Kids and Obesity

“Children are not just ‘little adults’. Solutions for childhood obesity must be designed for the unique needs of this patient population.”

 

A Wall Street Journal article entitled “Weight-Loss Surgery for Teens Get a Lift”, WSJ 2/10/10 (1) caught my eye recently. The article comments that obesity in kids 2-19 years old is growing similar to the rates that we are seeing in adults. (see graph above) Current estimates report roughly thirty percent of kids meet the criteria to be classified as obese.

Why is this happening? No one knows for sure, but the answer is probably multi factorial. Check out the segment reproduced below from a recent article in Tribune Newspapers, 4/4/10 (3) that was distributed through “The Edge” that relates material obesity to offspring obesity.

What can be done about it? Besides diet and exercise, and without consensus on the cause of this epidemic, efforts are diverse. One positive note is that the American beverage association has reported that sales of soda and other drinks in US secondary schools have dropped since 2004.(2)

There is no point in waiting for obese children to become obese adults and continue to develop co-morbid conditions. Should we intervene surgically? Probably, but which procedure? Weight loss surgery is still very uncommon, <1% of all bariatric surgeries in the US. One thing for sure is that kids are not just little adults. Children are a unique patient population and must be treated as such. Some interventions that are possible for adults are not recommended in children. For instance, certain classes of antibiotics that are commonly used in adults affect the bone growth plates in kids and are therefore not recommended. In other words, we want all kids to grow, that’s the definition of being a kid…just not to the point of morbid obesity. Stopping growth altogether is not the solution. Clearly somewhat of a conundrum.

There is a tremendous amount of research and interest in this space worldwide. As the science becomes clarified, however, the question remains: what are we doing to address this growing segment…both at work and at home?

 

From Tribune Newspapers (3):

• Almost half of U.S. women today begin pregnancy overweight or obese, automatically increasing the likelihood that their babies will be born either too small or too large, both of which increase the risk of obesity for the child later in life. Further, studies show that how much weight a pregnant woman gains and whether she develops gestational diabetes can influence her child’s weight in adulthood. The odds of being overweight at age 7 were 48 percent higher for children of women who gained more weight than recommended during pregnancy compared with women who met weight guidelines, according to a study by Stettler and colleagues published in 2008 in the American Journal of Clinical Nutrition.

• In a study published recently in Pediatrics, a team led by Asheley Cockrell Skinner, an assistant professor of pediatrics at the University of North Carolina School of Medicine, found that obese children as young as age 3 had higher levels of C-reactive protein, a marker for inflammation that is linked to heart disease in adults. C-reactive protein levels can rise for a number of reasons, and about 15 percent to 20 percent of children have above-normal levels. But among obese 3-year-olds, 45 percent had elevated levels. It’s not clear yet whether this inflammation remains high in obese children or causes any long-lasting harm.

• “That indicates to me that when we see what appears to be a chubby kid on the outside, there may be something different on the inside, compared with healthy kids,” she says. “It’s a red flag that something is not quite right.” It may be a baby’s weight at age 1 that matters most, experts say. Weight that is too high for the child’s height can spell trouble. A study by Dr. Elsie M. Taveras, an assistant professor of population medicine and pediatrics at Harvard Medical School, published last year in Pediatrics, found that rapid increases in weight-for-length measurements during the first six months of life were associated with a greatly increased risk of obesity at age 3.

• No one is sure why rapid weight gain in the first year is important. It could be that when a baby is fed more than it needs, the brain’s development is affected so that it signals the need for excessive amounts of food, Stettler says. Likewise, too much food might program an infant’s pancreas, and the body’s response to insulin, in a manner that leads to obesity. Whatever the cause, Taveras says, “excessive weight gain in those first six months of life is not baby fat that is going to go away.”

  1. Weight-Loss Surgery for Teens Gets a Lift
  2. Soft-Drink Sales Drop in Schools
  3. Obesity risks start before birth
  4. Large Study Finds Shift Toward Extreme Obesity in Children and Teens
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About Ed Chekan, MD, FACS

Minimally Invasive Surgeon An American Board of Surgery certified, Fellowship trained Minimally Invasive Surgeon that fills the gap between the clinical practice of surgery and the business of medical device innovation. Minimally Invasive Surgery Medical Devices Device Tissue Interaction Life Science Education Professional Education Opinions expressed here are my own.
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