Is obesity preventable, and how can it be prevented?

To lose excess weight and control weight, expert help must be sought and an appropriate treatment plan must be determined. Physical activity levels should be increased, and daily walking and exercise should become a habit. Diet alone is not sufficient for treatment; in fact, it can lead to problems associated with malnutrition in growing and developing children. Other methods for combating obesity include:

• Avoid long-shelf-life, high-calorie, processed foods
• Avoid consuming artificial sugars and monitor daily salt intake
• Prefer healthy cooking techniques
• Drink enough water throughout the day to meet the body's needs
• Change eating habits and eat meals slowly
• Be careful about fat consumption, and consume saturated fats as little as possible.
• Pay attention to dietary diversity and eat a balanced diet from all food groups.
• Eat vegetables and fruits in season.
• Engage in regular activity, i.e., lead an active life.
• Choose a family and social environment that promotes regular eating and an active lifestyle.

Is obesity a treatable disease?

Yes, it is a treatable disease. Physical activity, healthy eating, and behavioral changes are used in obesity treatment to aid weight loss. In some cases, surgical methods developed to combat obesity may be utilized.

What is Obesity in Children, and How Common is it?

The main cause of simple obesity is consuming more energy than the body expends. Scientific studies show that obesity rates among children are increasing every day, especially in developed and developing countries. In the United States, one in three children is reported to be obese. Studies in our country show that one in four children is obese.

Is an overweight child a healthy child?

Simple obesity occurs due to an imbalance between the energy a person consumes and expends. The dietary histories of these children often include excessive consumption of sugar and sugary foods/drinks, fatty or processed foods. Sometimes, large portion sizes or inadequate intake of nutrients in appropriate proportions can also contribute to this condition. They are taller than their peers before puberty, but early onset of puberty and early cessation of growth can negatively affect their adult height. In particular, attitudes such as “He's a child, let him eat, his body will lose the weight over time, he's so cute when he's chubby” on the part of family members or caregivers play a role in the development and worsening of obesity.

When Should Excess Weight in Children Be Taken Seriously and Treated?

Early treatment is very important in children over the age of two who are experiencing rapid weight gain and have reached excessive weight limits. Waiting for obesity to develop will result in a long and difficult treatment process. In children over the age of six, if obesity has developed or rapid weight gain has been detected, the causes should be investigated without delay, and early solutions should be sought by making the necessary changes in nutrition and activity.

Are there risk factors for obesity in children, and if so, what are they?

Yes, there are, and the main causes are:

• Low birth weight
• Early transition to bottle feeding (early weaning from breast milk)
• Maternal factors (smoking, diabetes, excessive weight gain during pregnancy, high BMI)
• Children who grow too quickly between 3 months and 2 years of age
• The presence of obese individuals among relatives is a risk factor for obesity in childhood.

Other risk factors for obesity in children can be evaluated under two headings:

1. Medical reasons: These account for approximately 10% of obese children

• Genetic reasons
• Brain tumors
• Certain hormones secreted by the brain and kidneys
• Thyroid disorders
• Certain medications (steroids, some antidepressants)

2. Non-medical causes; These account for approximately 90% of obese children

• Dietary habits
• Lack of physical activity
• Psychological issues
• Individual, family, and social lifestyle habits
• Accessibility and advertising
• Seeking emotional support
• Sleep irregularities
• Socioeconomic factors
• Environmental factors

Is obesity genetic or familial?

Scientific studies have shown that genetic factors play a role in obesity. Additionally, it has been demonstrated that if one parent is obese, the risk of their child developing obesity increases by 2-3 times, and if both parents are obese, this risk increases by 15 times. It is important to remember that the primary factor here is that children model their parents' eating and lifestyle habits.

What are the clinical symptoms of obesity?

The first and most obvious symptom of obesity is an increase in the amount of fat in the body. The symptoms associated with the development of obesity are as follows:

• Fat accumulation around the waist
• Sleep apnea, snoring, and difficulty sleeping
• Constant and excessive sweating
• Shortness of breath
• Difficulty with physical activity
• Constant fatigue and feeling tired
• Skin problems such as rashes, acne, and infections
• Joint and back pain
• Leg pain due to excessive weight
• Psychological problems such as depression and social isolation
• Intolerance to heat

How is Obesity Diagnosed in Children?

