The document summarizes a seminar on obesity in children and adolescents. It discusses definitions of obesity and overweight, prevalence and trends, causes including exogenous factors like poor diet and lack of exercise as well as endogenous genetic and endocrine factors. Complications of childhood obesity discussed include psychological issues, sleep apnea, non-alcoholic fatty liver disease, diabetes, and cardiovascular risks. Screening and normal values for tests to evaluate complications are also presented.
This document provides an overview of childhood obesity including prevalence, risks, environmental and genetic factors, critical periods of development, diet, physical activity, and recommendations for prevention. Some key points:
- Rates of childhood obesity in the US have increased 2-3 fold over the last 25 years. Approximately 18.8% of US children ages 6-11 are overweight.
- Risk factors for childhood obesity include family history, low income, lack of physical activity, excess calorie intake, excessive screen time, and lack of breastfeeding.
- Critical periods for the development of obesity are gestation, ages 5-6, and adolescence. Early life nutrition and growth patterns can impact future health.
This document outlines key information about childhood obesity including:
1. Definitions of overweight and obesity in children based on BMI percentiles. Almost 1/3 of US children are overweight or obese.
2. Causes of childhood obesity including genetic, environmental, and endocrine factors such as certain medications and diseases.
3. The pathophysiology involves genetic and environmental components impacting caloric intake and expenditure as well as hormones that regulate appetite and metabolism such as leptin, insulin, ghrelin, and PYY.
This document discusses obesity in children. It notes that obesity is reaching epidemic proportions globally, including in developing countries. In India, studies have shown increasing rates of overweight and obesity in children, particularly in urban and affluent populations. Childhood obesity can lead to health issues not only during childhood but also in adulthood. The causes of childhood obesity are often exogenous or environmental factors like diet, sedentary lifestyle, and genetics. Treatment involves dietary changes, increased physical activity, behavior modification, and treatment of any related health complications. A multidisciplinary approach with family involvement tends to have the best outcomes.
This document discusses childhood obesity. Some key points:
- Childhood obesity is increasingly common and difficult to treat. It can lead to health issues like diabetes and persist into adulthood.
- Obesity in children is different than in adults and is influenced by growth. BMI percentiles must account for age and sex.
- Treatment aims for weight maintenance rather than loss to avoid impacting growth. Lifestyle changes like increased activity and healthier eating are recommended.
- Risk factors include sedentary behavior, high fat diets, and lower socioeconomic status. Prevention requires addressing societal and environmental contributors.
This document discusses childhood obesity as a global health concern. It provides information on what BMI is and how it is used to diagnose obesity in children. It describes the various health effects of childhood obesity, including psychological effects, cardiovascular issues, metabolic disorders and others. It discusses factors that contribute to childhood obesity such as genetics, diet, physical inactivity, and social determinants. Prevention strategies mentioned include improving access to healthy foods, increasing physical activity and making changes to the home and school environments.
This document defines childhood obesity and discusses its prevalence, etiology, comorbidities, evaluation, intervention, and prevention. Childhood obesity is defined as a BMI above the 95th percentile. It affects 31% of children aged 2-6 years and 16% of children aged 6-19 years. The main causes include environmental factors like increased consumption of unhealthy foods and decreased physical activity, genetic predispositions, and certain endocrine conditions. Obesity can lead to serious health issues like diabetes, hypertension, sleep apnea, and mental health problems. Evaluation involves growth monitoring and testing for underlying causes and comorbidities. Treatment focuses on nutrition, exercise, and behavior changes, while prevention emphasizes healthy eating, activity, and limiting screen
The document discusses childhood obesity and the role of parents in preventing and treating it. It provides evidence from several studies that treating parents alone through education and lifestyle changes leads to better weight loss outcomes in children compared to only treating the children. Parents have significant influence over their child's diet, physical activity, and home environment. Therefore, new interventions should focus on empowering parents to create a healthy lifestyle for their families.
This document provides an overview of childhood obesity including prevalence, risks, environmental and genetic factors, critical periods of development, diet, physical activity, and recommendations for prevention. Some key points:
- Rates of childhood obesity in the US have increased 2-3 fold over the last 25 years. Approximately 18.8% of US children ages 6-11 are overweight.
- Risk factors for childhood obesity include family history, low income, lack of physical activity, excess calorie intake, excessive screen time, and lack of breastfeeding.
- Critical periods for the development of obesity are gestation, ages 5-6, and adolescence. Early life nutrition and growth patterns can impact future health.
This document outlines key information about childhood obesity including:
1. Definitions of overweight and obesity in children based on BMI percentiles. Almost 1/3 of US children are overweight or obese.
2. Causes of childhood obesity including genetic, environmental, and endocrine factors such as certain medications and diseases.
3. The pathophysiology involves genetic and environmental components impacting caloric intake and expenditure as well as hormones that regulate appetite and metabolism such as leptin, insulin, ghrelin, and PYY.
This document discusses obesity in children. It notes that obesity is reaching epidemic proportions globally, including in developing countries. In India, studies have shown increasing rates of overweight and obesity in children, particularly in urban and affluent populations. Childhood obesity can lead to health issues not only during childhood but also in adulthood. The causes of childhood obesity are often exogenous or environmental factors like diet, sedentary lifestyle, and genetics. Treatment involves dietary changes, increased physical activity, behavior modification, and treatment of any related health complications. A multidisciplinary approach with family involvement tends to have the best outcomes.
This document discusses childhood obesity. Some key points:
- Childhood obesity is increasingly common and difficult to treat. It can lead to health issues like diabetes and persist into adulthood.
- Obesity in children is different than in adults and is influenced by growth. BMI percentiles must account for age and sex.
- Treatment aims for weight maintenance rather than loss to avoid impacting growth. Lifestyle changes like increased activity and healthier eating are recommended.
- Risk factors include sedentary behavior, high fat diets, and lower socioeconomic status. Prevention requires addressing societal and environmental contributors.
This document discusses childhood obesity as a global health concern. It provides information on what BMI is and how it is used to diagnose obesity in children. It describes the various health effects of childhood obesity, including psychological effects, cardiovascular issues, metabolic disorders and others. It discusses factors that contribute to childhood obesity such as genetics, diet, physical inactivity, and social determinants. Prevention strategies mentioned include improving access to healthy foods, increasing physical activity and making changes to the home and school environments.
This document defines childhood obesity and discusses its prevalence, etiology, comorbidities, evaluation, intervention, and prevention. Childhood obesity is defined as a BMI above the 95th percentile. It affects 31% of children aged 2-6 years and 16% of children aged 6-19 years. The main causes include environmental factors like increased consumption of unhealthy foods and decreased physical activity, genetic predispositions, and certain endocrine conditions. Obesity can lead to serious health issues like diabetes, hypertension, sleep apnea, and mental health problems. Evaluation involves growth monitoring and testing for underlying causes and comorbidities. Treatment focuses on nutrition, exercise, and behavior changes, while prevention emphasizes healthy eating, activity, and limiting screen
The document discusses childhood obesity and the role of parents in preventing and treating it. It provides evidence from several studies that treating parents alone through education and lifestyle changes leads to better weight loss outcomes in children compared to only treating the children. Parents have significant influence over their child's diet, physical activity, and home environment. Therefore, new interventions should focus on empowering parents to create a healthy lifestyle for their families.
