Physical appearance; In our age, it is at the top of the issues that people attach great importance to, and even at the top for many people. Among physical appearance characteristics, height and weight are important in themselves. If we rank people according to their weight, from thin to fat; We can name it as very thin-thin-slender-normal-curvy-fat and extremely fat. While there is extreme thinness at one end of the weight scale, there is extreme obesity, that is, OBESITY, at the other end. Both extreme thinness and obesity are serious health problems that pediatricians and pediatric hormonal disease specialists frequently encounter and follow closely.
Obesity is a very important condition that occurs as a result of excessive fat storage in the body and an excessive increase in the ratio of fat to body mass. It is a health problem. Obesity not only spoils the physical appearance. It can cause very serious physical and psychological problems.
The most commonly used measure when diagnosing obesity is body mass index (BMI). BMI is body weight in kilograms; It is obtained by dividing the height in meters by the square of the height. In other words; It is the number obtained as a result of dividing the body weight in kilograms by the body area in square meters. If the *BMI calculated in this way is below 5%, there is EXCESSIVE WEALTH, if it is between 85-95%, there is OBESITY DANGER, and if it is above 95%, there is OBESITY. .
Obesity is seen in approximately 18% of children between the ages of 6-18. Obesity has become 2-3 times more common in the last 20 years. For this reason, it has become one of the increasingly common health problems of the last decades. Obesity, which begins in childhood, unfortunately continues into adulthood. 69% of obese children aged 6-9 and 83% of obese children aged 10-14 remain obese in adulthood.
Obesity causes:
In children and adolescents (aged 12-18) Only 10% of obesity seen in young people may be due to hormone disorders and genetic diseases. 90% of obesity is of external origin. Genetic and environmental factors may be effective alone or together in the emergence of exogenous obesity. Having a family history of diabetes is among the risk factors. If both parents are obese, there is a possibility that their children will also be obese; It is 15 times more common than children whose parents are of normal weight. The basis of obesity is that the energy intake is more than the energy spent, so the excess energy is converted into fat and stored by the liver. An obese child may have the characteristic of not eating more than others but spending less than others. Among the causes of obesity due to the child's environment, low mobility, eating habits and psychological stress are important. Children and young people's love of television, computers and smartphones also causes them to eat too much and gain weight because they cannot spend enough of the nutrients they consume. In addition, high-calorie ready-made foods and sugary foods such as 'fast food' cause obesity.
The socioeconomic status of the family also affects obesity. Obesity is more common in children of families whose economic situation is inadequate and whose diet is high in carbohydrates. The tendency to obesity is higher in those who are the only child of their family.
How is obesity diagnosed?
The disease is diagnosed. History, examination findings and laboratory tests enable the diagnosis. If the patient's history, examination findings, and results of blood and urine tests suggest a hormone disease, the patient should be sent to a pediatric endocrine (hormone) diseases specialist.
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Prevention of obesity:
To prevent obesity, families should have a healthy diet and stay away from high-energy foods. Daily activity should be increased to prevent eaten food from being converted into fat and stored. Television viewing time in school children More than 2 hours of sleep time and more than 1 hour of computer use pave the way for obesity. In addition, eating habits while watching television or using the computer also play an important role in the emergence of obesity. These harmful habits should be prevented. Walking and exercising regularly every day is very important in preventing obesity and maintaining a healthy body structure.
*The child should be weighed every Sunday morning and his weight should be recorded. Before weighing, it should be ensured that the child has not had breakfast, has gone to the toilet and urinated and defecated, and is wearing only underwear.
*Children should be taught healthy and regular eating habits.
*Children should be very close to their parents. One should keep in mind that they imitate them and even like to imitate them, and parents should set an example for them with their diet.
*Eating and snacking in a hurry leads to obesity. They should be ensured that they learn to chew bites for a long time and that feeding should take at least 20 minutes.
*They should be ensured to stay away from fatty foods, fried foods, desserts, sugary foods, floury foods and foods with low nutritional value.
*They should stay away from fast food type foods
*They should stay away from very sweet and very sugary fruits.
