Obesity in children and adolescents represents one of the most frustrating and difficult diseases to treat. The prevalence of childhood obesity in the United States has risen dramatically in the past several decades. In a recent study the Journal of the American Medical Association (JAMA), researchers have shown that among children aged 6 through 19 years in 2001-2002, 31.5% were at risk for becoming overweight or already overweight and 16.5% were overweight compared with 29.9% and 15.0%, respectively compared to 1999-2000. Clearly, the epidemic is on the rise. Although 25 to 30 percent of children are affected, this condition is underdiagnosed and undertreated.
Previous reports based on NHANES (National Health and Nutrition Examination Survey) data have shown continuous increases in overweight and obesity among adults and in overweight among children and adolescents during the past two decades. This increase has been attributable to environmental factors related to both caloric intake and physical activity. In the same recent JAMA issue, researchers tested the hypothesis that overweight adolescents are more susceptible to the adverse effects of fast food than lean adolescents. Fast food is ubiquitously available and heavily marketed to adolescents. An estimated 75% of adolescents eat fast food 1 or more times per week. Their investigation suggests that overweight adolescents are less likely to compensate for the energy in large portions of fast food than their lean counterparts.
Obesity treatment often fails because of the methods used defeat it. No individual can conquer obesity in the long run by using just will power and effort. Obesity is a disorder of abnormal brain chemistry and needs to be treated as such. When brain metabolism decreases, individuals are not able to burn calories effectively. Brain mapping studies show a 30% reduction in brain metabolic rate in the average obese individuals who have only one health problem. The reduction percentage is probably even higher with those obese individuals who develop multiple medical problems including menopause, depression, hypertension. In addition, emotional factors can play a role in what foods we choose to eat. Many individuals do not realize how often they cheat on their diet by eating junk, food and foods high in salt or sugar in order to aid their ailing emotions. Memory and attention disturbances also cause individuals to make the wrong choices, because when these faculties fail, anxiety and stress usually follows resulting in the individual finding comfort in binging on junk food.
Because obese children may suffer life-long physical and emotional consequences, it is imperative to discuss prevention with parents. All obese children should be screened for cardiac risk factors, as well as for possible orthopedic, dermatologic and psychiatric sequelae. Treatment should be initiated when the trend in increasing weight obviously surpasses the trend in increasing height. Treatment plans should include reasonable weight-loss goals, dietary and physical activity management, behavior modification and family involvement, which may include weight loss in the parents.
1.Hedley AA, Ogden CL, Johnson CL, Carroll MD, Curtin LR, Flegal KM. Prevalence of overweight and obesity among US children, adolescents, and adults, 1999-2002. JAMA. 2004 Jun 16;291(23):2847-50.
2.Ebbeling CB, Sinclair KB, Pereira MA, Garcia-Lago E, Feldman HA, Ludwig DS. Compensation for energy intake from fast food among overweight and lean adolescents. JAMA. 2004 Jun 16;291(23):2828-33.
3.Moran R. Evaluation and treatment of childhood obesity. Am Fam Physician. 1999 Feb 15;59(4):861-8, 871-3. Review.
Eric R. Braverman, M.D.
Dr. Braverman is a Summa Cum Laude and Phi Beta Kappa graduate of Brandeis University and NYU Medical School, did brain research at Harvard Medical School, and trained at an affiliate of Yale Medical School. He is acknowledged worldwide as an expert in brain-based diagnosis and treatment, and he lectures to and trains doctors in anti-aging medicine.