Over the past 20 years, clinical obesity among adolescents has skyrocketed all over the world and it is considered an epidemic.

Definition

Obesity means having too much body fat. A BMI at or above the “95th percentile” line on the chart is considered in the obese range. A BMI number that is equal to or greater than the 85th percentile line but less than the 95th is considered overweight.

Parameters measured:

1. Weight for height.
2. Skinfold thickness. This is measured at the triceps (back of the upper arm) with a caliper that pinches the skin and fat together. It will be higher than expected in an overweight child.
3. The best measurement to take is the body mass index (BMI). However BMI is not accurate in very short or tall teens and in smaller children.
4. Waist circumference, sagittal diameter, and waist-to-hip ratio. These are used to estimate the amount of fat deposited in the skin and inside the abdominal cavity.

Causes

1. Genetic
   Children of significantly overweight parents have a greater risk of developing weight disorders than peers from non-obese parents. If one parent is obese or overweight, their teen has an 80% chance of being overweight. This is probably because of a combination of genetics and family behaviour and habits. Since the first discovery of a gene for leptin, a weight-regulating hormone was found a decade ago, more than 300 obesity-related genes have been located. Some genes relate to how the body burns up calories and others affect the brain chemistry that controls appetite and feelings of satiation. Still, other genes relate to where fat is deposited on our bodies.
2. Enviromental
   • Excessive intake of food
   • Reduced physical acitivityMany studies have shown that kids who spend more time watching television and playing video games are at higher risk of becoming overweight.
3. Underlying medical conditionIllnesses that can cause obesity include endocrine problems and some genetic syndromes. A doctor will be able to rule out an underlying medical problem by a physical examination and by taking a medical history. Sometimes laboratory tests are needed. Some medications like steroids can also cause weight gain.

Complication:

• Type 2 diabetes mellitus
• Hypertension
• Asthma
• Cardiac disease
• High cholesterol
• Fatty liver
• Sleep apnea
• Gallbladder disease
• Kidney disease
• Pancreatitis
• Eye diseases
• Nerve damage
• Various gastrointestinal disorders
• Various skeletal and orthopedic problems
  • Blount disease
  • Arthritis
  • Slipped capital femoral epiphyses
• 80% increase in incidence of obesity in adulthood
• Obesity in adulthood likely to be more severe with earlier onset of co-morbidities
• Pyschological issues (depression and low self esteem)
• Pseudotumor cerebri
• Polycystic ovary syndrome (PCOS)

Can I take some medications to lose weight?

None of the new medicines to treat obesity are approved for teenagers to use and the risk of dangerous complications is far greater than any benefits they might have.

How can I lose weight?

• It is important to lose weight slowly and don’t go on a crash diet as obesity develops over time and cannot be solved overnight.
• The best way to have a healthy weight is prevention.
• Eat together as a family, and don’t watch TV during meals. Families that do not eat together tend to consume more fried foods and soda and less fruits and veggies than families that share meals.
• Set short-term goals for changes in your diet and exercise on a weekly basis. Make sure the goals you set are realistic.
• Have a record of your food intake and exercise.
• Stop eating when you’re full and turn down helpings when you are no longer hungry.
• Eat healthy meals and snacks Elaborate-green veges, fruits, less starchy food, fried food, sugary drinks eg carbonated drinks.
• Do not skip meals especially breakfast.
• Build activity into your daily life with household chores, walking to school, parking far from buildings and taking the stairs.
• Bariatric surgery is becoming more common for the severely obese adolescent. When combined with psychological and nutritional support, surgery can yield to significant and lasting weight loss.