In adults and young adults (older children), obesity is diagnosed by calculating the Body Mass Index (BMI). In children, however, height and body weight values are often used to diagnose obesity. In older children, body weight is divided by the square of height in meters to calculate body mass index, but unlike in adults, the decision is not based on a fixed value. Children whose body mass index percentiles fall between 85% and 95% on age- and gender-specific curves are considered overweight, while those above 95% are considered obese. However, it should be noted that there are other methods for determining body fat percentage.

What Diseases Can Childhood Obesity Cause in Childhood and Later Life?

Obese children are large and develop early. Before puberty, their height and bone maturation levels are ahead of their peers. Therefore, puberty symptoms appear at an early age, and growth is completed at an early age. In addition;

• Walking is delayed in obese children.
• There is excessive fat accumulation in the lower parts of the extremities (arms and legs).
• Orthopedic problems such as flat feet and leg deformities are frequently observed.
• Rashes may develop in skin folds and between the legs due to friction.
• Fat accumulation in the breast area (gynecomastia) is observed in obese boys.
• Skin cracks (stretch marks) are observed in the abdomen and buttocks due to excess fat.
• Skin infections may develop due to an increase in subcutaneous fat tissue.
• Difficulty breathing is a significant respiratory problem in obese children.
• Obesity causes diseases such as cardiovascular disease, hypertension, and diabetes to appear in childhood.
• Blood lipids and cholesterol levels increase.
• Since obesity develops as a result of an unbalanced diet, the consumption of essential nutrients is insufficient, leading to a decrease in the development and effectiveness of the immune system. For this reason, obesity acts as a precursor to various diseases.

!!! The earlier obesity begins, the greater the risk of disease.

What Can Be Done to Protect Children from Obesity?

• Correcting poor eating habits
• Eating regular meals
• Choosing balanced foods for snacks and main meals
• Reducing consumption of sugar and foods high in sugar
• Regulating daily fat intake and patterns
• Regulating daily fiber intake through adequate consumption of fruits and vegetables
• Avoiding high-energy drinks but increasing fluid intake
• Ensuring that daily nutritional requirements are met through frequent meals (5-6 meals/day).
• Creating behavioral change in regulating the appropriate amounts required, Changing lifestyle
• Developing a more active lifestyle
• Including sports activities in daily life
• Monitoring advertisements
• Advertisements for foods that are high in energy value and low in nutritional value, especially those that appeal to children, should be restricted
• School cafeterias should sell foods that are appropriate for children's health and nutrition (such as milk, ayran, yogurt, cheese, sandwiches, fresh fruit, and fruit juices).
• Nutrition services in educational institutions at all levels should be supervised by dietitians.

How is Obesity Treated in Children?

The treatment of childhood obesity is a serious problem that requires teamwork. The doctor, family, dietitian, physical therapist, and psychologist play key roles in this team. The involvement of teachers and friends also facilitates treatment. Treatment is more successful in children who want to lose weight and seek support from their family and professional team.

First, any underlying medical conditions and genetic factors contributing to obesity must be investigated and treated.

If there is no medical cause, the individual's diet and lifestyle are evaluated. In cases of simple obesity, the most important component of treatment is lifestyle changes.

Healthy eating, regular exercise, regulating sleep schedules, and reducing the amount of time spent in front of screens (computers, televisions, smartphones, etc.) are recommended lifestyle changes. It should be remembered that this is the main approach in treatment. It should be remembered that if lifestyle changes are not made or sustained, treatment is likely to fail, or obesity is likely to recur after treatment.

Which Obese Individuals Are More Likely to Benefit from Treatment?

• Children who genuinely want to lose weight or whose parents seek help
• Those with other illnesses in addition to obesity
• Those who have developed complications and psychological problems related to obesity
• Those with a family history of diabetes or cardiovascular disease
• Children with high blood pressure

When it comes to active treatment stages

1. Exercise Therap

It should be remembered that support from a physical therapist will increase the effectiveness of treatment at this stage.

Aerobic exercises (walking, running, cycling, swimming) and muscle strengthening are generally recommended as types of exercise. Exercise increases energy consumption and, according to some studies, also reduces appetite. It prevents complications associated with obesity. While body fat mass decreases with diet therapy alone, when exercise is combined with diet, fat mass decreases while body protein mass is preserved.

