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Causes and
Prevention of Morbid
Obesity
Causes of Morbid Obesity
Obesity
results from consuming more calories than the body uses. Genetic and
environmental factors influence body weight, but precisely how they
interact to determine a person's weight is still unclear. One proposed
explanation is that body weight is regulated around a set point, similar
to a thermostat setting. A higher-than-normal set point may explain why
some people are obese and why losing weight and maintaining weight loss
are difficult for them.
Genetic Factors: Recent research suggests that on the average,
the genetic influence contributes to about 33 percent of body weight, but
the contribution may be more or less in a particular person.
Socioeconomic Factors: Such factors strongly influence obesity,
especially among women. In the United States, obesity is more than twice
as common among women in lower socioeconomic groups as among women in
higher ones. Why socioeconomic factors have such a strong influence on
women's weight is not fully understood, but sanctions against obesity do
increase with increasing social status. Women in higher socioeconomic
groups have more time and resources for the dieting and exercise that
enable them to conform to these social demands.
Psychological Factors: Emotional disturbances, once considered an
important cause of obesity, are now considered a reaction to the strong
prejudice and discrimination against obese people. One type of emotional
disturbance, a negative body image, is a serious problem for many young
obese women. It leads to extreme self-consciousness and discomfort in
social situations.
What is Morbid Obesity?
Obesity is a disease that affects nearly one-third of the adult American
population (approximately 60 million). The number of overweight and obese
Americans has continued to increase since 1960, a trend that is not
slowing down. Today, 64.5 percent of adult Americans (about 127 million)
are categorized as being overweight or obese. Each year, obesity causes at
least 300,000 excess deaths in the U.S., and healthcare costs of American
adults with obesity amount to approximately $100 billion.
Obesity is the second leading cause of
unnecessary deaths.
-
Despite its toll taken in death and
disability, obesity does not receive the attention it deserves from
government, the health care profession or the insurance industry.
- Research is severely limited by a shortage of
funds.
- Inadequate insurance coverage limits access to
treatment.
-
Discrimination and mistreatment of persons
with obesity is widespread and often considered socially acceptable.
Severe obesity has long-term effects on you
and others
Fact: Mortality risks associated with severe obesity have
been estimated at 6 to 12 times greater than that of a normal-weight
population.
Obesity and Children
Today's youth are considered the most inactive generation in history
caused in part by reductions in school physical education programs and
unavailable or unsafe community recreational facilities. In the U.S., only
the state of Illinois requires daily physical education for students in
grades K to 12.
Many adverse health effects associated with overweight are observed in
children and adolescents. Overweight during childhood and particularly
adolescence is related to increased morbidity and mortality in later life.
Many
parents are rightly concerned about their child's weight and how it
affects them. They look for specific answers for prevention and treatment
options. Unfortunately, the state of the science is a lot less precise
than we would like. Are kids too concerned about their weight? What are
the best strategies for prevention? What treatments work over a long time?
Researchers are trying to answer those and many other questions. In many
cases, common sense works well.
In
situations where there are serious health, psychological or social
problems, parents should seek out the best possible advice.
Obesity in children and adolescents is a serious issue with many health
and social consequences that often continue into adulthood. Implementing
prevention programs and getting a better understanding of treatment for
youngsters is important to controlling the obesity epidemic.
The
percentage of children and adolescents who are overweight and obese is now
higher than ever before. Poor dietary habits and inactivity are reported
to contribute to the increase of obesity in youth.
Causes of
Morbid Obesity in Children
There are many factors that contribute to causing
child and adolescent obesity - some are modifiable and others are not.
Modifiable causes include:
-
Physical Activity - Lack of
regular exercise.
-
Sedentary behavior - High
frequency of television viewing, computer usage, and similar behavior
that takes up time that can be used for physical activity.
-
Socioeconomic Status - Low
family incomes and non-working parents.
-
Eating Habits -
Over-consumption of high-calorie foods. Some eating patterns that have
been associated with this behavior are eating when not hungry, eating
while watching TV or doing homework.
-
Environment - Some factors are over-exposure to advertising of foods
that promote high-calorie foods and lack of recreational facilities.
Non-changeable causes include:
Prevention of
Morbid Obesity in Children
Teaching
healthy behaviors at a young age is important since change becomes more
difficult with age. Behaviors involving physical activity and nutrition
are the cornerstone of preventing obesity in children and adolescents.
Families and schools are the two most critical links in providing the
foundation for those behaviors.
Families coping with Morbid Obesity in Children
Parents are the most important role models for children. Results from an
American Obesity Association survey show that:
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The majority of parents in the
U.S. (78 percent) believe that physical education or recess should not
be reduced or replaced with academic classes.
-
Almost 30 percent of parents
said that they are "somewhat" or "very" concerned about their children's
weight.
