Email
Print
Feed
Obese Kids: Bearing the Weight of Adult Diseases |
Tweet |
Loving parents look at their chubby little cutie and just know the innocence and carefree days of childhood will pass much too fast for this jolly toddler. They know their youngster will soon enough be exposed to the dark complexities of a modern world. What Mom and Dad likely don’t recognize is their unwitting role in what has become a national epidemic, with dire health consequences for an increasing number of kids.
“There’s no question obesity in children is the number-one public health problem we face in this country today,” says Dr. Jeffrey Schwimmer, a pediatric gastroenterologist at the University of California, San Diego and a leading researcher in the field. “It’s the most common chronic condition of children locally and nationally.”
It might seem parents and grandparents would be most interested in recent headlines devoted to the problem, but childhood obesity is an issue that also weighs heavily on the taxpayer and health-insurance consumer: The Surgeon General says future healthcare costs associated with overweight children may exceed those linked with smoking. Meanwhile, insurance companies often will not pay to treat the primary cause—obesity—but end up paying for treatment of diseases caused by it.
Schwimmer says a study under way to more closely examine the costs of childhood obesity is already producing startling observations. Year by year, for example, the local cost associated with children’s obesity grows by about 50 percent.
There is no shortage of other compelling statistics to illustrate the rampant extent of fatness among children:
*In 1970, 5 percent of kids in the United States were obese. In 2000, the number had tripled to 15 percent—about 9 million children. In California, it grew to 20 percent.
*Between 100,000 and 150,000 kids in San Diego County are obese.
*The number of overweight children younger than 5 has shown “significant increases,” according to the American Academy of Pediatrics.
*Diseases long associated with adult obesity are showing an alarming increase in overweight children. These include Type II diabetes (once known as adult-onset diabetes), hypertension, fatty liver disease, gallbladder disease, asthma and sleep apnea (a potentially fatal breathing disorder that affects up to 10 percent of overweight kids).
Why such a rise in numbers? The easy answer rounds up the usual suspects: Americans’ love affair with fast food and junk food; too much time in front of the TV or computer; high-calorie school lunches; the demise of the once-mandated physical education class; time-challenged parents who too frequently opt for convenience over nutrition.
Schwimmer and other researchers point to more complicated explanations that underscore the complexity of treating overweight kids. Genetics, gender, race, ethnicity, socioeconomic status and lifestyle patterns all figure into the problem.
Just when is a child considered overweight as opposed to carrying “baby fat”? There’s the stereotype of a youngster weighing 200-plus pounds, but a potentially serious weight problem with a child may not be easily identifiable. Even kids of “normal weight” may be at a high risk for obesity because of family history.
Recognizing this, the American Academy of Pediatrics last summer issued its first policy statement specifically dealing with identifying overweight kids and preventing obesity. It suggests doctors routinely measure a child’s BMI—body mass index—a ratio that helps physicians chart signs of an increased risk of obesity. Doctors also are encouraged to ask parents about their family histories and their living environment.
“We can identify who is at the greatest risk for developing obesity and the disease complications from it at an early age,” says Schwimmer, who also heads the Weight & Wellness Clinic and the Fatty Liver Clinic at Children’s Hospital. “Early intervention is always more effective.”
Weight problems in infants and toddlers are more easily addressed, he adds, because parents are better able to regulate food intake. Effective treatment becomes more difficult as children grow, with the overweight early adolescent more than 80 percent likely to remain obese as an adult.
That the overweight child—the overweight anybody—needs to eat sensibly and exercise regularly is not news. Finding ways for increasingly busy parents to help combat child obesity is challenging but doable, say longtime San Diego pediatricians Leonard Kornreich and Stephen Carson. Both stress the importance of parents making time to introduce healthy behavior changes to the whole family.
“Parents and older siblings must set an example,” says Kornreich, a former chief of staff at Children’s Hospital and current president of the county’s largest group of primary pediatricians. Calorie-counting is too difficult with children, he says, so he advises parents to serve meals that provide 30 to 40 percent protein, 30 to 40 percent carbohydrates and less than 30 percent fat. Even if a child won’t eat salad or vegetables, keep setting them in front of the youngster, he says. Serve meals at fixed times and serve them at the table—not in front of the television.
Carson, a pediatrician for 24 years currently practicing in Hillcrest, knew it was a bad sign when he could look around any shopping mall and see many mothers with children as old as 6 in strollers. It’s a convenience to the parent pressed for time, but it also deprives youngsters of needed activity at a stage when they are naturally the most active.
“Parents may seem overwhelmed, but they have to take the time to educate themselves about what to do to help their children,” he says. Parents should be aware of how often they satisfy a child’s emotional needs with food or reward a toddler’s good behavior with a lollipop—not the right signals to send.
Carson offers one simple guideline pertaining to exercise: A child shouldn’t be inactive for more than an hour at a time. Plopping a fussy toddler in front of the TV to keep him quiet relays another bad signal. Instead, Carson recommends helping the child find things to keep active. Watching cartoons is out, but dancing to music videos is in.
The overweight teen requires some major behavioral adjustments. Nine times out of 10, Carson says, the child will have at least one parent who is overweight, and family involvement to foster healthy changes is imperative.
Don’t be critical of the child, and don’t make him or her feel different, says Carson. Chances are the teen’s self-esteem has already been damaged. Don’t prepare a separate meal for the child, but do offer a number of options. Have each member of the family participate in a regular activity, be it walking, swimming or karate.
In a perfect world, these changes would easily be incorporated into a family’s lifestyle. In reality, such modifications may seem overwhelming. The doctors’ advice?
“Focus on the possible things kids can do to improve their health,” says Schwimmer. “Children with higher self-esteem are better able to make changes.”
“Get children moving,” Kornreich says. “Get them out of the house and active. Concentrate on gradually introducing changes.”
“The number-one message parents need to understand,” Carson says, “is that lifestyles begin the first year of life.”
Do you like what you read? Subscribe to San Diego Magazine »
