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Overweight and obesity in children

 
, medical expert
Last reviewed: 11.04.2020
 
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At present, the terms "obesity in children" and "excess body weight" are equally often used in pediatrics, and the term "overweight" is more preferable.

Obesity (Latin adipositas, alimentary obesity) is a chronic eating disorder characterized by excessive accumulation of adipose tissue in the body.

Read also: Obesity - Overview of information

ICD-10 codes

  • E65-E68. Obesity and other types of redundancy.
  • E66. Obesity.
  • E66.0. Obesity caused by excessive intake of energy resources.
  • E66.8. Other forms of obesity.
  • E66.9. Obesity, unspecified.
  • E68. Consequences of redundant feeding.

Epidemiology of childhood obesity

In economically developed countries, including Russia, 16% of children already have obesity and 31% are at risk of developing this pathology, which occurs more often in girls than in boys.

According to the WHO Regional Office for Europe (2007), over the past twenty years, the prevalence of obesity has increased 3-fold, reaching the scale of the epidemic. According to epidemiological studies, if there is obesity in the father, the probability of its development in children is 50%, in the presence of this pathology the mother has 60%, and if both parents have 80%.

The causes of the epidemic of obesity are the change in the diet (increased consumption of energy-rich food), eating habits (fast-food meals, frequent use of prepared breakfast cereals), inadequate intake of fruits and vegetables, and a sharp decrease in physical activity.

trusted-source[1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15]

What causes obesity in children?

In the vast majority of children, obesity is not associated with hereditary or endocrine diseases, although the role of hereditary predisposition to obesity is considered established. The leading role in the formation of a positive energy balance has genetically determined features of metabolism and the structure of adipose tissue:

  • increased number of adipocytes and their accelerated differentiation from fibroblasts;
  • congenital increased activity of lipogenesis enzymes and reduced lipolysis;
  • increasing the intensity of fat formation from glucose;
  • decreased leptin formation in adipocytes or a defect of receptors to it.

The pathogenesis of obesity

One of the main pathogenetic mechanisms of obesity in children - energy imbalance: energy consumption exceeds the energy expenditure. As it has been established at the present time, the pathogenesis of obesity is based not only on energy but also on nutritional imbalances. Obesity in children progresses if the body is unable to provide oxidation of incoming fat.

Obesity in children: species

Obesity in children currently does not have a generally accepted classification. In adults, the diagnosis of obesity is based on the calculation of BMI [the ratio of body weight (in kilograms) to the height of a person (in meters), squared]. According to BMI, you can overestimate the obesity of trained athletes or muscular children, nevertheless the calculation of BMI is the most reliable and reliable method of determining excess body weight. Other methods of assessing obesity are also used, but they are either very expensive (ultrasound, CT, MRI, X-ray absorptiometry), or require special equipment (caliper), or poorly reproduced (measurement of waist and hip extent), or do not have standards for childhood bioelectrical impedance analysis).

How to recognize obesity in children?

Obesity in children is not accompanied by specific changes in the results of a general blood test and urinalysis. Biochemical blood test reveals:

  • increased cholesterol, triglycerides, low-density lipoproteins, free fatty acids;
  • reduction of high-density lipoproteins;
  • acidosis;
  • Hyperinsulinemic type of glycemic curve.

Obesity screening

Systematic (once a quarter) monitoring of mass-growth indicators with the definition of BMI, as well as blood pressure.

Treatment of obesity in children

Obesity in children should be treated with the following goals: achieving an energy balance between energy consumption and its consumption. The criterion for the effectiveness of treatment of obesity in children is a decrease in body weight. A prerequisite for dietary therapy in all age groups is the calculation of nutrition for proteins, fats, carbohydrates, and also for calories, comparing the actual and recommended intake.

How to prevent obesity in children?

Obesity diagnosed in childhood is preserved in 2/3 of adolescents, and the frequency of its detection increases by 3-4 times.

As established in the course of a 10-year prospective observation of the dynamics of the main risk factors for cardiovascular disease, more than half of the subjects retained excess body weight and a third - hypercholesterolemia; every fourth has a high level of HDL cholesterol and one in five has a high level of triglycerides.

What prognosis is obesity in a child?

Obesity in children has a favorable prognosis for life.

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