I. Exercise therapy.
With the wind of “weight loss”, exercise for weight loss has become a generally respected weight loss method in recent years medical workers and the majority of obese patients, that this method of weight loss has “a hundred benefits and no harm”. Therefore, it is also feasible for children to choose sports to lose weight.
Japanese scholars believe that sports therapy can strengthen the energy consumption of children, promote the increase of basal metabolism and improve the oxidation of fat, and the interplay of exercise therapy and diet therapy can play a significant effect, while the use of exercise therapy alone to reduce weight is very difficult, especially in children is more difficult.
So, how to exercise exercise therapy for childhood obesity is good?
Generally speaking, should strictly grasp the principle of gradual and orderly, like food therapy in stages. Can’t ask obesity children from inactive lifestyle immediately change to intensity of body consumption state, this is absolutely forbidden.
Secondly, physical therapy for children should also be carried out under the guidance of a doctor, and should never be done on its own. Because unreasonable physical therapy can further dysfunction of the cardiovascular system and the vegetative nervous system, the result is not only failure to lose weight, but also easy to cause harmful complications.
In a variety of physical therapy programs, you can focus on some of the content not to bipedal support, such as sitting or lying exercises, swimming, rowing, cycling, as well as ice skating, excursions, older children can be required to adhere to the daily running exercise. However, a comprehensive exercise program must be drawn up and approved by the doctor.
In addition to the above, in the daily life of obese children to sweep, fold bedding, wash dishes and so on as a content of physical activity, this is also obese children exercise therapy more suitable method.
In short, as long as the exercise therapy is exercised reasonably, it is possible to receive a better effect. Do not because of the results of exercise, children’s appetite increased, let it eat more staple food, exercise therapy with diet therapy, such as regular meals, less snacks, drink some vitamin-rich drinks, chew slowly, etc., only the organic combination of the two, exercise to lose weight can be effective.
Second, psychotherapy.
Psychological treatment methods for children are sometimes more effective than diet and medication. Because children’s psychology is in the stage of adjustment and adaptation, through effective psychological adjustment, can completely change the children’s bad eating habits.
The psychological treatment of children’s obesity can use the following methods.
1.To educate the knowledge of obesity disease through the form of holding children’s summer camps, ask relevant experts to explain the knowledge of obesity disease, improve children’s awareness of the consequences of obesity disease, so that children can consciously and voluntarily accept weight loss treatment.
2.Teach children scientific eating habits tell children not to eat too fast, implement regular meals at fixed points and reduce snacks.
3.Encourage children to participate in more sports teach children not to sleep after eating, not to eat while watching TV, and to be properly active after eating.
4, encourage children to overcome inferiority complex sometimes due to physical obesity often ridiculed by peers, at this time should encourage children to face the reality, proactive participation in weight loss. Once effective, they should be encouraged to persist.
5.Help the child to establish a behavioral weight loss program.
Third, drug treatment
If lifestyle interventions fail, they should be evaluated by a specialist. The specialist should assess the extent and degree of coexisting disorders and consider a treatment approach that includes medications. Currently, pharmacologic interventions are designed to increase energy expenditure (stimulation), suppress caloric intake (appetite suppression), limit nutrient absorption, and/or mediate insulin production or action.
Stimulants The use of metabolic stimulants to treat obesity has had many twists and turns throughout history. Many anti-obesity drugs were once considered safe and effective, i.e., thyroid hormones, dinitrophenols, amphetamines, fluphenazine, dexfenfluramine, phenylpropanolamine, and ephedra, and were later abandoned because they were more dangerous and in some cases caused life-threatening complications.
In a short-term trial in adolescents consuming a moderate low-calorie diet, caffeine plus ephedrine was compared with placebo, and although the drug-treated subjects lost more weight, there were excessive side effects. Therefore, these medications cannot be recommended.
Appetite suppressants The only appetite suppressant currently approved for use in obese adolescents (16 years of age and older) is sibutramine combined with caloric restriction and a comprehensive family behavioral program. During the initial 6-month period, sibutramine reduced BMI by 8.5 ± 6.8% in 43 obese adolescents compared to 4.0 ± 5.4% in 39 placebo-treated subjects. No further weight loss occurred during the subsequent 6 months of treatment. However, 19 of the 43 subjects treated with sibutramine developed mild hypertension and tachycardia, forcing a reduction in the drug dose, and five of them discontinued the drug application due to persistent elevation of blood pressure. Other potentially serious complications included insomnia, anxiety, headache, and depression.
Appetite suppressant medications should be complementary to diet and exercise programs and should never replace dietary modification and exercise. These medications have a moderate effect on total body weight, with considerable variation in response between individuals. The application of appetite suppressant medications may achieve maximum effect 4-6 months after initiation of treatment, but the body will return after discontinuation of the medication. It is recommended that the duration of use of such drugs should not exceed 2 years.
Administration of leptin therapy to children with hereditary leptin deficiency resulted in significant weight loss. It is questionable, however, whether non-leptin deficient forms of obesity can achieve results with similar treatment.
Fourth, surgery
In severely obese patients, the long-term effectiveness of lifestyle interventions and pharmacological treatments is usually disappointing. Significant weight loss is very rare, rarely durable, and commonly associated with metabolic and vascular complications. More intense therapeutic approaches, such as surgical treatment of obesity, may be required for extreme obesity and severe coexisting disorders. The most commonly used surgical approaches today are the laparoscopic gastric banding approach and the gastrointestinal diversion approach. Gastric banding may cause esophageal dilatation and achalasia and may worsen gastroesophageal reflux. Other potential complications include malposition of the puncture port, rupture of the insufflation sac, and infection. The most serious complication is a potentially fatal pulmonary embolism. the mortality rate for RYGB is in the range of 1-5%. Complications can be reduced if the procedure is done laparoscopically by an experienced surgeon. There is relatively little published literature on experimental adolescent surgical procedures, but the results may be similar to surgical treatment of obesity in adults and should be further investigated.