In 1986, the first epidemiological survey on obesity among preschool children aged 0-7 years in eight provinces and cities nationwide showed that less than 1% of children were obese due to overnutrition, but the figure rose to 1.76% in 1996, with an average annual growth rate of 9.3%. And the incidence of obesity among adolescents aged 7-18 years old has increased nearly five times in 10 years. In recent years, Beijing, Shanghai and other large cities school-age children’s obesity has been as high as 10% on average, some age groups have exceeded 20%. China’s urban children’s overweight obesity rate growth rate greatly exceeds that of Europe and the United States and other developed countries, so rapid growth trend, so that obesity has become the main health problems affecting children and adolescents.
1.What is child obesity
Child obesity generally refers to the accumulation of excessive body fat, weight more than the average standard weight calculated according to the length of more than 20%, is one of the common nutritional diseases, seriously affecting the healthy growth of children. The disease is a syndrome caused by a variety of factors and is the result of energy intake exceeding consumption and energy being stored in the body in the form of fat.
Zhang Zhixin, deputy director of the outpatient department of China-Japan Friendship Hospital and an expert in childhood obesity and diabetes, believes that obesity can be seen in children of any age, with a peak incidence at the age of 5 to 6 years old or adolescents. The main performance for the child appetite is very good, like to eat greasy, sweet food, lazy activity, physical obesity, subcutaneous fat is thick, uniform distribution is different from the pathological obesity, cheeks, shoulders, breasts, abdominal wall fat accumulation is obvious.
2, the classification of children’s obesity
Childhood obesity is generally divided into simple obesity and pathological obesity two categories.
Most children simple obesity is due to unreasonable diet and poor living habits lead to long-term intake of calories more than the consumption of calories, excess heat into fat and accumulation in the body (subcutaneous tissue, around the viscera, abdominal cavity large omentum), resulting in the body fat cell number and fat cell volume increases, the total number of fat in the human body increased significantly and obesity, children simple obesity of material metabolism The material metabolism of simple obesity in children is slow and persistent, and the basal metabolism level is low, and the anabolism exceeds the catabolism. Simple obesity accounts for 99% of the total number of obese children.
Children’s pathological obesity is caused by central nervous system diseases, endocrine disorders, metabolic diseases and other drugs and other factors. In addition to physical obesity, often accompanied by some signs and symptoms of the primary disease.
3.What are the hazards of childhood obesity
Childhood obesity can lead to many hazards at different ages.
Infants are too fat can make their start walking time delayed, and often because of calcium deficiency, overweight, the occurrence of knee inversion or knee valgus and flat feet. At the same time, the pediatric organism’s reaction to the outside world, resistance to decline, prone to a variety of infections, especially respiratory infectious diseases. Long-term obesity of children will also occur hyperlipidemia, which will lead to atherosclerosis, hypertension, coronary heart disease, fatty liver, diabetes and other childhood adult diseases.
The following are specific hazards
1, children’s cardiovascular, respiratory function to produce long-term chronic (sometimes irreversible) damage: childhood simple obesity delay the development of children’s aerobic capacity, early use of cardiopulmonary reserve function, reduce physical health level.
2, to the liver and endocrine, metabolic impact: easy to form fatty liver, hyperlipidemia, hyperinsulinemia, insulin resistance and metabolic syndrome, and eventually develop to type 2 diabetes, and the proportion of obese patients in type 2 diabetes is very high. Some people have found in part of the population, the proportion of obesity and overweight in children with type 2 diabetes can be as high as 88.5%.
3, the formation of insurmountable psychological behavior damage: so that children’s self-esteem, self-confidence suffered serious damage, suppress the development of children’s potential, on the shaping of children’s character, temperament training, habit formation has a destructive negative impact.
4, become adult cardiovascular disease, diabetes, hypertension, some parts of the important risk factors of cancer: obesity can cause changes in the structure and function of the heart, myocardial biopsy has found obese people cardiomyocyte hypertrophy, patients exist to varying degrees have left ventricular enlargement, serious people can also appear heart failure. Childhood obesity patient’s heart rate arrhythmia and the incidence of stroke death is significantly higher.
5, the impact on sexual development and sexual psychology: due to obesity caused fatty breast enlargement of boys, genitalia buried and other abnormal performance, resulting in their anxiety about the development of sexual characteristics and low self-esteem.
