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. 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

12. Leptin pathway

14. Grades of obesity
• BMI – Weight (kg) / height (m2)
• Grade 1 – 25-29
• Grade 2 - 30 -40
• Grade 3 - > 40

15. Obesity - pathophysiology

16. Obesity – clinical features

17. Obesity – clinical features
• Knock knee
• Slipped femoral capital epiphysis
• Psychological trauma
• Depression

18. Obesity - complications

19. Obesity – work up

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

23. •THANK YOU