In addition to all these effects, exercise also provides psychological improvement. It contributes to resolving psychological problems such as anxiety, depression, mood disorders, decreased self-esteem, and body image distortion, and facilitates compliance with the diet. Exercise physiology in childhood differs from that in adulthood. During adolescence, whether or not the child has entered puberty determines their physiological characteristics related to exercise.

2. Behavioral Therapy

It should be noted that the support of a psychologist or even a child psychiatrist will increase the success of treatment at this stage.

The motivation of the child or adolescent is important for the success of treatment. It is also very important to assess the goals of the patient and their family before treatment. Sometimes goals may be unrealistic (such as losing excessive weight in a short period of time). Many obese individuals believe that they will lose weight by skipping breakfast or lunch. However, the real issue is slow weight loss and maintaining the weight lost.

Family cooperation is also important in treatment. Especially when working with adolescents, it is important that the patient takes responsibility and control, while the environment remains in a supportive role.

By learning about the child's family structure, socio-economic and cultural status, child-parent-friend relationships, lifestyle, and interests, and providing the necessary psychological treatment to support the child, more effective and long-term treatment is possible.

3. Regulating Nutritio

This stage of treatment must be carried out with the support of a dietitian and, if necessary, an endocrinologist.

Principles of nutritional treatment The basic principle of nutritional treatment for obese children is to provide the energy and nutrients necessary for normal growth and development. Approximately 55-60% of the daily energy intake should come from carbohydrates, 12-15% from proteins, and 30% from fats, all in amounts appropriate for the child's age. This will help limit the excess energy previously consumed by the child and balance their nutrient intake.

What are the parameters to consider in the content of nutrients?

1. Energy: Changes in body composition during a child's growth and development period should be carefully evaluated, taking gender into account. When daily energy requirements are met, body weight is maintained. Energy expenditure components include basal metabolic rate (BMR) or resting energy expenditure (REE), physical activity (PA), and energy expended for growth and development (G+D) in children and adolescents. Carbohydrates: 55-60% of energy should come from carbohydrates. The majority of carbohydrates should be complex types.
   
   The diet should also be high in fiber. Oligosaccharides and polysaccharides, which are high in fiber, create a feeling of fullness and thus control energy intake.
   
   For this purpose, vegetables, fruits, dried legumes, and grain products should be preferred. In addition to being low in energy, fiber-rich foods take longer to chew and slow down gastric emptying. This leads to consuming less food. They also increase bowel movements, thereby increasing stool volume. The recommended amount of fiber intake is 12-24 g/day for children and 25-35 g/day for adolescents and adults.
    
2. Proteins: 12-15% of dietary energy should come from protein. In children and adolescents, the quality of protein is as important as the quantity. 50% of the total protein intake should come from animal sources. Of this animal-based protein, 70-80% should come from skim milk and dairy products, and 20-30% from meat, fish, and eggs. It is recommended that 25% of the remaining 50% of total protein come from dried legumes and fruits and vegetables.
3. Fats: Within the framework of healthy eating recommendations, 25-30% of energy should come from fats. Maintaining this amount is important in terms of the individual's acceptance of the diet, the utilization of fat-soluble vitamins, and the contribution of energy to protein synthesis. In addition, the consumption of fats containing monounsaturated and polyunsaturated fatty acids is important for rapid growth during childhood and adolescence.

Is Surgery Feasible for Obese Children?

Surgical intervention should be considered in cases where these approaches have failed. Before reaching this stage, the individual should be closely evaluated, monitored, and treated by a pediatric endocrinologist, child psychiatrist, and dietitian.

In the treatment of obesity, when diet and exercise fail, the success rate of surgery is quite high. Obesity surgery not only improves the individual's aesthetic appearance but also contributes positively to their quality of life. For this reason, it is very important to achieve permanent weight loss through surgery for diseases such as cardiovascular diseases, psychological disorders, and sleep apnea. The method used in obesity surgery is determined on an individual basis. Patients can return to their work and social lives shortly after a comfortable surgical procedure and achieve their ideal weight with proper planning.

This topic is discussed in detail in another article of ours, which can be read here.

Are There Any Weight Loss Medications?

There are some medications used in adults. However, the use of these medications is not recommended for children under the age of 16.

What Should Parents Pay Attention to Regarding Childhood Obesity?