1) Childhood obesity is an increasing problem in New Zealand society, affecting 31% of children aged 5-14.
2) The document aims to promote physical activity and healthy eating choices to help stop childhood obesity, particularly through initiatives at Kaurilands Primary school.
3) Childhood obesity rates vary between cultures and are more prevalent among Māori and Pacific Islander children.
Management of childhood obesity through nutrition interventionswanmk166
This document summarizes a case study of an 11-year-old girl seeking treatment for childhood obesity. It provides background on childhood obesity rates and risk factors. An initial assessment found the girl to be in the 99th percentile for BMI and at risk for comorbidities. After two follow-up appointments spanning 4 months, she lost 12 pounds through dietary changes like reducing juice and snacking, and increased physical activity goals. Her nutrition diagnosis addressed high sugar intake and sedentary lifestyle contributing to obesity.
This document discusses pediatric obesity, including its definition using BMI, epidemiology, causes, complications, treatment, and prevention. Regarding definition and BMI, obesity in children is defined as excess body fat that negatively impacts health, and is diagnosed using BMI centiles where overweight is >91st centile and obese is >98th centile. The document then reviews the rising global rates of pediatric obesity and risk of obesity continuing into adulthood. Causes discussed include genetic predisposition and obesogenic environmental factors that promote overeating and sedentary behaviors. Complications can impact nearly every organ system, while treatment involves lifestyle changes and may include multidisciplinary programs depending on severity. Prevention strategies incorporate breastfeeding, appropriate portion sizes,
This document discusses childhood obesity including its definition, epidemiology, risk factors, causes, evaluation, treatment, and management. Some key points include:
- Childhood obesity is defined as a BMI at or above the 95th percentile for age and sex. It can be caused by genetic and environmental factors.
- Rates of childhood obesity have tripled since the 1970s globally and in countries like the US and KSA. Risk factors include family history, low income, and lack of physical activity.
- Evaluation of an obese child includes medical history, exam, and tests to check for underlying causes and comorbidities. Treatment focuses on lifestyle changes like diet, exercise, and behavior modification for the whole
This document provides an overview of obesity, including its definition, measurement, prevalence, causes, evaluation, treatment approaches, and a case study. It defines obesity as a BMI over 30 kg/m2 and notes the increased prevalence in the US and worldwide. The evaluation of patients with obesity involves taking a history, physical exam, assessing comorbidities, fitness, and readiness to change. Treatment options include lifestyle management, pharmacotherapy, and surgery. A case study is then presented and discussed in terms of appropriate treatment goals.
This document discusses obesity in children and adolescents. It outlines the increasing prevalence of childhood obesity globally and defines obesity as having a body mass index above the 95th percentile for age. Childhood obesity is associated with increased risk of health issues like high blood pressure, diabetes, and cardiovascular disease. Treatment involves lifestyle changes like diet and exercise, while medications and bariatric surgery are only considered for severe cases. Education programs are needed to prevent obesity.
This document provides information on childhood obesity including:
- Childhood obesity is determined using Body Mass Index (BMI) and affects over 12.7 million children in the US.
- Major contributing factors include physical inactivity, consumption of high-calorie foods, and increased screen time.
- Childhood obesity increases the risks of health issues like diabetes, cardiovascular disease, depression, and more.
- Promoting healthy habits like increasing physical activity to 1 or more hours per day, encouraging nutritious food choices, and limiting screen time to less than 7 hours can help address this public health issue.
- Parents play a key role by being healthy role models, making healthy options available, and
This document provides an overview on approaching short stature in children. It discusses defining short stature, the importance of accurate measurements and growth charts, common causes including familial, constitutional, and endocrine factors. The document outlines the assessment process including history, examination, and initial investigations. Key differentials like familial vs constitutional short stature and Turner vs Noonan syndrome are reviewed. Management focuses on treating underlying causes, nutrition, psychological support, and growth hormone therapy in select cases. Regular follow-up is emphasized as the main initial management step for short stature.
Childhood obesity is a medical condition where children weigh more than expected according to their age and height. It is caused by genetics, lack of physical activity, unhealthy eating habits, and medical or psychological conditions. Complications include type 2 diabetes, high cholesterol, high blood pressure, bullying, learning problems, and depression. Prevention involves limiting sugary drinks and eating outside food, providing fruits and vegetables, encouraging physical activity, limiting screen time, ensuring enough sleep, and making healthier choices.
This document discusses causes and risk factors for childhood obesity. It identifies several socioeconomic factors that increase obesity risk, such as lower income levels, lack of access to healthy foods, and greater exposure to junk food marketing. Family environment factors are also examined, including single-parent households, lack of parental involvement in meal preparation and eating, and psychosocial issues like neglect. Lifestyle behaviors like insufficient physical activity and high consumption of fast food are identified as additional risk factors. Potential health outcomes of childhood obesity and approaches for prevention through education are also summarized.
This document discusses childhood obesity, its causes, health effects, and prevention. It notes that a lack of physical exercise and unhealthy food choices can lead a initially mildly obese child to become severely obese by age 18. The main causes discussed are increased screen time reducing activity, unhealthy family eating habits, marketing of fast food to children, and unsafe neighborhoods discouraging outdoor play. Health effects of childhood obesity include physical issues like diabetes and cancer, as well as emotional impacts like low self-esteem and depression. The document recommends preventing childhood obesity through proper diet, exercise, community support, and legal measures.
This document discusses failure to thrive in children. It begins by defining failure to thrive as inadequate nutrition leading to abnormal growth. Growth charts are then reviewed as tools to identify failure to thrive. The causes of failure to thrive are categorized as inadequate calories, inability to utilize calories, and increased caloric needs. Child abuse, including neglect, medical child abuse, and physical/sexual abuse, are also discussed as potential causes. The evaluation, treatment, and multidisciplinary management of failure to thrive are outlined.
1. This document provides guidance on evaluating short stature in children. It outlines steps to determine if a child's height is abnormal, investigate potential underlying causes, and decide which tests are appropriate.
2. The first steps are to measure the child's height, weight, and proportions, then compare to growth charts and calculate midparental height. Bone age testing can indicate if growth is delayed or accelerated.
3. Potential causes of short stature discussed include familial, constitutional, endocrine, congenital, chronic disease, and metabolic factors. The document provides examples of diseases for each category.
4. Recommended initial investigations include basic blood tests. Further tests are tailored to the suspected condition and may
This document discusses childhood obesity, its causes, and potential solutions. It notes that childhood obesity can lead to long-term health issues. While genes may play a small role, the main causes are environmental factors like parenting, food marketing, and lack of physical activity. The document recommends intervention programs, limiting junk food and screen time at home, and increasing exercise as ways to help address the problem.
obesity in children , causes of obesity, approach to children obesity, complication of obesity, obesity definition, how to manage obesity, guidelines in pediatric obesity
The document discusses obesity, including its prevalence, complications, and treatment. Some key points:
- Obesity is defined as having a BMI of over 30 or excess body fat of over 20%. It results from consuming more calories than expended.