*Oily nuts should be consumed very little.
*Cola and soda. should stay away from all sugary drinks, especially sugar.
*It is beneficial to eat salad, vegetables and fruits right before the main meal.
*To prevent malnutrition at school; The lunch box should be prepared at home and should be filled with foods that digest slowly and prevent getting hungry quickly, such as boiled eggs, chicken, pieces of meat, kidney beans, milk, buttermilk and yoghurt. Fruit, not juice, should be placed in the bag.
*Children should definitely be prevented from eating in front of the television or in front of the computer.
*Walking should be especially encouraged and preferred instead of getting in the car.
*Instead of taking the elevator, going up and down the stairs should be preferred.
*Every day, cycling, swimming, brisk walking for at least 30 minutes a day. Walking should be made a habit (not with the slow walk of a man in the market, but with the walk of a man running away from the rain).
*In addition, the child; They should be encouraged to do all kinds of sports appropriate to their age on a daily basis.
Treatment of obesity:
Treatment of obesity. It is a multifaceted treatment that requires patience. In order to achieve the goal, the patient, family, pediatric endocrinologist, child's regular doctor, dietitian and sometimes psychologist must cooperate closely as a team. It is a very wrong approach to take an obese patient to a dietitian without having him examined and evaluated by a doctor. In order to get results from the treatment, the family must support and help the child. Some obese parents do not accept that their children are obese. Sometimes, even if parents accept the disease, they do not accept treatment. This situation may lead to the emergence of a much more extreme type of obesity in the child, called "LETHAL OBESITY".
If obesity is due to a hormone disorder; In order to apply specific treatment for that disease, the patient must be followed up and treated by a pediatric hormone diseases specialist.
If obesity is due to external causes, these causes are tried to be corrected. Foods include fried foods, fatty foods, fatty parts of meat, cream, fatty foods. Cheese, fatty nuts and sugary foods should be removed. It is very important to eat vegetables and salads at every meal, consume plenty of fruits, and prefer to eat fruits with their peels. Sugary drinks such as soda and cola should be avoided. In addition, adding sugar to drinks such as tea, coffee and milk should be stopped.
Increasing daily activity along with a healthy and balanced diet and regular walking and sports are necessary to maintain the ideal weight. If balanced nutrition and sports are not maintained, obesity may occur. It starts again.
Drug treatment is not recommended under the age of 18. Drug treatment in children can only be applied to those with lethal obesity.
Adolescent obesity If other treatment methods are insufficient, surgical methods can be used to place a band on the stomach.
Negative consequences of obesity:
The harmful consequences of obesity are many. It negatively affects almost all body organs. Here, the most important negative effects will be mentioned. Obesity mostly causes psychological disorders in the early years. The child may be socially excluded from the school and play environment. This situation leads to a decrease in the child's self-confidence. Depression and school failure may then occur.
Obesity can lead to hypertension, diabetes, gallstones and inflammations, fatty liver, heart failure, heart attacks, brain hemorrhages and strokes.
Obese children may experience a breathing disorder called obstructive sleep apnea, which can even lead to death by stopping breathing during sleep if left untreated. In addition, the skeletal system is also negatively affected in obese patients. Severe pain in the feet and legs, disorders in the bones, joints and spine occur.
If the child or adolescent is obese, their situation should be investigated without waiting for their lives to become obese and endanger their lives. Preventing obesity is easier and more satisfactory than treating it. Neglected obesity can progress to MORBID OBESITY. Unfortunately, this type of obesity can even lead to sudden death.
Last word: AN OVERWEIGHT CHILD IS NOT A HEALTHY CHILD.
*BMI is the body weight in kilograms; It is obtained by dividing the height in meters by the square of the height. In other words; It is the number obtained as a result of dividing the body weight in kilograms by the body area in square meters.
** As screening tests in an obese patient; Fasting blood sugar, sugar load test, fasting insulin level, fasting cortisol, free T4, TSH, cholesterol, HDL cholesterol, LDL cholesterol, VLDL cholesterol, triglycerides, liver enzymes (AST and ALT) and urinalysis must be performed.
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