Parents should teach their children the basics of healthy eating at an early age and get them used to regular, healthy eating. Simply telling them is not enough; parents must also set an example. Children should be encouraged to choose healthy snacks instead of packaged foods. Sugary or additive-containing foods and beverages should not be used as rewards. Children should be fed in portions appropriate for their age so that they can consume carbohydrates, proteins, fats, fiber, vitamins, and minerals in a balanced manner. It is very important to ensure that children exercise regularly, get enough sleep, minimize their screen time as much as possible, and spend quality time with them by playing, listening to them, and talking to them. Children can be given responsibilities around the house.

What Can Families Do to Prevent Their Children from Becoming Obese?

• Yeterli sebze ve meyve tüketimini sağlayın.
• Televizyon izlemeye, video oyunları oynamaya ve bilgisayar kullanmaya ayrılan süreyi sınırlandırın.
• Düzenli spor ve egzersiz yapmasını sağlayın ve bu amaçla uygun bir sosyal çevre ve arkadaş çevresi oluşturun.
• Çocuğunuzun şekerli içecekler (soda, kola ve meyve suyu gibi) tüketmesine izin vermeyin.
• Evinize sağlıksız gıdalar (şeker, çikolata, cips, bisküvi, şekerli içecekler gibi paketli gıdalar) almamalısınız.
• Aile olarak sağlıklı beslenme kurallarına uymalı ve çocuğunuza iyi örnek olmalısınız.
• Çocuğunuzun boy ve kilosunu düzenli aralıklarla takip etmeli ve obezite seviyesine ulaşmadan gerekli önlemleri almalısınız.
• Sağlıklı gıdaların nasıl hazırlanacağı konusunda eğitim almalısınız.
• Çocuğunuzun yeterli uyku almasını sağlamalısınız.
• 3-5 yaş için 10-13 saat uyku
• 5-12 yaş için 9-12 saat uyku
• 12 yaş ve üzeri için 8-10 saat uyku
• Obezite ile mücadele için vakit kaybetmeden profesyonel yardım almak gerekir.
• “FAST FOOD YERİNE YÜKSEK LİFLİ GIDALAR TERCİH EDİLMELİ”

What changes when children lose weight?

According to scientific research, a weight loss of 5 kilograms reduces the likelihood of diabetes by 50%. Therefore, while diabetes-related deaths decrease by 40 percent; people's life expectancy increases by 3-4 years. In case of 10 kg weight loss, the probability of death from any cause decreases by 20%, the probability of death due to cancer decreases by 37%, and the probability of developing cancer decreases by 40%. The likelihood of death due to heart disease decreases by 15% and the likelihood of general hospitalization decreases by 25%. When 10 kilograms are lost, life expectancy increases by 5-6 years.

In addition, the individual's quality of life and desire for life increases.

Does Obesity Cause Cancer?

Obesity can lead to an increased risk of cancer. Obesity, which is considered among the most risky diseases, can threaten a person's health by triggering cancer. In particular, obesity predisposes to breast, pancreatic, colon, uterine and esophageal cancers.

Is Obesity Deadly in Children?

Obesity is a strong risk factor for many diseases and premature death. The life expectancy of a 25-year-old man with obesity is reduced by 22% and life expectancy is reduced by 12 years.

Does Obesity Cause Psychological Problems?

As obesity threatens physiological health in many ways, it also negatively affects the mental health of the person. Obesity can often lead to depression and other psychiatric disorders. There are studies showing a linear relationship between obesity and decreased self-worth. The desire to cope with personal inadequacy can turn into a rigid attitude towards eating behavior. In this respect, “dieting and weight loss” may function to regain power and control, allowing the person to redefine themselves, at least in appearance.

Does Excessive and Uncontrolled Internet Use Cause Obesity in Children?

The Internet, which can be useful in many areas, especially in communication and education, can negatively affect children's mental and physical health and lead to anxiety disorders and obesity, especially when used uncontrollably in childhood. Long hours spent using the internet can lead to inactivity, eating disorders and orthopedic problems in children. As a child becomes increasingly isolated from the social environment and sedentary on the internet, his or her eating patterns may also change. As a result, he/she gains weight rapidly and faces the threat of obesity.

*** The information provided here, the content of the website is organized for the purpose of informing the visitor. No information should be considered as advice by visitors and should not lead to any decision or action. Families should have their patient examined by a pediatric surgeon, consult with him/her and make a decision by consulting his/her knowledge.