Yeditepe University Koşuyolu Hospital Pediatric Endocrinologist of Pediatrics Department Assoc. Dr. Elif Sağsak answered questions about the causes and treatment of obesity in children. 

Has the Incidence of Obesity Increased in Children?

Obesity is still a very important public health problem today. According to studies, obesity is seen in 10% of primary school children. So, 10 out of every 100 children are obese. Since there are studies based on statistics from previous years, it is possible to say that the incidence of obesity in children has increased even more, especially after the Covid 19 Pandemic. The main factor in this increase is the immobility of children. However, changing eating habits is another important factor.

Why Do Children Become Obese?

The main cause of obesity in children is excessive calorie intake. In addition to the over-calorie diet, it is inevitable for the child to gain weight with inactivity.  What should be done to prevent obesity? First of all, if you have children, it should be ensured that they stay away from foods such as junk food. Healthy foods will be consumed along with it, but the portions on the plates should also be reduced. Carbohydrates are important for children. However, choosing good carbohydrates is just as crucial.

What is the Cause of Obesity in Toddlers?

Today, obesity can be seen even in children under 2 years of age. There are many factors in the emergence of this situation. For example, not being able to take breast milk and being mostly nursed with formula can be the cause of obesity. However, the fact that the mother smokes during pregnancy or the presence of diabetes in the mother also increases the tendency to obesity. Some genetic diseases are also known to increase the risk of obesity in children. Of course, even if children are little, nutrition is still very important.

How To Tell If Your Child Is Obese?

Body mass index is also used to determine whether children are obese. The calculation is made according to the height and weight of the child. However, the diagnosis is made according to the percentile values defined as growth curves. Children with a body mass index above the 95 percentile are defined as obese, and those between 85-95 are defined as overweight. It is also extremely important for children to be overweight in case of obesity development if it is not taken into consideration.

What Diseases Can Obesity Cause in Children?

In children who are obese for a long time, insulin resistance occurs first. Besides, diabetes, hypertension, and fatty liver disease are also some of the diseases that can occur in obese children. Obesity also poses a risk for orthopedic problems in children, one of which is the curvature of the legs. Again, early adolescence in special girls is one of the important problems that can be caused by obesity in children. Psychological problems such as introversion and depression may also develop due to situations such as not liking the child's physical appearance and reactions from friends.

Why is Obesity the Cause of Early Puberty?

The age of adolescence covers a very wide range. Girls from 8 to 13 years old and boys from 9 to 14 years old can develop puberty. Therefore, it is normal for a girl to enter puberty at the age of 10 or 13. However, if a 6–7-year-old girl reaches the weight she will be 10 years old at the age of 6, she thinks "yes, I have reached that weight, now I can enter puberty" and puberty begins. Therefore, early puberty can be seen in children who are bulky and obese, especially in girls.

What Problems Can Early Adolescence Cause in Children?

Early adolescence of children affects priority final heights. In other words, as their peers continue to grow, the child stops growing taller.  Menstruation in girls can also start early. However, at this age, the child is not ready for menstruation. Adolescence is also a period of intense spiritual changes. The premature nature of all these changes also negatively affects the child. Therefore, children need to enter adolescence on time in order to avoid all these psycho-social problems.

What to Do To Protect Children From Obesity?

The family and the physician must work together to prevent obesity and treat obesity in children. In addition, if the child is old enough to understand what is said, it is necessary to talk to him/her one-on-one. The aim here is to convey obesity and the consequences it may cause to both the family and the child. In some cases, parents may also have obesity problems. At this point, the whole family may need to change both their nutrition program and treatment if necessary. 

In addition, it is valuable to establish good communication between the family and the physician. What should be considered in the nutrition of children? The habit of junk food should be abandoned, portions should be reduced, and the Mediterranean type of diet, which is predominantly vegetable and fruit at home, should be expanded. In addition, since sleep pattern is an important criterion in the weight loss process, if the child's sleep pattern is disturbed, it may also need to be corrected.

How to Treat Obesity In Children?

In the treatment of obesity in children, it is primarily investigated whether there is an underlying hormonal problem that may cause obesity. If such a result is detected, treatment is applied accordingly. However, if a problem that may cause obesity in the child is not detected, the desired results can be achieved with a lifestyle change, a change in diet, and a more active life. The most important thing to know at this point is to be patient. Because the treatment of obesity in children is not an event that will be completed in a month or two. Habits need to be adopted as a lifestyle.

Does Childhood Obesity Carry Over into Adulthood?

Try to reduce screen exposure. Studies have shown that children with more than 2 hours of screen exposure a day are more likely to be obese. In addition, studies have shown that children who are obese in childhood are 80% more likely to face obesity in adulthood. We also know that obesity is the basis of many deadly diseases. That's why we do not like obesity in childhood and adulthood.