- It is common worldwide and in countries like India and China. In the US, over 30% of adults are obese, costing $147 billion annually.
- Obesity increases the risk of conditions like diabetes, high blood pressure, high cholesterol, heart disease, stroke, arthritis, and some cancers.
- Treatment involves lifestyle changes like diet and exercise. For higher-risk patients, treatment may include medication or surgery to help with weight loss and reduce
Service providers who receive high nutrition risk referrals, particularly Registered Dietitians, need to be knowledgeable about general and clinical pediatric nutrition as well as counselling skills for working with families and children.
This is the third of five self-directed training modules available in PowerPoint presentations that have been developed and evaluated to respond to this need
1) Short stature can be caused by disease, disability, or social stigma and requires evaluation.
2) A child is considered short if their height is below the 3rd percentile or more than 2 standard deviations below the median height for their age and sex.
3) Approximately half of children with short stature have a physiological/familial cause, while the other half have a pathological cause like malnutrition, chronic illness, hormonal deficiencies, or genetic syndromes.
4) Evaluation of a child with short stature involves taking a thorough history, performing anthropometric measurements and growth chart analysis, conducting a physical exam, and ordering initial lab tests and bone age assessment.
Basic approach on short stature in childrenAzad Haleem
This document provides an overview of short stature, including definitions, types, diagnostic principles, causes, and management. It defines short stature as height below the 3rd percentile and discusses types such as familial short stature. Diagnosis involves accurate height measurements, bone age assessment, mid-parental height comparison, and medical investigations. Causes include growth hormone deficiency, Turner syndrome, and small size at birth. Management consists of dietary counseling, growth hormone injections, and limb lengthening procedures depending on the underlying cause.
This document discusses obesity in children. It defines obesity and related terms like overweight, defines it using BMI percentiles. It discusses the pathogenesis involving hormones like leptin and ghrelin. Risk factors include genetic predisposition and lifestyle factors. Obesity can cause medical conditions like diabetes, hypertension, fatty liver disease. Evaluation involves history, exam and investigations. Management focuses on diet modification, physical activity and lifestyle changes.
Obesity in children is defined as excess body fat that increases health risks. The prevalence of childhood obesity is increasing globally and in India. Obese children often remain obese as adults, increasing their risk of cardiovascular disease, diabetes, and other health issues. Causes of obesity include genetic factors, medical conditions, medications, lifestyle and behavioral factors like poor diet and sedentary behavior. Evaluation and management involves lifestyle changes like diet and exercise as first-line treatment, along with addressing any underlying medical conditions and using medications in some cases. Bariatric surgery may be considered for severe obesity.
1) Childhood obesity is an increasing problem in New Zealand society, affecting 31% of children aged 5-14.
2) The document aims to promote physical activity and healthy eating choices to help stop childhood obesity, particularly through initiatives at Kaurilands Primary school.
3) Childhood obesity rates vary between cultures and are more prevalent among Māori and Pacific Islander children.
Management of childhood obesity through nutrition interventionswanmk166
This document summarizes a case study of an 11-year-old girl seeking treatment for childhood obesity. It provides background on childhood obesity rates and risk factors. An initial assessment found the girl to be in the 99th percentile for BMI and at risk for comorbidities. After two follow-up appointments spanning 4 months, she lost 12 pounds through dietary changes like reducing juice and snacking, and increased physical activity goals. Her nutrition diagnosis addressed high sugar intake and sedentary lifestyle contributing to obesity.
This document discusses pediatric obesity, including its definition using BMI, epidemiology, causes, complications, treatment, and prevention. Regarding definition and BMI, obesity in children is defined as excess body fat that negatively impacts health, and is diagnosed using BMI centiles where overweight is >91st centile and obese is >98th centile. The document then reviews the rising global rates of pediatric obesity and risk of obesity continuing into adulthood. Causes discussed include genetic predisposition and obesogenic environmental factors that promote overeating and sedentary behaviors. Complications can impact nearly every organ system, while treatment involves lifestyle changes and may include multidisciplinary programs depending on severity. Prevention strategies incorporate breastfeeding, appropriate portion sizes,
This document discusses childhood obesity including its definition, epidemiology, risk factors, causes, evaluation, treatment, and management. Some key points include:
- Childhood obesity is defined as a BMI at or above the 95th percentile for age and sex. It can be caused by genetic and environmental factors.
- Rates of childhood obesity have tripled since the 1970s globally and in countries like the US and KSA. Risk factors include family history, low income, and lack of physical activity.
- Evaluation of an obese child includes medical history, exam, and tests to check for underlying causes and comorbidities. Treatment focuses on lifestyle changes like diet, exercise, and behavior modification for the whole
This document provides an overview of obesity, including its definition, measurement, prevalence, causes, evaluation, treatment approaches, and a case study. It defines obesity as a BMI over 30 kg/m2 and notes the increased prevalence in the US and worldwide. The evaluation of patients with obesity involves taking a history, physical exam, assessing comorbidities, fitness, and readiness to change. Treatment options include lifestyle management, pharmacotherapy, and surgery. A case study is then presented and discussed in terms of appropriate treatment goals.
This document discusses obesity in children and adolescents. It outlines the increasing prevalence of childhood obesity globally and defines obesity as having a body mass index above the 95th percentile for age. Childhood obesity is associated with increased risk of health issues like high blood pressure, diabetes, and cardiovascular disease. Treatment involves lifestyle changes like diet and exercise, while medications and bariatric surgery are only considered for severe cases. Education programs are needed to prevent obesity.
This document provides information on childhood obesity including:
- Childhood obesity is determined using Body Mass Index (BMI) and affects over 12.7 million children in the US.
- Major contributing factors include physical inactivity, consumption of high-calorie foods, and increased screen time.
- Childhood obesity increases the risks of health issues like diabetes, cardiovascular disease, depression, and more.
- Promoting healthy habits like increasing physical activity to 1 or more hours per day, encouraging nutritious food choices, and limiting screen time to less than 7 hours can help address this public health issue.
- Parents play a key role by being healthy role models, making healthy options available, and
This document provides an overview on approaching short stature in children. It discusses defining short stature, the importance of accurate measurements and growth charts, common causes including familial, constitutional, and endocrine factors. The document outlines the assessment process including history, examination, and initial investigations. Key differentials like familial vs constitutional short stature and Turner vs Noonan syndrome are reviewed. Management focuses on treating underlying causes, nutrition, psychological support, and growth hormone therapy in select cases. Regular follow-up is emphasized as the main initial management step for short stature.
Childhood obesity is a medical condition where children weigh more than expected according to their age and height. It is caused by genetics, lack of physical activity, unhealthy eating habits, and medical or psychological conditions. Complications include type 2 diabetes, high cholesterol, high blood pressure, bullying, learning problems, and depression. Prevention involves limiting sugary drinks and eating outside food, providing fruits and vegetables, encouraging physical activity, limiting screen time, ensuring enough sleep, and making healthier choices.
