Children can be really mean to overweight and obese peers. Well-meaning grown-ups, too, can chip away at children’s confidence by calling them chubby or healthy. As childhood obesity skyrockets across the world and in India, we need to take a step back and consider it as a medical issue with both mental and physical health aspects.

Technically, a body mass index over 30 denotes obesity in adults. The measurement is slightly different for children – according to the US Centres for Disease Control and Prevention, children who are in the 95th percentile of weight for their age, height and gender, are considered obese.

Consider two 10-year-old girls who are each about 4.5 feet tall. One weighs 31.5kg and has a BMI of 16.5 – she is at a healthy weight. The second child weighs about 51kg, and has a BMI of 26.5 – because she is above the 95th percentile in her age group and height, she has obesity. (To calculate your child’s BMI, visit https://www.cdc.gov/healthyweight/bmi/calculator.html)

World Health Organization data show that over 38 million children under five years of age were overweight or obese by 2017. Another study with children aged 6-18 years, conducted between 2013 and 2018 found that 8.4% boys were overweight and 4.9% were obese, and 10.6% girls were overweight and 3.9% were obese.

This is starting to take a toll on the health of young India: The country’s first Comprehensive National Nutrition Survey (CNNS), launched on 8 October, found that 5 percent of children and adolescents aged 5-19 are overweight. The survey also found that over 9% of these kids aged 5-9 were pre-diabetic, and 1% already had diabetes!

In the spirit of starting a healthy conversation around childhood obesity, consider these five main reasons why it happens.

Diet
To state the obvious, eating large portions of energy-dense foods (deep-fried and junk food) with sweetened beverages, followed by little or no exercise, are indeed the culprit in many instances.
Children who regularly engage in this behaviour are more likely to have high cholesterol, high blood pressure and pre-diabetes (a stage before diabetes).

Genetics
Leptin, a gene, makes the satiety hormone in the body. This hormone works with other hormones and neurotransmitters to tell the brain to stop eating when we are full. A defect in this gene can lead to obesity in childhood. The leptin defect impairs satiety, affecting the function of appetite control centres in the brain.

Family history
Studies have shown that slow basal metabolic rate (BMR) is one of the key factors behind weight gain in children. BMR is the rate at which our bodies burn calories. Slow BMR means slow breakdown of calories in the body and therefore weight gain. Slow BMR tends to run in the family.

Psychological issues
When we are stressed, our body releases cortisol (also known as the stress hormone). High levels of cortisol can increase appetite. Excess calories get stored as fat under the skin – typically in the abdominal region, which may ultimately lead to abdominal obesity (fat around the abdomen and stomach).
Studies have shown that peer difficulties (being alone, excluded by peers) increase eating in children and adolescents, thus leading to obesity.

Hormone disorders
Hypothyroidism is a disorder in which the body can’t produce enough thyroid hormone. It is marked with sudden weight gain. The other symptoms of hypothyroidism are inability to handle the cold weather, joint and muscle pain, cramps, high cholesterol, puffy face, feet, and hands.

Cushing’s syndrome
This is an endocrine disorder in which the body releases a tremendous amount of cortisol hormone over a long period of time. Children with Cushing’s syndrome tend to be obese and grow more slowly than other children. Excess cortisol can lead to abdominal obesity, high blood pressure, abnormal glucose tolerance, and muscle weakness.

Other symptoms of Cushing’s syndrome include thin arms and legs, increased fat around the base of the neck, a fatty hump between the shoulders, weak muscles, and wide purple stretch marks on the abdomen, breasts, hips, and under the arms.

Eating disorder
Binge eating syndrome (BES) is an eating disorder characterized by recurrent episodes of eating large quantities of food. The loss of control during the binge is typically followed by feelings of shame, distress or guilt. However, studies are still going on to prove the cause behind BES.

Along with the excessive weight gain, other symptoms of BES in a child are:

  • The child feels uncomfortable or is fearful to eat around others
  • Steals or hoards food in strange places
  • Shows extreme concern with body weight and shape
  • Frequently looks in the mirror for perceived flaws in appearance
  • Developes food rituals like eating only a particular food or food group, excessive chewing, and not allowing foods to touch.
  • Has feelings of low self-esteem
  • Gets stomach cramps, other non-specific gastrointestinal complaints (constipation, acid reflux)

This article is contributed by myUpchar.com, India’s first and biggest resource for verified medical information. At myUpchar, researchers and journalists work with doctors to bring you information on all things health. For more information, read our article on Obesity: Symptoms and Prevention.

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