first weeks of losing weight, you need to feed the child according to the age norm. As is clear from the calculations of experts, this is already a significant limitation: overweight children usually overeat. In a few weeks, the child will adapt and it will be possible to switch to a low-calorie diet 5-6 times a day. The menu should focus on complex carbohydrates rich in fiber (vegetables and cereals), and exclude fast carbohydrates (buns, sweets, cookies, sugar). The amount of fat in the diet should be reduced, more than half of which should be omega acids and vegetable fats. All fried should be replaced with raw, steamed or boiled. You will have to forget about hot spices and sauces that stimulate appetite, ”the expert emphasizes.

You should remember about the food culture. Forbid your child to eat in front of a computer or TV, do not allow your child to eat at night. It is very important to observe the daily regimen and increase physical activity under the supervision of a doctor, notes Tatiana Butskaya. “Encourage the child to walk, walk, run a lot. Cancel trips to school (by tram, car), let him go on foot. Don’t buy devices that run after your child. I mean electric scooters and hoverboards. Buy your child an ordinary bicycle, a rope, a frisbee plate, a ball – with them physical activity will only be a joy, and the extra pounds will go away unnoticed. Sign up your child in the pool or go on vacation to the sea, but do not buy an all inclusive, ”the pediatrician sums up.

If the child is ready to work out at home or in the gym, that’s great. You should start with exercises that do not put a heavy load on your legs. It is advisable to do it while sitting, lying down or on the wall bars.

In addition, it is necessary to weigh the child daily and keep a weight loss diary, while tracking that the child loses weight at a reasonable rate, and his dream of gaining a standard figure does not lead, as it happens with teenage girls, to starvation and anorexia.

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