This document discusses causes and risk factors for childhood obesity. It identifies several socioeconomic factors that increase obesity risk, such as lower income levels, lack of access to healthy foods, and greater exposure to junk food marketing. Family environment factors are also examined, including single-parent households, lack of parental involvement in meal preparation and eating, and psychosocial issues like neglect. Lifestyle behaviors like insufficient physical activity and high consumption of fast food are identified as additional risk factors. Potential health outcomes of childhood obesity and approaches for prevention through education are also summarized.
This document discusses childhood obesity, its causes, health effects, and prevention. It notes that a lack of physical exercise and unhealthy food choices can lead a initially mildly obese child to become severely obese by age 18. The main causes discussed are increased screen time reducing activity, unhealthy family eating habits, marketing of fast food to children, and unsafe neighborhoods discouraging outdoor play. Health effects of childhood obesity include physical issues like diabetes and cancer, as well as emotional impacts like low self-esteem and depression. The document recommends preventing childhood obesity through proper diet, exercise, community support, and legal measures.
This document discusses failure to thrive in children. It begins by defining failure to thrive as inadequate nutrition leading to abnormal growth. Growth charts are then reviewed as tools to identify failure to thrive. The causes of failure to thrive are categorized as inadequate calories, inability to utilize calories, and increased caloric needs. Child abuse, including neglect, medical child abuse, and physical/sexual abuse, are also discussed as potential causes. The evaluation, treatment, and multidisciplinary management of failure to thrive are outlined.
1. This document provides guidance on evaluating short stature in children. It outlines steps to determine if a child's height is abnormal, investigate potential underlying causes, and decide which tests are appropriate.
2. The first steps are to measure the child's height, weight, and proportions, then compare to growth charts and calculate midparental height. Bone age testing can indicate if growth is delayed or accelerated.
3. Potential causes of short stature discussed include familial, constitutional, endocrine, congenital, chronic disease, and metabolic factors. The document provides examples of diseases for each category.
4. Recommended initial investigations include basic blood tests. Further tests are tailored to the suspected condition and may
This document discusses childhood obesity, its causes, and potential solutions. It notes that childhood obesity can lead to long-term health issues. While genes may play a small role, the main causes are environmental factors like parenting, food marketing, and lack of physical activity. The document recommends intervention programs, limiting junk food and screen time at home, and increasing exercise as ways to help address the problem.
obesity in children , causes of obesity, approach to children obesity, complication of obesity, obesity definition, how to manage obesity, guidelines in pediatric obesity
The document discusses obesity, including its prevalence, complications, and treatment. Some key points:
- Obesity is defined as having a BMI of over 30 or excess body fat of over 20%. It results from consuming more calories than expended.
- It is common worldwide and in countries like India and China. In the US, over 30% of adults are obese, costing $147 billion annually.
- Obesity increases the risk of conditions like diabetes, high blood pressure, high cholesterol, heart disease, stroke, arthritis, and some cancers.
- Treatment involves lifestyle changes like diet and exercise. For higher-risk patients, treatment may include medication or surgery to help with weight loss and reduce
Service providers who receive high nutrition risk referrals, particularly Registered Dietitians, need to be knowledgeable about general and clinical pediatric nutrition as well as counselling skills for working with families and children.
This is the third of five self-directed training modules available in PowerPoint presentations that have been developed and evaluated to respond to this need
1) Short stature can be caused by disease, disability, or social stigma and requires evaluation.
2) A child is considered short if their height is below the 3rd percentile or more than 2 standard deviations below the median height for their age and sex.
3) Approximately half of children with short stature have a physiological/familial cause, while the other half have a pathological cause like malnutrition, chronic illness, hormonal deficiencies, or genetic syndromes.
4) Evaluation of a child with short stature involves taking a thorough history, performing anthropometric measurements and growth chart analysis, conducting a physical exam, and ordering initial lab tests and bone age assessment.
Basic approach on short stature in childrenAzad Haleem
This document provides an overview of short stature, including definitions, types, diagnostic principles, causes, and management. It defines short stature as height below the 3rd percentile and discusses types such as familial short stature. Diagnosis involves accurate height measurements, bone age assessment, mid-parental height comparison, and medical investigations. Causes include growth hormone deficiency, Turner syndrome, and small size at birth. Management consists of dietary counseling, growth hormone injections, and limb lengthening procedures depending on the underlying cause.
This document discusses obesity in children. It defines obesity and related terms like overweight, defines it using BMI percentiles. It discusses the pathogenesis involving hormones like leptin and ghrelin. Risk factors include genetic predisposition and lifestyle factors. Obesity can cause medical conditions like diabetes, hypertension, fatty liver disease. Evaluation involves history, exam and investigations. Management focuses on diet modification, physical activity and lifestyle changes.
Obesity in children is defined as excess body fat that increases health risks. The prevalence of childhood obesity is increasing globally and in India. Obese children often remain obese as adults, increasing their risk of cardiovascular disease, diabetes, and other health issues. Causes of obesity include genetic factors, medical conditions, medications, lifestyle and behavioral factors like poor diet and sedentary behavior. Evaluation and management involves lifestyle changes like diet and exercise as first-line treatment, along with addressing any underlying medical conditions and using medications in some cases. Bariatric surgery may be considered for severe obesity.
Childhood obesity is a growing global health problem defined as body mass index greater than the 95th percentile. It is caused by a combination of genetic and environmental factors that lead to increased energy intake and decreased energy expenditure. Obese children are at risk for complications affecting metabolic, cardiovascular, orthopedic and psychological health. Treatment involves lifestyle modifications like diet, exercise and behavior change with family support. In some severe cases, medication or bariatric surgery may be considered. Ayurveda views it as medoroga caused by excessive intake of fatty, sweet foods and lack of exercise, managed using depletion therapies, yoga, and herbal formulations to balance doshas.
This document discusses obesity in children and provides information on risk factors, evaluation, treatment, and prevention. Some key points include:
- Risk factors for childhood obesity include parental obesity, high birth weight, lack of breastfeeding, sedentary lifestyle, and genetic factors.
- Evaluation of an obese child includes examining growth charts, medical history, physical exam, and lab tests if indicated.
- Treatment focuses on behavior changes like increasing physical activity, improving diet, and reducing screen time. Medications are rarely used.
- Prevention strategies target various levels like families, schools, healthcare, and policy/environmental changes to promote healthy lifestyles.
This document discusses obesity in children and provides information on risk factors, evaluation, treatment, and prevention. Some key points include:
- Risk factors for childhood obesity include parental obesity, high birth weight, lack of breastfeeding, sedentary lifestyle, and genetic factors.
- Evaluation of an obese child includes examining growth charts, medical history, physical exam, and lab tests if indicated.
- Treatment focuses on behavior changes like increasing physical activity, improving diet, and reducing screen time. Medications are rarely used.
