What Can Be Done About Childhood Obesity?

child getting body fat measurementThe issue of childhood obesity, and the resultant health consequences of this problem, including adult obesity, prediabetes and diabetes, appears to be more prevalent in the news lately.

I have been seeing more literature coming across my computer screen addressing this subject. This post is the result of several articles I saw over this past week of mid-September, 2013.

One article stated that “severe obesity” is currently present in 5% of U.S. children, and the authors argued that this should be a new risk class among this age group. (1)

New research shows obese children have a four times greater risk of having high blood pressure when they reach adulthood compared to normal weight children. The study authors found that overweight children had double the risk of high blood pressure as adults and that,

Hypertension is no longer an adult disease. Obese children, in general, appear to be at a greater risk of cardiometabolic diseases – high blood pressure, high blood sugar, abnormal cholesterol levels, and excess belly fat.” (2)

The issue of childhood obesity is even more relevant in the wake of the recent decision by the American Medical Association to officially classify obesity as a disease. I believe this will encourage America’s physicians to recommend disease treatments, but what does that mean? A trip to the pharmacy? A trip to the operating room? Think about how children with “hyperactivity disorder” have been managed over the past 20 years.

Pharmacy management of childhood obesity is not a new concept. Here’s a 2007 paper on Pharmacotherapeutic Options for Overweight Adolescents in doctor lecturing patientThe Annals of Pharmacotherapy.

We can’t blame America’s physicians. They can counsel until the cows come home, but they can’t go home with their patients, look over their shoulders and tell them, “Don’t do that….don’t do that either…and also don’t do that…etc.”

The question is, “What do we do to address this problem?” Public health policies have not been able to make much headway in this area. Although just today I saw a report of a survey of children in grades 6 through 10 done over a period of about 10 years. The survey showed “increases in physical activity, consumption of fruits and vegetables, and having breakfast as the first meal of the day…declines in television viewing and consumption of sweets and sugary drinks.” Video game playing did not change with the exception that more girls began playing video games during the course of the study. (3)

Some believe this is a socioeconomic issue and more money is needed to address the problem. Others believe that the money is there to help, but people simply are not making good decisions. The possibility of restricting the types of food that can be purchased with public assistance money has also been raised.

Sugar taxes have been used to try to discourage unhealthy eating behavior, but a recent look at the effectiveness of this tax found that people simply exchange the taxed unhealthy food with an unhealthy food that has not been subject to a sugar tax. (4)

I also came across another recent study this past week that looked at the use of instant messaging via mobile phone to encourage people to maintain a healthy lifestyle in an effort to prevent type 2 diabetes. Text messages were sent to the participants’ mobile phones. The study was carried out using adult Asian Indian men at risk of developing type 2 diabetes, and seemed to be an effective way of preventing the development of type 2 diabetes in these at-risk men with study participants who were subject to text messages being 36% less likely to develop diabetes. (5)

children looking at text message to fight childhood obesityEvidently 95% of participants said they liked the text messaging approach, but I wonder if this would work with adolescents. Would they not figure out a way to disable the messaging or turn it into some kind of game that encouraged even more unhealthy and/or risky behavior – Something analogous to beer pong, but with Twinkies?

And then there’s surgery. Yes, despite the apparent improved lifestyle behavior along with the apparent leveling off of obesity among America’s youth, I believe surgery is going to become more and more common among America’s youth.

I have recently posted elsewhere about the CDC statistics on childhood obesity, and my belief that surgery is going to become more commonplace in the pediatric population. The medical literature seems to be marching toward this approach.

They may not be exactly the same procedures that are performed on adults, but I am willing to bet this is an area that is going to evolve. Do we need a new surgical subspecialty of pediatric bariatric surgeons ready to fight America’s childhood obesity problem with scalpel in hand?

As I said, it looks to me like the literature is starting to more widely support a surgical approach for obesity and other metabolic disorders. I recently posted about a study that seemed to support surgery for metabolic syndrome.

Another recent study looking at the benefit of the “growing trend of controversial obesity surgery for children and teens” found positive changes in the hearts of those who underwent surgery.

It was reported that the hearts of the pediatric obese surgical candidates looked like those of middle-aged patients preoperatively, but changed for the better after weight loss surgery. (6)

The cardiac structure and function in these extremely obese adolescents scheduled for bariatric surgery was much more impaired than one might have thought…Many of the abnormalities that we documented during the initial baseline study actually showed significant improvement after the weight loss had been obtained…”

There certainly are not any easy answers, especially when the parents of many of these children have lost control of their own health, as evidenced by the estimated almost 80 million pre-diabetic adults in the U.S., and the continuously growing numbers of diabetics.

We’ll see what the future brings.

If you are the head of a household with overweight or obese children, and you yourself are in this condition, you need to lead by example. There may be genetic challenges in your particular case, but do not dwell on them.  Do not make your children feel like victims. Do not feel like a victim yourself. No one expects you to be superman or superwoman. If you can’t do it for yourself, then do it for the sake of your children.

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About Robert Creighton

Dr. Creighton is a podiatrist and foot surgeon with over 26 years in podiatric practice treating thousands of patients afflicted with the physiological, physical, and psychological side effects and complications of diabetes and pre-diabetes metabolic syndrome. He believes these disorders present a pressing public health concern that need to be more actively addressed in a multidisciplinary way. Dr. Creighton graduated from what is now the Temple University School of Podiatric Medicine after receiving his undergraduate degree in Biology. He is certified by the American Board of Foot and Ankle Surgery, a member of the American Public Health Association, an American College of Sports Medicine certified personal trainer and a Member of the American Nutrition Association.

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