ANN/THE STAR – Childhood obesity has seen a concerning surge on a global scale. Research indicated that the prevalence of childhood and adolescent obesity has skyrocketed, surging from 6.1 per cent in 2011 to a staggering 14.8 per cent in 2019.
A 2017 study revealed that around 27-30 per cent of primary school-aged children were grappling with either excess weight or obesity. Parents must remain attentive and cautious, as youngsters who fall into the overweight or obese category may encounter significant health issues, even at their tender age.
HIGHER THAN HEALTHY
A child is considered overweight or obese if their weight is higher than what is considered healthy for his or her height and age. Height and weight measurements are use to calculate a number known as the body mass index (BMI). BMI is plotted on a chart to compare a child’s BMI to the BMIs of other children of the same age and sex.
If a child’s BMI is high compared with other children, then the child is overweight. If a child’s BMI is much higher than the average, passing a certain threshold, they are then considered to be obese. Children can be overweight or obese for different reasons. Young ones can become overweight by eating too much, eating unhealthy foods, not getting enough exercise and having poor sleep patterns.
When children gain weight, they have to work extra hard to regain a healthy weight. Less commonly, medical conditions like hypothyroidism, Cushing syndrome, brain lesions and underlying genetic syndromes, can make a person gain weight more easily. Such conditions should be suspected if the weight gain is rapid, particularly in very young children or if associated with poor growth.
Certain medicines or supplements can also make children gain weight more easily.
The surroundings in which children live and play are also very important in helping them maintain a healthy weight, eg the home environment, school and community. These days, many live in an “obesogenic” environment. This is an environment that makes it hard for people to eat healthily and exercise. Examples of obesogenic environments include schools and public places that do not have healthy food options, poor access to public parks, and lack of opportunities to be active, eg safe places to walk or cycle. Growing up in an obesogenic environment affects the child’s ability to lead a healthy lifestyle.
It’s important to note that the problems obesity can cause in adults, such as type 2 diabetes, high blood pressure (hypertension) and high cholesterol, can also occur in children. Statistics show that these chronic diseases are now increasingly being seen in children and teenagers.
These complications can occur in overweight children as young as eight to 10 years old, causing them to be at high risk of developing heart problems when they become adults.
Children who are overweight are more at risk of developing:
– Airway and breathing problems, eg asthma and sleep apnoea (a condition that makes people stop breathing for short periods during sleep)
– Knee or back pain
– Liver problems, ie fatty liver
– Poor self-esteem and depression.
Being overweight as a teenager or adult can also predispose your child to certain types of cancer. On the other hand, having a healthy weight as a child means that they are more likely to continue having a healthy weight later as they grow up and older.
Depending on your child’s age, and the presence of any disease symptoms and their severity, they might need tests to check for the health problems that can happen when children are overweight, eg high blood sugar, high cholesterol and abnormal liver function.
Such blood tests for screening can be considered after the age of seven to 10 years. Your child might also need to be tested for conditions that could be causing your child to gain weight easily if your child is very young or has other health concerns.
GETTING TO A HEALTHY WEIGHT
To help your child have a healthy weight, you need to help them eat healthy foods and be more active. Making changes in lifestyle, food intake and habits can be difficult at the beginning. Having goals and doing them together as a family help.
HAVING A HEALTHY AND APPROPRIATE AMOUNT OF FOOD INTAKE
Eat more vegetables and fruits every day. If your child does not like vegetables or fruits, start gradually. Eat these foods yourself to set a good example, and keep encouraging your child to do the same. The amount of food provided should be suitable according to the child’s sex, age and energy levels.
Reduce processed foods such as nuggets, sausages and those that are high in sugar, fat, oil and salt. Choose low-fat dairy options.
NOT TAKING SUGARY DRINKS
Encourage your child to drink more water and reduce, or better yet, avoid, sugary drinks. Be cautious of drinks that claim to be healthy, but are actually loaded with sugar – always read the nutrition label. Ingredients are listed on the label according to their amount in the product; so if sugar (or any sweet ingredient) is the first ingredient listed, that means it comprises the highest percentage of the drink. Studies in adults show that sugary drinks greatly increase the risk of having heart diseases. When going out to eat or for recreational activities, take along a bottle of water to help avoid sweetened drinks.
LIMITING SCREEN TIME
Limit screen time, eg watching TV or using the computer or mobile phones. Spending too much time staring at a screen enables a person to gain weight easily as they are usually just sitting and not moving.
MOVING AND EXERCISING MORE
Young children should be active throughout the day. For children above six years old, it is recommended to do moderate exercise or physical activities at least one hour a day. This can include sports, dancing, cycling, brisk walking, swimming, hiking, gym activities or playing in the field. If a child is not used to exercise, he or she might tire easily at first. Start slowly and do it on a regular basis.
Doing activities as a family will help the child to be motivated and enjoy them more. This can be as simple as going to the park to walk, cycle or play. Encourage opportunities to move and increase daily steps, eg using the stairs instead of elevators. Exercising alone without adjustment in food intake might not result in weight loss. However, it has many healthy benefits, both physically and mentally. When we exercise, we should not just focus on weight targets, but also overall health benefits. Focusing on weight targets alone will discourage a child from continuing to exercise if those goals are not reached.
GETTING ENOUGH SLEEP
Studies show that not having enough sleep makes people put on weight easily. Insufficient sleep also makes us feel negative, tired and stressed.
Children should have enough sleep as recommended for their age. Having consistent sleep routines can help children go to bed earlier. To avoid overstimulation, avoid screen time an hour before bedtime.
Healthcare professionals such as doctors, dietitians, physiotherapists and psychologists, can help achieve a healthy weight for a child. A child might not need to see all these professionals.
The doctor will help to determine what is a healthy weight for your child and if further tests are needed. Medicine to help lose weight is currently approved for obese children who are aged 12 and above. But these medicines will not work well in the long term if the child’s lifestyle remains unhealthy.
Do not give a child any medicine or supplements to lose weight that are not medically approved as they can have bad side effects.
Explain to your child that the aim at the end of the day is to feel better and to be healthy and strong.
Do not belittle their efforts nor overly focus on their weight or how they look.
Let your child know that they can talk to you if they are feeling sad or being bullied at school. – Dr Jeanne Wong Sze Lyn