-
12 percent of parents
considered their child overweight.
-
Comparing their own childhood
health habits to their children's, 27 percent of parents said their
children eat less nutritiously, and 24 percent said their children are
less physically active.
-
35 percent of parents rated
their children's school programs for teaching good patterns of eating
and physical activity to prevent obesity as "poor," "non-existent," or
"don't know."
-
Among six choices of what they
believed to be the greatest risk to their children's long-term health
and quality of life, 5.6 percent of parents chose "being overweight or
obese." More parents selected other choices as the greatest risk:
alcohol (6.1 percent), sexually transmitted disease (10 percent),
smoking (13.3 percent), violence (20.3 percent), and illegal drugs (24
percent).
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In terms of their own behavior,
61 percent of parents said that it would be either "not very difficult"
or "not at all difficult" to change their eating and/or physical
activity patterns if it would help prevent obesity in any of their
children.
Create an Active
Environment:
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Make time for the entire family
to participate in regular physical activities that everyone enjoys. Try
walking, bicycling or rollerblading.
-
Plan special active
family-outings such as a hiking or ski trip.
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Start an active neighborhood
program. Join together with other families for group activities like
touch-football, basketball, tag or hide-and-seek.
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Assign active chores to every
family member such as vacuuming, washing the car or mowing the lawn.
Rotate the schedule of chores to avoid boredom from routine.
-
Enroll your child in a
structured activity that he or she enjoys, such as tennis, gymnastics,
martial arts, etc.
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Instill an interest in your
child to try a new sport by joining a team at school or in your
community.
-
Limit the amount of TV
watching.
Create a Healthy Eating Environment:
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Implement the same healthy diet
(rich in fruits, vegetables and grains) for your entire family, not just
for select individuals.
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Plan times when you prepare
foods together. Children enjoy participating and can learn about healthy
cooking and food preparation.
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Eat meals together at the
dinner table at regular times.
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Avoid rushing to finish meals.
Eating too quickly does not allow enough time to digest and to feel a
sense of fullness.
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Avoid other activities during
mealtimes such as watching TV.
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Avoid foods that are high in
calories, fat or sugar.
-
Have snack foods available that
are low-calorie and nutritious. Fruit, vegetables and yogurt are some
examples.
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Avoid serving portions that are
too large.
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Avoid forcing your child to eat
if he/she is not hungry. If your child shows atypical signs of not
eating, consult a healthcare professional.
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Limit the frequency of
fast-food eating to no more than once per week.
-
Avoid using food as a reward or
the lack of food as punishment.
Health Risks, Diagnosis and Treatment
Determining if a child or
adolescent has a weight problem can be challenging. How do you know if the
excess weight your child has is part of the natural growth process, and
will your child just "grow out of?" How do you know if your child's weight
may be negatively affecting his or her health?
Health Risks of Morbid Obesity
Along with the rise in childhood
obesity, there has been an increase in the incidence and prevalence of
medical conditions in children and adolescents that had been rare in the
past. Pediatricians and childhood obesity researchers are reporting more
frequent cases of obesity-related diseases such as type 2 diabetes, asthma
and hypertension that once were considered adult conditions.
Diagnosing Morbid Obesity
There are some signs that may
help you determine if your child has or is at risk for childhood obesity,
such as:
- Family history of obesity.
- Family history of
obesity-related health risks such as early cardiovascular disease, high
cholesterol, high blood pressure levels, type 2 diabetes.
- Family history of cigarette
smoking and sedentary behaviors.
- Signs in the child of
obesity-related health risks from a pediatrician's evaluation including:
- Cardiac Risk Factors. Studies
of children with obesity show higher than average blood pressure,
heart rate and cardiac output when compared to children without
obesity.
- Type 2 Diabetes Risk Factors.
This involves glucose intolerance and insulin levels that are higher
than average.
- Orthopedic Problems. Some
symptoms include weight stress in the joints of the lower limbs,
tibial torsion and bowed legs, and slipped capital femoral epiphysis
(especially in boys).
- Skin disorders. Some are heat
rash, intertrigo, monilial dermatitis and acanthosis nigricans.
- Psychological / Psychiatric
Issues. Poor self-esteem, negative self-image, depression, and
withdrawal from peers have been associated with obesity.
- Patterns of sedentary behavior
(such as too much television viewing) and low physical activity levels.
- Taller height - children with
obesity are often above the 50th percentile in height.
- Smoking initiation. Research
studies show that youngsters use smoking as a method of weight control.
Parents, pediatricians and schools should work together to discourage
smoking as a weight control behavior for three main reasons: a) smoking
is not likely to be successful in controlling weight, b) smoking is
itself harmful, and c) smoking is associated with a decrease in sound
nutrition and physical activity patterns.
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