- Prevention strategies target various levels like families, schools, healthcare, and policy/environmental changes to promote healthy lifestyles.
chilhood obesity by dr abhishek saini, AMCHAbhishek Saini
This document discusses childhood obesity, including its definition, epidemiology, etiology, pathophysiology, health consequences, evaluation, and management. It begins with an introduction stating that childhood obesity is a complex, multifactorial problem that is increasingly common in both western and developing countries like India. If not addressed, obesity in childhood can lead to obesity in adulthood and medical complications. The rest of the document covers topics like the definition of obesity based on BMI, trends showing increasing obesity rates globally and in India, genetic and environmental causes of obesity, the role of the hypothalamus and hormones like leptin and ghrelin in regulating appetite and energy balance, potential comorbidities of obesity like cardiovascular, endocrine,
Peculiarities of children in differnet age groupAMIT NAWRANG
The document discusses childhood obesity, summarizing that approximately 21-24% of American children are overweight and 16-18% are obese, with the highest rates among certain ethnic groups. Childhood obesity increases the risk of health issues like diabetes and cardiovascular disease. While many factors contribute to obesity, over 90% of cases have no known medical cause. The document also examines tools to measure obesity like BMI, genetic conditions associated with childhood obesity like Prader-Willi Syndrome, and the importance of physical activity for children's health and development.
Obesity is defined as abnormal growth of adipose tissue due to enlargement of fat cells or increase in fat cell number. Central obesity is measured by waist circumference. Obesity is classified based on BMI and is associated with increased risk of comorbidities like diabetes, hypertension and dyslipidemia. It is caused by factors like unhealthy diet, physical inactivity, genetics and hormones. Treatment involves moderate calorie restriction and physical activity. Homoeopathic medicines like Calcarea carb, Natrum mur, Ammonium carb and Ferrum met can help in obesity management.
Childhood obesity is a serious public health problem associated with health risks. The number of overweight or obese children worldwide has increased threefold in the past 30 years. Obesity results from an energy imbalance where more calories are consumed than expended. Evaluation of obese children includes medical history, physical exam assessing BMI and waist circumference, and targeted testing depending on symptoms. Treatment involves lifestyle modifications like diet and exercise. Prevention strategies focus on promoting breastfeeding, limiting screen time and sugar-sweetened drinks, and increasing physical activity.
This document defines childhood obesity and discusses its prevalence, etiology, comorbidities, evaluation, intervention, and prevention. Some key points:
- Childhood obesity is defined as BMI above the 95th percentile for age and sex. Its prevalence is 31% for ages 2-6 and 16% for ages 6-19.
- Etiology includes environmental factors like increased consumption of unhealthy foods and decreased physical activity, as well as genetic and endocrine causes.
- Comorbidities include type 2 diabetes, hypertension, sleep apnea, and mental health issues.
- Evaluation involves medical history, physical exam, growth charts, and lab tests to check for comorbid conditions.
- Intervention consists
This document discusses various nutritional problems including protein-energy malnutrition, micronutrient deficiencies, and eating disorders. Protein-energy malnutrition manifests as kwashiorkor or marasmus depending on whether there is edema or wasting. Common micronutrient deficiencies in India are vitamin A deficiency which can cause blindness, and anemia. Prevention strategies include breastfeeding, immunization, supplementation, and food fortification. The document provides details on the causes, risk groups, clinical features and management of various nutritional problems.
The document discusses obesity, defining it as a condition of excessive body fat that is associated with various health risks, and examines its causes such as overeating, physical inactivity, and genetic factors; it also explores strategies for weight loss through diet, exercise, behavior modification, and in some cases medications, noting that most people regain lost weight without long-term lifestyle changes and support.
This document discusses failure to thrive and short stature in children. It defines failure to thrive as inadequate calorie intake to support a child's growth and metabolic demands, resulting in growth failure. Causes of failure to thrive include inadequate nutrition from medical issues, psychosocial factors, or increased calorie expenditure from illness or disease. The assessment and management of failure to thrive involves detailed history, examinations to identify underlying causes, nutritional rehabilitation, parental counselling, and medical treatment. Short stature is defined as height below the 3rd percentile or 2 standard deviations below the mean for age and sex. The document discusses normal growth velocity and the determinants of child growth.
Clinical Research Challenges and Best Practices in Pediatric Research in Canada - Dr. Al Wahab - 2015
Dr. Zeina AlWahab, M.D.
Prof. Peivand Pirouzi, Ph.D., M.B.A.
This document discusses various nutritional disorders including malnutrition, undernutrition, micronutrient deficiencies, overweight, obesity, and metabolic syndrome. It defines each condition and provides details on signs, causes, and health effects. Malnutrition refers to deficiencies or imbalances in energy and nutrient intake and includes undernutrition, micronutrient deficiencies, overweight, and obesity. Undernutrition is insufficient food intake over time and includes wasting, stunting, and being underweight. Micronutrient deficiencies involve inadequate intake of vitamins and minerals. Overweight and obesity result from excessive calorie intake over time and not enough physical activity.
This document provides an overview of pediatric obesity. It discusses the increasing global prevalence of obesity and its health consequences. Obesity is defined as a BMI above the 95th percentile for age and sex. Risk factors include genetic, lifestyle, and environmental factors like increased intake of processed foods and decreased physical activity. Obesity leads to medical comorbidities through pathways like increased inflammation and hormone dysfunction. Evaluation involves assessing growth trends, risk factors, and screening for related conditions. Treatment requires lifestyle modifications focusing on nutrition, behavior changes, and physical activity.
This document discusses gestational diabetes. It provides information on:
1. Gestational diabetes is a form of diabetes that develops during pregnancy in women who do not have diabetes otherwise. It is caused by pregnancy hormones and/or insulin deficiency.
2. While gestational diabetes usually resolves after delivery, it increases the mother's risk of developing type 2 diabetes later in life. It can also increase risks for the baby if not well controlled, such as being too large or jaundice.
3. Screening all pregnant women for gestational diabetes is recommended, as prior selective screening missed some cases. Screening and treatment can help reduce risks for both mother and baby.
obesity -medical information (causes, calculation ,management, )martinshaji
A disorder involving excessive body fat that increases the risk of health problems.
Obesity often results from taking in more calories than are burned by exercise and normal daily activities.
Obesity occurs when a person's body mass index is 25 or greater. The excessive body fat increases the risk of serious health problems.
The mainstay of treatment is lifestyle changes such as diet and exercise. Obesity is a complex disease involving an excessive amount of body fat. Obesity isn't just a cosmetic concern. It is a medical problem that increases your risk of other diseases and health problems, such as heart disease, diabetes, high blood pressure and certain cancers.
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This document provides an outline and introduction on obesity. It discusses the epidemiology of obesity as a growing global health problem. It covers classifications of obesity using BMI and waist circumference measurements. The document examines the physiological regulation of energy balance and hormones like leptin and ghrelins role. Causes of obesity include genetic and environmental factors. Complications of obesity include insulin resistance, type 2 diabetes, cardiovascular disease and effects on the pulmonary system.
