What Obesity Causes in Children?

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Definition:

Obesity is a chronic case of excessive body fat or adiposity that exceeds healthy limits. The most commonly accepted method to screen for excess adiposity is calculation of body mass index (BMI). Abnormal BMI cut-offs in children are determined by age- and gender-specific percentiles based on growth charts, as the amount of body fat changes with age and differs between boys and girls. Globally the definition of overweight and obesity changes; however, a BMI >85th percentile is defined as overweight or at risk for overweight in the US and UK, a BMI ≥95th percentile is variably defined as obesity or overweight, and a BMI >99th percentile is defined as morbid obesity. For paediatric under 2 years of age, BMI percentiles are not available; thus, obesity may be defined as a weight ≥95th percentile for height.

Aetiology:

Obesity in children is multifactorial. Interactions among factors such as genetic predisposition, behavioural and cultural practices, and environmental influences lead to discordant energy balance, with energy intake exceeding energy expenditure, eventually leading to obesity in predisposed people. Many factors typically co-exist in a person, making it difficult to determine the impact of any one factor independently of the others on the development of obesity. Behavioural and environmental changes must play an important role even in genetically predisposed children, as the prevalence of obesity in children has increased dramatically over the last 30 years despite a low likelihood of a rapid change in the genetic makeup of the population.

Pathophysiology:

Several physiological systems control how the body regulates its weight. The arcuate nucleus, located in the hypothalamus, serves as the master centre of weight regulation by integrating hormonal signals that direct the body to adjust its food intake and energy expenditure.

Risk factors:
  • rapid weight gain in infancy
  • weight gain in early childhood
  • sedentary lifestyle
  • maternal gestational diabetes
  • poor dietary choices
  • sleep deprivation
  • sleep deprivation
  • High cholesterol
  • Bone problems
  • Early heart disease

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