The Little Emperor – Part One – Medical Problems Associated With Childhood Obesity
The sleep-over was in full swing, eight rambunctious ten year-old boys laying waste to the room assigned to them, with pillow fights. Clearing the table of the remnants of dinner, I figured that I could have a little me-time. A plaintive voice was, however, piping up behind me, “Aunty, can I have ice-cream?” It was B, the roly-poly and quiet boy who was huffing and puffing after the pillow fight, which seemed to have winded him.
This was the child whose mother had sent a bag containing chips, fries and chocolate with her child, items normally restricted in our home. He had, earlier, proceeded to empty the contents of his goodie bag at record speed, munching away while the rest of the group played football in the clearing in the building compound.
Now, half- an-hour post dinner, he was craving ice-cream, which he proceeded to wolf down in alarming quantities to the accompaniment of giggles and sniggers from the other children.
This child brought to mind the obese Chinese children born of the single-child policy nicknamed “the little Emperor” phenomena by the Western media. Pampered and overindulged, these children grow up in urban families who seem unable to say “no” to them.
Is childhood obesity harmful?
All over the world, childhood obesity is being recognized as a health problem. Here’s why –
1.) Obese and overweight children run a very high risk of developing early hypertension and high cholesterol. At least 70% of obese children and adolescents have at least one risk factor of cardiovascular disease.
2.) They have higher blood sugar levels or are prediabetic, thereby being at a higher risk of being diabetic later.
3.) Obese children develop early arthritis, bone problems, sleep apnea, etc.
4.) Obese children have low self-esteem and could be stigmatized by their peer group. Teasing and bullying is a common feature in the childhood of overweight and obese children.
5.) Obese adolescents run the risk of having self-image issues, low self-confidence. They may suffer from anorexia or binge-eating, crash dieting, etc in order to fit in with their peer group.
As adults they could face the following problems-
1.) They have a higher chance of developing cardiovascular disease and diabetes, that too at an early age.
2.) Prone to develop joint pains, early arthritis, etc.
3.) Some types of cancers such as colorectal, breast, kidney, multiple myeloma, etc are commoner in overweight and obese persons.
4.) Obesity in children can result in structural changes in the thyroid gland.
Some recent data even suggest that healthy eating (quality rather than quantity) during pregnancy should be emphasized, as it reduces risk of obese offspring. The old wives’ dictum of eating for two during pregnancy should thus be taken with a pinch of salt.
Does MY child suffer from obesity??
Parents are often indulgent and blind to their child’s weight-gain, especially mothers who believe that a well-rounded child is also a testament to their good mothering. Moreover, it is difficult to be objective about your own child’s weight.
So what should a parent do when they suspect that their child is overweight?
The best solution should be to consult a pediatrician, if one is worried. Dr. Vikram Mardhekar, a Paediatrician practicing in Mumbai says, “Vaccination schedules and minor childhood ailments are a regular feature of childhood; so if the pediatrician mentions that your child’s weight is higher than is healthy, it is important to pay heed.”
An impartial marker of obesity is BMI or body mass index, which is the ratio of weight to height. Depending on the percentile of this value, the child is classified as underweight, normal, overweight or obese. This system is only used for children above the age of two years. However, although BMI above the 85th percentile indicates that child is overweight, sometimes a muscular child may have a higher BMI without being obese. Puberty with its growth spurts can often give misleading results.
Some conditions such as hypercortisolism, hyperinsulinemia, hypothyroidism, polycystic ovary syndrome, Laurence-Moon-Biedl syndrome, and Beckwith-Wiedemann etc all can lead to obesity.
Recently, an ‘obesity gene’ is also being implicated in obesity.
After calculating the BMI, examining and assessing the eating habits and activity levels, the pediatrician could refer the child to a dietician or an advanced weight loss programme.
How many times have we stopped to wistfully smile at the chubby child in the park or tweek the cheek of the roly-poly neighborhood kid? Studies indicate that obesity at an early age (even as early as two years) could be a marker of cardiovascular risk in later life. So the cooing and admiring of extremely chubby young children should perhaps be replaced by subtle warnings to their parents about their future health.
As a doctor who has seen the short and long term effects, I cannot emphasize enough, the need to prevent and treat obesity as seriously as any other illness in childhood.