How Do I Perform an Obesity Intervention?

Medically, children who weigh more than 20% of their standard weight by length are called pediatric obesity. More than 20% to 29% are mildly obese, more than 30% to 49% are moderately obese, and more than 50% are severely obese.

Basic Information

English name

pediatric obesity

Visiting department

Pediatrics, Endocrinology

Multiple groups

Children

Common causes

Related to overnutrition, psychological factors, lack of activity, genetic factors, etc.

Common symptoms

Progressive weight gain, general deviations in behavior and general increase in body fat

Causes of Pediatric Obesity

The cause has not been fully elucidated so far, and is generally believed to be related to the following factors.

Over nutrition

Excessive nutrition causes calorie intake to exceed consumption, and excess calories stored in the body as triglycerides cause obesity. Improper feeding of infants, such as feeding immediately every time the baby cries, and getting into the habit over time. In the future, if you are frustrated, you want to find something to eat, which is likely to cause infant obesity, or feeding infants with high-calorie solid foods too early to increase weight. Too fast to form obesity. Excessive nutrition in late pregnancy has become a cause of obesity after birth.

2. Psychological factors

Psychological factors play an important role in the occurrence of obesity. Emotional trauma or psychological disorders such as divorced parents, bereavement of mothers or mothers, abuse, doting, etc., can induce timidity, fear, loneliness, etc., which can lead to disunity, less activity or self-entertainment with eating, leading to obesity.

3. Lack of activity

Once children become obese, they are more reluctant to move due to inconvenience of movement, which leads to daily weight gain and a vicious circle. Certain diseases, such as paralysis, primary myopathy, or severe mental retardation, result in too little activity, reduced calorie consumption, and obesity.

4. Genetic factors

Obesity has a certain family genetic predisposition. Parents are obese, 70% to 80% of offspring are obese; one of the parents is obese, and 40% to 50% of offspring are obese; neither parent is obese, and only 1% of offspring are obese. The same disease rate is also very high in single egg twins.

5. Central regulatory factors

Normal human body has the function of regulating central energy balance to control weight relatively stable. Patients with this disease have an imbalance in regulating function, causing excessive intake of the body, exceeding demand, and causing obesity.

Clinical manifestations of pediatric obesity

Obesity can be seen in children of any age, with the age of less than 1 year old, 5 to 6 years old or adolescents as the peak incidence. The child has an excellent appetite, prefers greasy and sweet foods, is lazy in activities, is physically obese, has thick subcutaneous fat and is evenly distributed The differences in pathological obesity are obvious accumulation of fat on the cheeks, shoulders, breasts, and abdominal wall. White or purple markings can be seen on the abdomen. Boys were mistaken for genital hypoplasia due to the accumulation of fat in the perineum and the covering of the penis.

The weight exceeds the children of the same age, and the height and bone age are within the upper limit of the children of the same age. A few can exceed, the intelligence is normal, the sexual development is normal or early.

Obese children often have psychological disorders such as loneliness and inferiority, which can be one of the causes of obesity or one of the factors that maintain obesity.

Simple obesity increased blood insulin levels, no significant abnormalities in glucose tolerance test and fasting blood glucose. Total blood lipids, cholesterol, triglycerides and free fatty acids increased. Ultrasound showed different degrees of fatty liver.

Severe obesity can cause chest wall hypertrophy, elevated diaphragm, and difficulty in ventilation, resulting in CO ₂ retention and hypoxia, resulting in shortness of breath, cyanosis, secondary red blood cell enlargement, heart enlargement, and congestive heart failure, known as obese lung Heart syndrome.

Pediatric Obesity Treatment

Restrict diet

Restricting the diet not only achieves the purpose of weight loss, but also to ensure the normal growth and development of children. Therefore, it should not be rushed at the beginning to cause a sudden weight loss. It is only required to control the weight gain so that its weight drops to more than 10% of the average standard weight calculated for the length. , You do not need to restrict your diet.

The general principles of calorie control are: 2.51 to 3.35 MJ / d (600 to 800 kcal / d) under 5 years old, 3.35 to 4.18 MJ / d (800 to 1000 kcal / d) between 5 to 10 years old, and 4.18 to 5.02 MJ / 10 to 14 years old d (1000 ~ 1 200kcal / d).

Severe obese children can reduce their calories by 30% or more according to the ideal weight. The diet should be high in protein, low in carbohydrates and low in fat, and animal fat should not exceed 1/3 of total fat. And supply the required amount of vitamins and minerals. In order to satisfy children's appetite and eliminate hunger, you can eat more calories and bulky foods such as vegetables and fruits. Limit snacks and sweets and high-calorie foods such as chocolate.

2. Increase exercise

Obese children should exercise daily and develop habits. You can start with a small amount of exercise and then gradually increase the amount of exercise and activity time. Avoid strenuous exercise to prevent increased appetite.

3. Behavioral Therapy

Teach children and their parents how to manage behaviors. Older children should learn to self-monitor, record daily weight, activities, food intake and environmental factors, and summarize regularly. Parents help the child evaluate the implementation of treatment and establish good eating and behavioral habits.