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
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TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
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Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
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2. OBESITY IN
CHILDREN –
AN
OVERVIEW
Dr. Prashant (PG)
Dr. Dushyant (SR)
Dr. Ruchi Mishra
Assistant Professor(Paediatrics)
ESI PGIMSR, Basaidarapur, New
Delhi
3. What is obesity??
Grossly, overweight means excess body-weight for height. Overweight
& Obesity are objectively defined using age-specific & gender-specific
nomogram
Obesity is defined by WHO as excess in fat mass great enough to
increase the risk of morbidity, altered physical, psychological, or social
well-being and/or mortality
Weight Status Category Percentile Range
Underweight Less than 5th centile
Normal or healthy weight 5th-85th percentile
Overweight 85th-95th percentile
Obese 95th percentile or greater
Morbid obesity >120% of 95th percentile
4. Why to discuss obesity in children
• It has become a major global public challenge today.
• Complex, multifactorial, challenging and often, frustrating
problem that is escalating at an alarming rate in the
western world and paradoxically, also in developing
countries like India.
• 60-80% of obese adolescents are expected to remain
obese as adults.
• Cardiovascular diseases, Type II DM in young age,
Hypertension & Dyslipidemia, all are related to childhood
obesity.
• New issues like fatty liver disease, obstructive sleep
apnea, orthopaedic problems and psychological
abnormalities are also attributed to obesity in childhood.
5. Epidemiology
• Paediatric obesity continues to be a serious ongoing
health problem affecting 45 million children under 5
years worldwide(2010 data).
• Countries like us have a double whammy of trying to
prevent malnutrition at one end and finding nearly
1/5th of the population being obese.
• Combined prevalence of childhood obesity &
overweight in India is 19.3%(2010) as compared to
16.3% in (2001-2005).
• In 2016, an estimated 41 million children under the
age of 5 years were overweight or obese and over 340
million children and adolescents aged 5-19 year were
overweight or obese.
6.
7. Etiology of Obesity in Children and
adolescents
Obesity in
children
Exogenous
Increased
caloric intake
Decreased
energy
expenditure
Endogenous
Endocrine
Monogenic
Syndromic
Hypothalamic
10. Etiology of Exogenous Obesity
Chronic imbalance between energy intake and expenditure
o Increased intake of processed and refined diet, sugar-sweetened
beverages, increased time spent on TV viewing, internet browsing
or playing electronic games, reduced physical activity, reduced
sleep
Medications
o Glucocorticocoids, TCAs, Risperidone
Adverse metabolic programming (acts in conjunction
with diet and lifestyle factors)
o Infants born SGA, LGA, those born to mothers with obesity or
diabetes, and those with accelerated weight gain in infancy are
predisposed to obesity in childhood.
11. Nutritional obesity
Normal examination and
development with normal/linear
growth
1. Genetic predisposition
2. Higher socioeconomic status
3. Intrauterine factors
a) IUGR with rapid postnatal
catch-up weight gain
b) Excess maternal weight gain
c) Large for gestational age
d) Gestational diabetes
4. Nutritional
a) Formula (rather than breast)
feeding
12. Exogenous
• Chronic imbalance
between energy intake
and expenditure
• Increased intake of
processed and refund
diet, sugar-sweetened
beverages, increased
time spent on TV
viewing, internet
browsing or playing
electronic games,
reduced physical
activity, reduced sleep
Endogenous
• Monogenic causes –
Defects in genes
encoding melanocortin 4
receptor(MCAR), Leptin
receptor(LEP), pro-
opiomelanocortin(POMC)
etc
13. Exogenous
• Medications –
Glucocorticoids, TCAs,
Risperidone
• Adverse metabolic
programming (acts in
conjunction with diet and
lifestyle factors)
• Infants born SGA, LGA,
those born to mothers
with obesity or diabetes,
and those with
accelerated weight gain
in infancy are
predisposed to obesity
in childhood.
Endogenous
• Genetic syndromes –
Alstrom, Bardet-Biedel ,
Prader Willi, Beckwith-
Wiedmann, carpenter,
cohen, Albright
hereditary
osteodystrophy etc.
• Endocrinal causes –
Hypothyroidism,
Cushing syndrome,
hypothalamic obesity,
growth hormone
deficiency, persistent
hyperinsulinism
14. Poor start to life
Mismatch
pathway-IUGR
Developmenta
l pathway-
GDM,
hormonal,
epigenetic
Rapid growth
in infancy,
childhood
Poor PA
Calorie-dense
diet
Catch-up fat
Sedentary
lifestyle in
adolescence
Sarcopenia
Adiposity
IR
Young adults
Met S
IR, IGT, GDM
T2D
CAD
NAFLD
Obesity begets obesity
Shared behaviours
Shared biology in
families
15.
16.
17.
18. Hypothyroidism
• Hypothyroidism - associated with decreased
thermogenesis and decreased metabolic rate
• Decrease in energy expenditure
• Decrease in linear growth, causing the increase in
BMI
• There is increased permeability of capillaries
• Weight gain is mostly due to fluid retention ,not due
to fat deposition
19.
20. Prader Willi Syndrome
• Loss of expression of paternally
expressed genes on chromosome
15q11.2-q13
• Hypotonia, feeding difficulties and
failure to thrive in infancy
• Hyperphagia with food foraging
behaviour, rapid weight gain, after 1st
year
• IQ between 60-70, behavioural
problems
• Small facial features, almond shaped
eyes, small hands with slender
tapering fingers
• Hypogonadism
• Diagnosis: FISH or methylation
specific PCR
21. Bardet Biedel Syndrome
• Developmental delay, retinitis pigmentosa, postaxial
polydactyly, truncal obesity and renal abnormalities
• Onset of obesity within 1st year of life
Albright Hereditary Osteodystrophy
• Rounded facies, short stature
• PHP 1a, low Ca, high P, high PTH
• Short 4th & 5th metacarpal; metatarsal
22.
23. Hypothalamic Obesity
• The VMH, ARC, PVN, DMH, and LHA are involved in
control of appetite and energy expenditure.
• These areas produce several neuropeptides involved in
appetite regulation, including orexigenic peptides like
neuropeptide Y and anorexigenic peptides like the
melanocortins
• Injury or malformation may also affect binding of
peripheral intake-related signals, including cholecystokinin
(CCK), glucagon-like peptide (GLP-1), ghrelin, insulin,
and leptin.
• These peptides cross the blood brain barrier and bind to
their receptors in the hypothalamus to regulate appetite.
24. Monogenic obesity
• Recessive or co-dominant single gene mutation disrupting
leptin melanocortin pathway in the hypothalamus,
important for satiety regulation cause hyperphagia and
severe obesity
• LEP, LEPR, MC4R, others
26. Exogenous Obesity
• Chronic imbalance between caloric intake
and energy expenditure which includes
unhealthy eating patterns resulting in
energy excess and lack of physical
exercise
27. How to Measure Obesity
• BMI is important and commonly used
surrogate marker of obesity.
• Commonly used in children more than 2
year of age.
