Obesity is a growing epidemic all over the world. Nearly 40 to 50 per cent of children nowadays are overweight.

Why is obesity among children increasing?
It is mainly due to changes in lifestyle. Gadgets such TV and computers have become an important part of the lifestyle unlike in earlier days when kids played outdoors. The emphasis on studies and competitive environment at school and pressure from parents forces them to reduce on physical activity and focus on sedentary life. Play time should be enforced in schools and all kids, without exception, made to participate. This way, schools can play a very important role in promoting the child’s overall wellbeing and development.

Defining Obesity in Children and Adolescents:
Obesity is defined as an excessive accumulation of body fat. Obesity is present when total body weight is more than 25 percent fat in boys and more than 32 percent fat in girls. Although childhood obesity is often defined as a weight-for-height in excess of 120 percent of the ideal, skin fold measures are more accurate determinants of fatness.

What are the complications of excess weight among children?
There are several medical and psychological complications an overweight or obese child can suffer. An overweight child can suffer from diabetes and pediatric hypertension. The growing ‘early obesity epidemic’ is a significant and alarming cause of increasing diabetes. It can lead to cardiac problems from an earlier age. That is the reason that heart attacks are getting common among the younger people.
Other medical problems can include bone problems, such as hips, joints and spine since the child has to lug his own heavy weight. They can also suffer from sleep apnea. Such overweight children snore while asleep which in itself can lead to a lot of problems. Sleep apnea can cause decreased oxygen to the brain and body.
Psychological problems include low self esteem since they can get teased at school and play which can leave lasting scars on the mind. And also affects relationships with peers. Of all these complications social and psychological problems are the most significant consequences of obesity in children.

Causes of Childhood Obesity
As with adult-onset obesity, childhood obesity has multiple causes centering around an imbalance between energy in (calories obtained from food) and energy out (calories expended in the basal metabolic rate and physical activity). Childhood obesity most likely results from an interaction of nutritional, psychological, familial, and physiological factors.

• Food habits, easier affordability of junk and fast food.
• Over zealous feeding by parents to make the child chubby. It’s a very old concept that a child should be fat, especially among some communities. They offer kids fatty foods to children, which has adverse effects if eaten in excess.
• Lack of activity: children sit for the whole day before TV or computer and become overweight. In the recent years an average child spends several hours each day watching television; time which in previous years might have been devoted to physical pursuits. Obesity is greater among children and adolescents who frequently watch television, not only because little energy is expended while viewing but also because of concurrent consumption of high-calorie snacks.
• Heredity, familial: The risk of becoming obese is greatest among children who have two obese parents.
• Medical problems: Hormonal, genetic, thyroid problems can also cause obesity among children but that percentage is very small.

Can obesity be corrected or reversed?
A child, for example of five years has the weight of an eight year old; it can be modified by diet control. For example, diet control and activity can help reduce weight over a period time. In children, you should never reduce weight unlike adults. An overweight child should be prevented from putting on more weight. We have also to rule out any medical problems that manifest. Junk food is a major contributor as can be seen in western countries where severe curbs have been put on its sales.
Most cases of obesity are caused by wrong or over nutrition and lack of activity.

Treatment of Childhood Obesity
Preventing obesity is so much easier than treating it or its complications and steps should be taken to solve this serious health crisis at the community and family level
Obesity treatment programs for children and adolescents rarely have weight loss as a goal. Rather, the aim is to slow or halt weight gain so the child will grow into his or her body weight over a period of months to years. For every 20 percent excess of ideal body weight, the child will need one and one-half years of weight maintenance to attain ideal body weight.
Early and appropriate intervention is particularly valuable. There is considerable evidence that childhood eating and exercise habits are more easily modified than adult habits. Three forms of intervention include:

1. Physical Activity
Adopting a formal exercise program, or simply becoming more active, is valuable to burn fat, increase energy expenditure, and maintain lost weight. Most studies of children have not shown exercise to be a successful strategy for weight loss unless coupled with another intervention, such as nutrition education or behavior modification.
Also by installing exercises which involves more fun proves to not only improve their movement skills and functional cardiovascular efficiency, but the use of interactive and virtual-reality products like Trazer and Sportwall significantly improve both the participation and retention rates of young people who don't normally participate in traditional exercise and sports programmes.

2. Diet Management
Fasting or extreme caloric restriction is not advisable for children. Not only is this approach psychologically stressful, but it may adversely affect growth and the child's perception of "normal" eating. Balanced diets with moderate caloric restriction, especially reduced dietary fat, have been used successfully in treating obesity. Nutrition education may be necessary. Diet management coupled with exercise is an effective treatment for childhood obesity.

3. Behavior Modification
Many behavioral strategies used with adults have been successfully applied to children and adolescents: self-monitoring and recording food intake and physical activity, slowing the rate of eating, limiting the time and place of eating, and using rewards and incentives for desirable behaviors. Particularly effective are behaviorally based treatments that include parents.

What are the precautions that parents should take to ensure their child doesn’t become obese?
A child doesn’t have mind of its own so parents should ensure that it is given a healthy diet. It is best to avoid junk foods and stick to regular meals rather than frequent snacking. Kids should also be encouraged to engage in as much physical activity as possible. As a rule, one hour of physical activity three to four times a week should be encouraged. Parents should ensure that the child spends less time watching TV and playing computer and electronic games. Cutting down on these two helps promote activity which in turn, regulates weight.
Food sent with the child to the school for breaks should not contain chocolates and other high fat foods. Fried food etc should be avoided and allowed only as a treat.

Prevention of Childhood Obesity
Obesity is easier to prevent than to treat, and prevention focuses in large measure on parent education. In infancy, parent education should center on promotion of breastfeeding, recognition of signals of satiety, and delayed introduction of solid foods. In early childhood, education should include proper nutrition, selection of low-fat snacks, good exercise/activity habits, and monitoring of television viewing. In cases where preventive measures cannot totally overcome the influence of hereditary factors, parent education should focus on building self-esteem and address psychological issues.

“Awareness and education are key to fighting this problem now”

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