Four renowned doctors share insights on the dangers and management of childhood obesity. Physical & Psychological Effects Of Childhood Obesity

Mapping The Surge: Prevalence & Patterns Of Childhood Obesity

Dr Suresh Lalwani, MBBS, 1996, from SMS JAIPUR; MD (Pead) SN Medical College, Jodhpur, 2000; SR from National Pediatric Center, Delhi; Past President, IAP Hadhoti Society; Director, Lalwani Nursing Home; Visiting Consultant, Shri Ji Hospital.

The prevalence of childhood obesity has escalated to alarming levels. The increase in being overweight from 8% to 20% among children and adolescents aged 5-19 between 1990 and 2022 underscores the magnitude of this public health challenge. This surge is not limited by gender, with 19% of girls and 21% of boys classified as overweight in 2022. Furthermore, the obesity rates within this age group have quadrupled, from 2% in 1990 to 8% in 2022.

The situation is particularly concerning among younger children. In 2022, 37 million children under 5 were overweight. The geographical distribution reveals a stark reality: Almost half of these children resided in Asia, highlighting the global nature of the epidemic and its reach beyond traditionally high-income countries.

The rising prevalence of childhood obesity calls for urgent comprehensive strategies that include promoting healthy eating, increasing physical activity, and providing education about maintaining a balanced lifestyle. Early intervention is critical to prevent the progression of obesity into adulthood, where it poses greater risks for noncommunicable diseases such as diabetes and cardiovascular diseases. Policies aimed at reducing the consumption of energy-dense, nutrient-poor foods, increasing access to affordable healthy foods, and providing safe spaces for physical activity are essential steps towards reversing this trend.

Physical & Psychological Effects Of Childhood Obesity

Dr Sahil Virmani, practicing paediatrician and neonatologist for the last 14 years. MBBS from Delhi; DCH and DNB from Maharashtra. He works at his own 45-bed multispecialty, NABH-approved hospital. It also has a six-bed level two nursery. Prior to this, he worked at various government and corporate hospitals.

Being overweight and obese result from an imbalance of energy intake (diet) and energy expenditure (physical activity). In most cases, obesity is a multi-factorial disease due to obesogenic environments, psycho-social factors and genetic variants. Children in low- and middle-income countries are more vulnerable to inadequate pre-natal, infant, and young child nutrition. At the same time, these children are exposed to high-fat, high-sugar, high-salt, energydense, and micronutrient-poor foods, which tend to be lower in cost as well as nutrient quality.

Being overweight in childhood and adolescence is associated with greater risk and earlier onset of various non-communicable diseases, such as Type 2 diabetes and cardiovascular disease. Childhood and adolescent obesity have adverse psychosocial consequences; they affect school performance and quality of life, compounded by stigma, discrimination and bullying. Children with obesity are very likely to be adults with obesity, and are also at a higher risk of developing non-communicable diseases in adulthood.

Addressing this issue requires a concerted effort to improve dietary quality and physical activity levels, particularly in low- and middleincome countries. As we strive to combat this growing epidemic, we must remember that ‘the health of our children is the foundation of our society’s future’, emphasising the urgent need for targeted, sustainable solutions to protect and nurture the next generation.

Adolescent Obesity & Its Long-Term Health Implications

Dr Smita Ramachandran, MBBS; MD, Paediatrics; FIPAE (AHERF); Consultant Paediatric & Adolescent Endocrinology. She has been a Consultant Paediatric & Adolescent Endocrinologist at Venkateshwar Hospital, Dwarka, New Delhi.

Adolescent obesity is a significant public health concern due to its strong association with various long-term health problems and increased mortality rates in adulthood. Prevalence of being overweight and obese has increased from 16.3% to 19.3% in adolescents after 2010.

Nearly 75-80% of adolescents with obesity are likely to continue to be obese as adults. The alarming rise in obesity rates among adolescents is attributed to sedentary lifestyles, poor dietary habits, and socio-economic factors. These children are at a higher risk of developing metabolic syndrome, obstructive sleep apnoea and increased risk of PCOS in girls.

Beyond immediate health risks such as cardiovascular disease, Type 2 diabetes and musculoskeletal problems, adolescent obesity is associated with a myriad long-term health complications. These include increased risk of developing chronic conditions like hypertension, dyslipidemia, and fatty liver disease, which can persist into adulthood and can result in significant morbidity and mortality. Moreover, obesity during adolescence is closely linked to psychological distress, low self-esteem and poor body image, leading to higher rates of depression and anxiety.

Empowering and educating adolescents to make healthier lifestyle choices and promoting supportive environments both at home and in schools are crucial steps in curbing the obesity epidemic and mitigating its long-term health consequences.

Holistic Approaches To Managing Childhood Obesity

Dr Madhukar Pandey, MD, Paediatric; Consultant Paediatrician, Pragya Mother And Child Care Hospital, Varanasi.

Being overweight and obese, as well as their related non-communicable diseases, are largely preventable and manageable. At the individual level, people may be able to reduce their risk by adopting preventive interventions at each step of the life cycle, starting from pre-conception and continuing during the early years.

These include:

• Ensure appropriate weight gain during pregnancy.

• Practice exclusive breastfeeding in the first 6 months after birth and continued breastfeeding until 24 months or beyond.

• Support healthy eating, physical activity and sleep, regardless of current weight status.

• Limit screen time.

• Limit consumption of sugar, sweetened beverages and energy-dense foods.

• Avoid tobacco and alcohol.

• Limit energy intake from total fats and sugars, and increase consumption of fruit and vegetables, as well as legumes, whole grains and nuts.

• Engage in regular physical activity.

Effective management of childhood obesity also includes behavioural interventions that focus on creating a supportive environment for children. Parents and caregivers play a crucial role in modelling healthy behaviours and providing opportunities for physical activity and nutritious eating. Pharmacotherapy can be considered in specific cases where lifestyle interventions alone have not been sufficient. Orlistat is the only drug approved by the US FDA for the treatment of obesity in adolescents aged 12 years and older.