28. BODY MASS INDEX (BMI)
• Correlates well with fat mass
• >2 years
Overweight - BMI>85th centile
but <95th centile
Obese - >95th centile
Extreme - > 120% of 95th
centile
• < 2 years
• Sex specific weight for recumbent
length is >97.7 centile of WHO
growth charts.
29. Considerations using BMI
• Doesn’t differentiate between fat mass and lean mass
• Fat mass prediction based on BMI is different for
Asians,
• - Have higher fat mass as compared to Caucasians for
same BMI
• - Fat distribution is more central so waist maybe a
better marker.
• Indian children recommended to use WHO charts for
< 5 years and IAP charts > 5 years
30. Other Indicators of Obesity
1. Age specific growth charts
2. Skin fold thickness
3. Waist circumference
4. Waist-hip ratio
5. Waist-height ratio
6. Body fat measurement techniques like DEXA, CT,
MRI, USG for subcutaneous and intra-abdominal fat.
31. IMPLICATIONS OF
CHILDHOOD OBESITY
Obesity-related diseases rarely seen in children in
the past, including obesity-associated sleep apnea,
NAFLD with resultant cirrhosis, and type 2 diabetes
are increasingly diagnosed in pediatric patients.
34. Screening for complications
• Above 10 years: All obese/ overweight children
• < 10 years: Overweight/ obese with additional risk markers:
-Family history of obesity, dyslipidemia, GDM, T2DM or early CVD
-Acanthosis nigricans
-LBW with rapid catch-up growth in early childhood
Waist to height ratio>0.5
Waist to height ratio, BMI and waist circumference for screening paediatric
cardio-metabolic risk factors
What should be tested?
BP
Fasting blood glucose, consider OGTT if high risk
TG, HDL-C
ALT for NAFLD
PCOS, if hirsutism or oligomenorrhea in pubertal girls
36. NAFLD
• Surrogate marker is ALT.
• Interpretation is age/sex specific
• Persistently high ALT ( >2 times the normal for more than 3
months → Investigate for NAFLD
• ALT > 80 – increased concern → Exclude other causes
• Liver biopsy is confirmatory.
• Early changes are reversible by dietary management
NAFL NASH
NAFLD with
fibrosis
NAFLD with
cirrhosis
37. Type II DM
Diagnosis
• HbA1c > 6.5%
or
• FBG >126
or
• 2 hr PL Gl > 200
or
• RBG > 200
Treatment
• If HbA1c > 6.5%-
Metformin
• If HbA1c is between 6.5-
9.0 – Metformin + Dietary
& behaviour changes
• If HbA1c > 9.0 or with
metabolic
decompensation– Insulin
+ metformin
38. Hypertension
Blood Pressure Stages of Hypertension
< 90th percentile Normal
> 90th percentile Elevated BP
> 95th percentile or 130/80 – 139/89
mm Hg
Stage 1 hypertension
> 95th percentile + 12 mm Hg Stage 2 hypertension
39. Hypertension
• Three main pathophysiological mechanisms:
a) Disturbances in autonomic function (increased heart rate
variability due to an altered balance between
parasympathetic and sympathetic activity)
b) Insulin resistance (insulin resistance associated with
obesity may prevent insulin-induced glucose uptake but
leave the renal sodium retention effects of insulin relatively
preserved, thereby resulting in chronic volume overload
and high BP)
c) Abnormalities in vascular structure and function
(increased intimal-medial thickness)
40. Dyslipidemia of Obesity
• ↑ TG & FFA
• ↓ HDL-c with HDL dysfunction
• Normal or ↑ ed LDL-c
• ↑ ed apolipoprotein B
41. Hypertension
Rule out secondary causes of HTN
ARBs, CCB, Beta-blockers and diuretics may be used
Target BP<95th percentile in absence of comorbidities
and <90th percentile in presence of comorbidities.
Dyslipidemia
Primary target is LDL-c ≤95th percentile
Statins –drug of choice, indicated in >10 yrs of age
LDL-c of ≥190 mg/dL after a 6 month trial of lifestyle
management
LDL-c between 160-198 mg/dL, drug treatment
indicated in presence of other risk factors
Fibrates indicated if TG>500 mg/dL
42. Metabolic Syndrome
1. Waist circumference, ↑ TG, HDL, fasting glucose
and blood pressure measurements have been
associated with metabolic syndrome
2. There is accumulation of cardiovascular and
metabolic factors which predispose to type II DM in
future
3. It includes presence of central obesity & only 2 of
these-
- hypertension
- impaired fasting glucose
- high TG
- low HDL
43. Screening for Metabolic syndrome
• Look for abnormal fat distribution
• Impaired glucose tolerance test
• Hypertension
• ↑ fasting insulin/ HOMA IR
• Elevated FFA
• ↑ CRP
• ↑ Adiponectin
• ↑ Inflammatory cytokines
44. MANAGEMENT OF OBESITY
• Prevention is best management.
• Education of child and family, both are required.
• Also steps taken by government and authorities for
restrictions on advertisements of unhealthy food.
• Initiation of Sugar tax.
• Clear labelling of calorie & nutritional content on
every foodpack
• Education on reading labels & controlling portion
size.
45. MANAGEMENT OF OBESITY (contd.)
• Easy & pocket friendly access to healthy food.
• Increasing physical activity, both at home & school.
• Health education at school
• Nutrition as part of regular curriculum
• Physical education at school
• Safe and easy access to play area for children
46. Early childhood diet and physical activity
Infancy
Exclusive breastfeeding for first 6 months
Complementary feeding with home-based foods
Childhood
Avoid overfeeding and force feeding
Discourage juices, soda and junk foods
Daily physical activity for atleast 1 hr.
Regular monitoring of height, weight, BMI
TV/ computer time restricted to <2 hours/day
Discourage grazing
Snacks= Fruits, salads, low fat milk, sprouts
Adolescents
Encourage adequate & regular meals, avoid meal skipping
Activity-aerobic and muscle strengthening
Body image, emotional needs
47. Treatment of Obesity
• Target weight loss: Depends on age and BMI
-6-<10 Year : 0.5 kg/week
- ≥10 year : 1 kg/week,setting goal for 10% weight loss
• Diet and lifestyle modification
-Caloric intake below energy expenditure levels
-Elimination of sugared beverages, high intake of water
& fiber.
-Emphasis on regular structured meals(6 meal pattern)
-Involvement of whole family, group sessions.
