Aug
18
Obesity is recognised as one of the most serious and growing public health challenges in Europe. The World Health Organisation (WHO) has suggested this trend is particularly worrying in children. In the UK, the Government has launched its Change4Life advertising campaign to help stem the rise of obesity in the UK.
Without action, an alarming nine in ten adults and two-thirds of all children will be obese by 2050 and severely obese individuals are likely to die, on average, some 11 years earlier than those with a normal healthy weight .
In January 2008, the UK Government set the following objective in their strategy ‘Healthy Weight, Healthy Lives’
To reverse the rising tide of obesity and overweight in the population by ensuring that all individuals are able to maintain a healthy weight. By 2020 we will have reduced the proportion of obese children to 2000 levels.
It is often the case that parents are unaware of the risks associated with sedentary lifestyles and constant snacking and often refuse to accept that their children are overweight – even when told by a health professional.
Obesity defined
Obesity is defined as excess body fat accumulation with multiple organ-specific pathological consequences. NICE recommends that overweight and obesity is assessed using the Body Mass Index (BMI) which is defined as weight in kilograms divided by height in metres squared (kg/m²).
One drawback to the classification is that it does not take into account those people with a large muscle mass. NICE recommends that waist circumference can be used in addition to BMI to assess obesity risk in adults with a BMI of less than 35kg/m².
Waist circumference provides an estimate of abdominal obesity, itself related to the risk of coronary heart disease and type II diabetes. To ensure an accurate measurement, the tape should be positioned on the umbilicus whilst the patient is relaxed. For men, a waist circumference of 94cm to 102cm is classed as ‘high’, while one above 102cm is ‘very high’. The respective figures for women are 80cm to 88cm and 88cm respectively.
The WHR (waist size divided by hip size) can also be used to provide an estimate of abdominal obesity. The accepted ratio in the UK is that a ratio above 0.95 in men would be described as a health risk with the figure being 0.85 for women.
In children, obesity is measured by the BMI, provided the values are related to reference standards for age and sex. NICE do not currently recommend using waist circumference as a means of diagnosing childhood obesity. Age- and sex-specific percentile charts from 1990 are used by NICE, advising that a tailored clinical intervention be considered if the child’s BMI is above the 91st percentile.
Culture and individual psychology can also play an important role in the development of obesity. It is well recognised that repetition of everyday activities, over time, form habits that are difficult to change later in life. Children with obesity often have a negative self-image, lowered self-esteem and a higher risk of depression along with exposure to bullying and social exclusion.
Impact of child obesity
The adverse health effects of excess weight in children are increasingly apparent with higher incidence of type 2 diabetes, metabolic syndrome, non-alcoholic fatty liver disease and sleep apnoea. The evidence of the problem of excess weight being continued into adulthood has lead to a number of proposed strategies being published.
The Government Children’s Plan recognises child obesity as one of the most serious challenges for overweight children suggesting it is linked to a number of poor outcomes. There is strong evidence of a correlation between excess weight in children and excess weight in their parents.
Other factors
A meta-analysis has found that the risk of overweight in children is reduced by 4% for each extra month that the child is breastfed, with the benefit lasting nine months. The Department of Health recommendation is that babies are breastfed exculsively for six months wherever possible. The optimum time for baby weaning is six months and evidence has shown that babies that are weaned earlier than this can show rapid weight gain in infancy, which may increase the risk of child obesity.
In the next article, we will look at the management options available.
Obesity Facts : Are Your Kids Overweight?
With fast fooderies sprouting up on every corner and a public obesity epidemic that – - appallingly – - is increasingly afflicting supine toddlers
Fighting Childhood Obesity in the Stateline
By encouraging our children to have balanced diets and get plenty of exercise maybe we can stop this epidemic of childhood obesity.
Prevent Childhood Obesity – How To Get Rid Of Childhood Obesity …
Due to changing lifestyles and unhealthy eating habits, young children are facing the problem of obesity. Obesity is a very unhealthy.
Pupils to keep food diaries in child obesity initiative …
More than 300 children to take part in survey, to be extended nationwide in autumn.
Child Obesity: a Pictorial : Healthbolt
Children will hopefully pick up healthier eating habits this way for the rest of their lives, also! You can find some additional interesting reading over at the Dietary Supplement Information Bureau
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Apr
3
Management of Obesity
Filed Under Obesity | Leave a Comment
Unlike other medical conditions, obesity does not lend itself to the classic medical model where the doctor diagnoses the condition, prescribes a treatment and remains responsible for the treatment outcome. In obesity, the patient exerts the greatest control over the treatment outcome and the success or otherwise of any therapy.
The key aim of weight management is risk factor reduction rather than a return to an ideal of healthy weight range. The first step on this process is a combination of supervised diet, exercise and behavioural change. In children, measurement and plotting BMI is a vital step as research shows that many parents are no longer able to identify whether their children are overweight or not.
In the UK, current dietary allowances are outlined in the Eatwell Plate (www.eatwell.gov.uk) which aims to suggest a proportioned, balanced and healthy diet with a combination of different foods from five groups for children aged two years and over. It should be noted that the consumption of calorically sweetened drinks should be limited as it has been shown that they contribute to the development of obesity in children.
It is also important that children and young people achieve at least 60 minutes (moderate intensity) physical activity each day. Adults should achieve a total of at least 30 minutes on five or more days of the week. It has been shown that individuals that have a genetic mutation associated with high BMI may be able to offset their increased risk for obesity through physical activity.
Although bahavioural changes combined with diet and increased physical activity can lead to weight loss, adults with depression and eating disorders often need ongoing psychological support. Anti-obesity drugs can be considered when there has been no improvement after three to six months in the BMI or reduced markers of co-morbidity.
Anti-obesity drugs
Sibutramine
Sibutramine inhibits the reuptake of noradrenaline and serotonin in the brain and this has the effect of reducing food intake as well as attenuating the fall in metabolic rate linked with weight loss. It is not recommended for patients who are under 18 or over 65 years old. It is available as capsules (prescription needed in the UK) in 10mg and 15mg strengths marketed as Reductil.
Orlistat
The prescription strength product containing 120mg orlistat is marketed as Xenical. It is used in conjunction with a hypocaloric diet in people with a BMI of 30kg/m² or more, or with people with a BMI of 28kg/m² with other risk factors such as type II diabetes and hypertension.
The first and only non-prescription weight loss aid licensed throughout Europe launches this month. The product is called Alli and is available in the UK in capsule form containing 60mg orlistat. It is licensed for use in weight loss for adults with a BMI>28 and will be available through community pharmacies shortly.
Rimonabant
The European Medicines Agency suspended the use of rimonabant (Acomplia) in October 2008 after a review showed that any benefit was outweighed by the risk of psychiatric side-effects (particularly depression) in clinical use.
Resveratrol
It has long been known that the skins of certain fruits (grapes, blueberries and cranberries) and wine contain a compound called resveratrol, which has beneficial antioxidant properties, but that’s not all…
Recent animal and in vitro studies suggest that resveratrol can also have a positive effect on helping to maintain normal-range cholesterol levels, supporting insulin health and optimizing metabolic and immune pathways that protect cells and improve mitochondrial function. A risk free trial of Resveratrol Select Weight Loss formula is available *HERE*
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