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Obesity in children
Dr Gururaja R
MD,DNB (Paed)
What is obesity?
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
Overweight 85th-95th percentile
Obese 95th percentile or greater
Morbid obesity >120% of 95th percentile
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.
Why to discuss obesity in children
• 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
Epidemiology
• • Paediatric obesity continues to be a serious
ongoing health problem affecting 45 million
children under 5years 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.
Epidemiology
• 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
Etiology
• Exogenous
• Over eating
• Poor energy expenditure
• Sedentary life style
Etiology
• Endogenous
• Genetics
• Laurence Moon Biedel syndrome
• Turner syndrome
• Prader - willi syndrome
• Endocrine
• Hypothyroidism
• hypopitutarism
• Cushing syndrome
• Polycystic ovary obesity syndrome
Etiology
• Hypothalamic
• Frolich syndrome
• Deficiency of leptin
• Drug induced
• Steroids
• Clonazepam
• Valproate
Leptin pathway
Grades of obesity
• BMI – Weight (kg) / height (m2)
• Grade 1 – 25-29
• Grade 2 - 30 -40
• Grade 3 - > 40
Obesity - pathophysiology
Obesity – clinical features
Obesity – clinical features
• Knock knee
• Slipped femoral capital epiphysis
• Psychological trauma
• Depression
Obesity - complications
Obesity – work up
Obesity – work up
• LFT
• Serum electrolytes
• Thyroid profile
• Urinary cortisol levels
• USG abdomen
• Lipid profile
• Blood sugar
• HbA1C
• Sleep studies
• ECG
Obesity - management
• Life style modification
• Dietary measures
• Physical exercise
• No junk foods
• Decrease screen time
• Specific management for cushing syndrome,
hypothyroidism, growth harmone deficiency
Obesity - management
• Metformin, vitamin E, pioglitazone
• Statins for dyslipidemia
• Polycystic ovary syndrome – metformin, OCP
and antiandrogens
• Orlistat - inhibitor of gastric lipase
• CPAP for sleep apnoea
• Surgical management for severe obesity –
Bariatric surgery
•THANK YOU
Obseity in children.pptx
Obseity in children.pptx
Obseity in children.pptx
Obseity in children.pptx
Obseity in children.pptx
Obseity in children.pptx
Obseity in children.pptx
Obseity in children.pptx
Obseity in children.pptx

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Obseity in children.pptx

  • 1. Obesity in children Dr Gururaja R MD,DNB (Paed)
  • 2. What is obesity? 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 Overweight 85th-95th percentile Obese 95th percentile or greater Morbid obesity >120% of 95th percentile
  • 3. 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.
  • 4. Why to discuss obesity in children • 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 5years 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.
  • 6. Epidemiology • 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
  • 7. Etiology • Exogenous • Over eating • Poor energy expenditure • Sedentary life style
  • 8. Etiology • Endogenous • Genetics • Laurence Moon Biedel syndrome • Turner syndrome • Prader - willi syndrome • Endocrine • Hypothyroidism • hypopitutarism • Cushing syndrome • Polycystic ovary obesity syndrome
  • 9. Etiology • Hypothalamic • Frolich syndrome • Deficiency of leptin • Drug induced • Steroids • Clonazepam • Valproate
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  • 14. Grades of obesity • BMI – Weight (kg) / height (m2) • Grade 1 – 25-29 • Grade 2 - 30 -40 • Grade 3 - > 40
  • 17. Obesity – clinical features • Knock knee • Slipped femoral capital epiphysis • Psychological trauma • Depression
  • 20. Obesity – work up • LFT • Serum electrolytes • Thyroid profile • Urinary cortisol levels • USG abdomen • Lipid profile • Blood sugar • HbA1C • Sleep studies • ECG
  • 21. Obesity - management • Life style modification • Dietary measures • Physical exercise • No junk foods • Decrease screen time • Specific management for cushing syndrome, hypothyroidism, growth harmone deficiency
  • 22. Obesity - management • Metformin, vitamin E, pioglitazone • Statins for dyslipidemia • Polycystic ovary syndrome – metformin, OCP and antiandrogens • Orlistat - inhibitor of gastric lipase • CPAP for sleep apnoea • Surgical management for severe obesity – Bariatric surgery