Childhood obesity is a major problem in Anguilla and many other countries. This largely preventable condition can have serious consequences if not dealt with appropriately. Overweight and obese children are likely to stay obese into adulthood, and more likely to develop noncommunicable diseases like diabetes and cardiovascular diseases at a younger age. The health and economic costs of childhood obesity are enormous in Anguilla.
What is obesity?
Generally overweight and obesity are defined as ”abnormal or excessive fat accumulation that presents a risk to health”.
In adults the most commonly used measure for overweight and obesity is the Body Mass Index (BMI) – a simple index to classify overweight and obesity in adults. It is defined as the weight in kilograms divided by the square of the height in meters (kg/m2).
Obesity has been more precisely defined by the National Institute of Health (the NIH) as a BMI of 30 and above. (A BMI of 30 is about 30 pounds overweight.)
The BMI provides the most useful population-level measure of overweight and obesity, as it is the same for both sexes and for all ages of adults. However, it should be considered as a rough guide because it may not correspond to the same body fat percentage in different individuals. BMI does not measure body fat directly, but research has shown that BMI is correlated with more direct measures of body fat such as skinfold thickness measurements, bioelectrical impedance, and densitometry.
It is difficult to develop one simple index for the measurement of overweight and obesity in children and adolescents because their bodies undergo several physiological changes as they grow. Depending on the age, different methods to measure a body’s healthy weight are available. Your healthcare provider would be able to discuss with you various child growth standards for different groups.
What causes childhood obesity?
Obesity is a complex problem with many drivers, including our behaviour, environment, genetics and culture.
Many studies have investigated these factors, but the bottom line is that obesity is caused by an energy imbalance: taking in more energy through food than we use through activity.
Children become overweight and obese for a variety of reasons. The most common causes are genetic factors, lack of physical activity, unhealthy eating patterns, or a combination of these factors. Only in rare cases of being overweight caused by a medical condition such as a hormonal problem.
Physical activity is associated with numerous health benefits for children, such as muscle and bone strength, health and fitness, improved quality of sleep and maintenance of a healthy weight. To tackle the problem of childhood obesity, various groups must be involved – not only health professionals. We need the active engagement of schools, communities, families and individuals.
Most of us here in Anguilla will agree that our children are consuming too many calories – and too much sugar. The consumption of sugar sweetened beverages by children in Anguilla is alarming. A single 330ml can of a soft drink with added sugar (which can contain as much as 35g of sugar) may instantly take a child over his or her maximum recommended daily intake of sugar.
Lack of physical activity. Most experts recommend that all children and young people should engage in moderate to vigorous intensity of physical activity for at least 60 minutes every day. Many schools already offer physical activity classes, but we need to do more to encourage children in Anguilla to be more active every day.
Childhood obesity – management
If a parent thinks his or her child is overweight or obese he or she should have the individual assessed by a qualified healthcare provider. It is important to determine if there are any underline causes of the child being overweight or obese, and these will be investigated.
If the child is obese, the doctor will try to ascertain if there are signs of any conditions related to obesity (such as hypertension, hyperinsulinaemia, dyslipidaemia, type 2 diabetes, psychosocial dysfunction and exacerbation of asthma) and what the risks are for these conditions developing.
The healthcare provider should try to find out if the child is suffering from any psychological distress such as low self-esteem, or from teasing and bullying.
The child’s family history is also important, as well as the child’s and family’s lifestyle, diet and physical activity.
Any environmental, social and family factors that may contribute to being overweight or obese, and how successful previous treatment has been, will be examined.
Management of childhood obesity often involves a team approach involving several healthcare professionals and many other professionals. Referral to various specialists might also occur.
Conclusion
Residents of Anguilla cannot continue to ignore the enormous impact of childhood obesity on the island. Children who are overweight or obese are at risk of developing chronic diseases such as heart disease and diabetes later in life. They are also more prone to develop stress, sadness, and low self-esteem. Childhood obesity is a major public health problem that will have tremendous economic and health consequences if we do not try to decrease and prevent it.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge MB BS DGO MRCOG is an Obstetrician/Gynaecologist and Family Doctor who has over thirty-five years in clinical practice. Dr Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 4975828).
