Healthy Living: Scary Facts

Obesity in the United States is an epidemic that is growing at an accelerating rate!
Obesity is defined as a high ratio of body fat to lean body mass, specifically a Body Mass Index greater than 30. www.obesity.org
Indiana ranks among the nation’s most obese states
The American Academy of Pediatrics recommends all children should have their Body Mass Index evaluated yearly
The costs of health care directly related to obesity were estimated at $102.2 billion in 1999.
The latest estimates put the number of overweight and obese American adults at 97 million… and counting. Medical experts are even comparing the explosive “outbreak” of obesity to an epidemic of a communicable disease. Those are strong yet appropriate words. Obesity definitely increases the risks of high blood pressure, high cholesterol, Type II diabetes, coronary heart disease, stroke, gallbladder disease, osteoarthritis, sleep apnea, and breast, prostate, and colon cancers.
A recent study conducted by the Centers for Disease Control and Prevention and state health departments found that the percentage of obese people 18 years and older climbed from 12 percent in 1991 to nearly 18 percent in 1998. A steady increase was seen in all states, in both sexes, and across age groups, races, and educational levels.
Sweeping changes in lifestyle have caused Americans to lose energy, yet their calorie intake remains high. We now have a tendency to sit in front of the computer or TV instead of engaging in more active lifestyles. This energy imbalance would partly account for this alarming trend.
Many individuals who are battling a weight problem struggle from a sense of shame, guilt and feelings of inadequacy, which only takes away from their sincere desire to more effectively mange their weight. Therapy for some is seen as a viable option for supportive assistance in better understanding self-defeating thought and behavioral patterns, which at times, may make progress seem impossible.
The problem of childhood obesity in the United States has grown considerably in recent years. Between 16 and 33 percent of children and adolescents are obese. Obesity is among the easiest medical conditions to recognize but most difficult to treat. Unhealthy weight gain due to poor diet and lack of exercise is responsible for over 300,000 deaths each year. The annual cost to society for obesity is estimated at nearly $100 billion. Overweight children are much more likely to become overweight adults unless they adopt and maintain healthier patterns of eating and exercise.

What is obesity?

A few extra pounds do not suggest obesity. However they may indicate a tendency to gain weight easily and a need for changes in diet and/or exercise. Generally, a child is not considered obese until the weight is at least 10 percent higher than what is recommended for the height and body type. Obesity most commonly begins in childhood between the ages of 5 and 6, and during adolescence. Studies have shown that a child who is obese between the ages of 10 and 13 has an 80 percent chance of becoming an obese adult.

What causes obesity?

The causes of obesity are complex and include genetic, biological, behavioral and cultural factors. Basically, obesity occurs when a person eats more calories than the body burns up. If one parent is obese, there is a 50 percent chance that the children will also be obese. However, when both parents are obese, the children have an 80 percent chance of being obese. Although certain medical disorders can cause obesity, less than 1 percent of all obesity is caused by physical problems. Obesity in childhood and adolescence can be related to:

poor eating habits
overeating or binging
lack of exercise (i.e., couch potato kids)
family history of obesity
medical illnesses (endocrine, neurological problems)
medications (steroids, some psychiatric medications)
stressful life events or changes (separations, divorce, moves, deaths, abuse)
family and peer problems
low self-esteem
depression or other emotional problems

What are risks and complications of obesity?

There are many risks and complications with obesity. Physical consequences include:

increased risk of heart disease
high blood pressure
diabetes
breathing problems
trouble sleeping

Child and adolescent obesity is also associated with increased risk of emotional problems. Teens with weight problems tend to have much lower self-esteem and be less popular with their peers. Depression, anxiety, and obsessive compulsive disorder can also occur.

How can obesity be managed and treated?

Obese children need a thorough medical evaluation by a pediatrician or family physician to consider the possibility of a physical cause. In the absence of a physical disorder, the only way to lose weight is to reduce the number of calories being eaten and to increase the child=s or adolescent=s level of physical activity. Lasting weight loss can only occur when there is self-motivation. Since obesity often affects more than one family member, making healthy eating and regular exercise a family activity can improve the chances of successful weight control for the child or adolescent.

Ways to manage obesity in children and adolescents include:

start a weight-management program
change eating habits (eat slowly, develop a routine)
plan meals and make better food selections (eat less fatty foods, avoid junk and fast foods)
control portions and consume less calories
increase physical activity (especially walking) and have a more active lifestyle
know what your child eats at school
eat meals as a family instead of while watching television or at the computer
do not use food as a reward
limit snacking
attend a support group (e.g., Weight Watchers, Overeaters Anonymous)

Obesity frequently becomes a lifelong issue. The reason most obese adolescents gain back their lost pounds is that after they have reached their goal, they go back to their old habits of eating and exercising. An obese adolescent must therefore learn to eat and enjoy healthy foods in moderate amounts and to exercise regularly to maintain the desired weight. Parents of an obese child can improve their child's self esteem by emphasizing the child's strengths and positive qualities rather than just focusing on their weight problem.
When a child or adolescent with obesity also has emotional problems, a child and adolescent psychiatrist can work with the child's family physician to develop a comprehensive treatment plan. Such a plan would include reasonable weight loss goals, dietary and physical activity management, behavior modification, and family involvement.