48. Weight management and treatment goals based on
BMI percentiles and health status
BMI Status Classification Treatment goal
< 85th percentile Normal weight for height Maintain BMI percentile to
prevent obesity
85th-95th percentile At risk for overweight Maintain BMI with ageing
to reduce BMI to < 85th
percentile; if BMI > 25
kg/m2, weight
maintenance
95th percentile Overweight weight maintenance
(younger children) or
gradual weight loss
(adolescents) to reduce
BMI percentile
49. Weight management and treatment goals based on
BMI percentiles and health status
BMI Status Classification Treatment goal
30 kg/m2 Adult obesity cut-off
point
Gradual weight loss (1-2
kg/month) to achieve
healthier BMI
95th percentile and co-
morbidities present
Overweight with co-
morbidities
Gradual weight loss (1-2
kg/month) to achieve
healthier BMI; assess
need for additional
treatment of associated
conditions
50. Pharmacotherapy
-Very limited role
-Orlistat (gastrointestinal lipase inhibitor)
-In children ≥12 yrs of age
-Discontinue treatment if <5%
weight loss in 3 month
-Metformin: Useful in insulin resistant
condition, not as an anti-obesity agent
51. Behavioral Treatment Strategies for
Obesity during Childhood and
Adolescence
Dietary Approaches
1) Encourage intake of ≥5 servings of fruits &
vegetables daily
2) Decrease intake of calorie-dense foods such as
saturated fats, salty snacks and high glycemic foods
such as candy
3) Minimize intake of sugar-containing beverages.
4) Minimize eating outside home and fast-food in
particular
5) Eat breakfast daily
6) Avoid skipping meals
52. Behavioral Treatment Strategies for
Obesity during Childhood and
Adolescence
Physical Activity
1) Decrease sedentary behaviour such as watching
TV, internet browsing and playing video games for
>2 hr/day
2) Engage in fun and age-specific exercise that is
appropriate to the individual’s abilities
3) Increase intensity, frequency and duration of
exercise gradually as tolerated
4) More than 1 hr of physical activity daily
53. Indications of Medical Treatment
• Only after a formal program of lifestyle intervention
has failed
• Only to be used in conjunction with high intensity
lifestyle modification program
• Should re-evaluate or reconsider if patients does not
have 4% reduction in BMI/BMI z score reduction after
12 weeks of therapy
54. Bariatric Surgery
• Attained near final height and Tanner stage 4 or 5 with
BMI>40 or BMI>35 with significant co-morbidities.
• Extreme obesity and co-morbidities persist despite
compliance with formal lifestyle modification
program.
• Full psychological evaluation of family for support.
• Ability to adhere to exercise and dietary program
• ONLY by An EXPERIENCED SURGEON and TEAM
55. FOOD FOR THOUGHT
Food Calories(kcal)
Double cheese burger 440
Single cheese burger 300
French fries 230
Regular pizza 714
Choco lava cake 500
Chhole bhature 511
Aloo parantha 175
1 packet maggie(medium) 360
1 bowl momos 366
56. CASE - 1
RAHUL
12 Years ,Male
Excessive weight gain – 1 year
Weight of the child - 45 kg
Height of the child – 140 cm
BMI = ???
Weight (kg)/ height(m2 )
22.95
Overweight
58. TIME FOOD ITEM QUANTITY CALORIE
VALUE
PROTEIN
CONTENT
7:00 AM Parantha
Dal
Buffalo milk
2
1 katori
1 glass
(250ml)
240 + 90
86
238
4
6
11
11:00 AM Parantha
Potato Sabzi
2
1 katori
240 + 90
90
4
2
02:00 PM Rice
Dal
2 katori
1 katori
172
86
4
6
once in two
days
Ice cream 1 cup 102 2.5
once in two
days
Maggi/macroni 1 plate 110 2.5
08:00 PM Rice
Dal
2 katori
1 katori
172
86
4
6
11:00 PM Buffalo milk
Bournvita
1 glass
(250ml)
2 tsf
238
50
11
2
TOTAL 2090 65
59. ACTIVITY & SLEEP
Cricket 30 mins twice or thrice a week
Playing mobile games 1 – 2 hours
T.V. Watching 1 - 2 hour
Screen time = 2 – 4 hours
Sleeps for about 7- 8 hours
60. INVESTIGATIONS
B sugar (Fasting) – 85 mg/d (<110mg/dl)
T cholesterol – 112 (<170mg/dl)
Triglycerides – 95 (<90 mg/dl)
HDL – 47 (27-67 mg/dl)
T bil – 0.6 (0.1-1.1 mg/dl)
AST – 75 (<46 IU/L)
ALT – 80 (<35 IU/L)
ALP – 717 (<800 IU/L)
T protein & Albumin – 8.5 & 4.6 (6-8 gm/dl ; 3.7-5.3 gm/dl)
S Insulin – 1.2 (< 15 mU/L )
S Cortisol – 155.5 (50-230 ng/ml @ 8 am)
HbA1c – 5.6% (4.2-6.2% - non diabetic)
USG abdomen – grade 2 fatty liver
61. Recommended calorie intake for males (9-13 yr) for
relatively sedentary level of activity is 1800 kcal ;
moderate level – 1800-2200 kcal ; for active – 2200-2600
kcal
The child is taking 2090 calories which is in excess to his
requirement for that level of activity
Also his diet is rich in fatty food and deficient in fruits and
vegetables.
62. CASE - 2
TRILOK
11 Years ,Male
c/o Gaining weight – 1-2 years
Hypogonadism
Weight of the child - 57 kg
Height of the child – 143 cm
Waist circumference– 83cm
BMI = ???
27.87
Obese
63. Waist to height ratio ???
0.58
Stretched penile length – 4 cm
Testicular volume – 5 cc
65. TIME FOOD ITEM QUANTITY CALORIE
VALUE
PROTEIN
CONTENT
7:00 AM Tea
Biscuit
1 cup
1 packet
60
250
1
5
11:00 AM Dalmoth
Juice
50 gms
1 glass
370
61
8
1
02:00 PM Parantha
Potato Sabzi
2
1 katori
240
90
4
2
During tution
hours
Soya sticks 1 packet 554 7.5
Street food
(daily)
Chowmein/
Pav Bhaji
1 full plate/
2 pav & sabzi
470 12
9:00 PM Rice
Dal
1 katori
1 katori
86
86
2
6
TOTAL 2267 48.5
66. Activity & Sleep
2 kms walk to school & Tution nearby – Total 30 min daily
Playing mobile games - Around 30 mins
T.V. Watching – 3 hours (1:00 pm – 3:00 pm & 8:00pm –
9:00 pm)
Screen time = 3.5 hours
Sleeps for about 8 hours
67. INVESTIGATIONS
B sugar (PP) – 95 mg/dl (<110mg/dl)
T cholesterol – 152 (<170mg/dl)
Triglycerides – 79 (<90 mg/dl)
HDL – 46 (27-67 mg/dl)
T bil – 0.4 (0.1-1.1 mg/dl)
AST – 35 (<46 IU/L)
ALT – 27 (<35 IU/L)
ALP – 728 (<800 IU/L)
LH – 0.9 (1-10 U/L in males)
FSH – 4.2 (1-10 U/L in males)
S Progesterone - <0.05 (0-20 ng/ml in males)
S testosterone - <0.02 (3-12 ng/ml in males)
69. Recommended calorie intake for males (9-13 yr) for
relatively sedentary level of activity is 1800 kcal ;
moderate level – 1800-2200 kcal ; for active – 2200-2600
kcal
The child is taking 2267 calories which is in excess to his
requirement for that sedentary life style
Also daily intake of street foods and junk foods has made
him obese.
The screen time should be reduced to less than 2 hours
per day/