In addition, due to social customs and identity prejudice, obese children may face more pressure and obstacles in the process of growing up in the school, job hunting, social, marriage and other aspects.
What are the best ways to help children say goodbye to obesity and restore their normal weight?
Zhang Zhixin, deputy chief physician, believes that childhood obesity is the result of many factors, and bad habits are the main cause of childhood obesity. In the treatment process, if only a single method is used, the effect is not ideal. For the treatment of simple obesity in children, the current emphasis is on “weight gain control” as the guiding ideology, and the treatment method recognized as suitable for obesity in children at home and abroad is a comprehensive treatment program including diet adjustment, exercise and health education, etc. with behavior correction as the key. Parents help their children to establish a healthy life style in order to restore and maintain a normal weight in the long term.
Diet Therapy
The general principle should be to limit energy intake while ensuring growth and development needs. Food should be diversified, with sufficient vitamins, and minimize the intake of stimulating condiments and easily digested and absorbed carbohydrates (such as sucrose). Eat less fatty foods and increase protein diet in moderation, such as soy products, lean meat, etc. However, it is not a mention of weight loss that a little sugar and sugar-containing foods cannot be eaten. The important thing is that pediatric obesity is obesity in the developmental period, and extreme caloric restriction should be avoided, and when reducing carbohydrates, it should not be too low to avoid ketosis. Extreme dietary restriction can cause psychological depression in children and sometimes resistance to treatment. As long as the diet of obese children is reasonably adjusted, good results can be achieved that both lose weight and do not affect the growth and development of children.
It is also a difficult task to treat children on diet and make them endure the pain of hunger. Parents should take the initiative to master the knowledge of nutrition, before the diet control, be sure to obesity hazards, diet reasoning and treatment plan, patiently and in detail to tell the children, in order to get their cooperation, this point for the smooth implementation of diet therapy or not, has a key role.
Exercise therapy
Children are often “the fatter the lazier”, – the body fat accumulation, the slightest activity will be sweating, shortness of breath, easy fatigue. Exercise therapy for fat children to lose weight should take the method of gradual exercise, exercise should focus on safety, fun, easy to adhere to long-term, can effectively reduce fat.
Dr. Zhang Zhixin, deputy chief physician, suggests that you should start with small-volume activities, and then gradually increase the amount of exercise and activity time. Emphasis on weight-shifting exercise, aerobic exercise and anaerobic exercise alternately, should also pay attention to flexibility exercise. Exercise intensity to the average intensity, generally 50% of the maximum oxygen consumption (about 60%-65% of the maximum heart rate). Exercise frequency is 3-5 times a week, 1-2 hours each time. Exercise period to 3 months as a phase, a year as a cycle.
It should be noted that obese children should avoid strenuous exercise to prevent increased appetite.
Common misconceptions about parents helping their children lose weight
”Choose drugs to lose weight for your child, and the same diet pills that adults take can be taken by children.” –Children are better off not choosing drugs to lose weight.
The weight loss rules that are talked about in society are not suitable for children. children should not lose weight by using common adult medications, surgical fat removal, fasting or starvation therapy, etc. Before the age of 18 is a critical period of healthy growth and development for children, and any overly aggressive treatment may pose a negative impact on the child’s growth and development.
Zhang Zhixin, deputy chief physician, believes that it is usually not recommended to choose drug treatment for simple obesity in children. If obesity has seriously affected the child’s life and study, and caused other complications, drugs must be used under the guidance of a doctor. The use of drugs for short-term rapid weight loss is prone to problems with the nervous system, circulatory system, endocrine system, and even lead to kidney function damage, and can even increase the risk factors for cardiovascular disease in adulthood.
”Weight loss is only successful when the weight comes off.” — The absolute number of weight loss is not the goal of weight loss in children.
In the process of weight loss treatment for obese children, many parents are anxious to know how many pounds their children can lose in how long, hoping to see quick results after taking weight loss measures. The absolute weight loss of children to measure the effect of weight loss is inappropriate, children’s height is growing, school-age children can generally increase 5-6 cm per year, if you can keep the weight does not increase or slowly increase, six months to a year after the degree of obesity can be improved.