Hotels San Diego Downtown - Heavy Kids Face Health Problems, Have Few Options

Source        - http://www.usatoday.com/
By                - Nanci Hellmich  
Category  - Hotels San Diego Downtown  
Posted By - San Diego Hampton Inn

 

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About 4% to 6% of children and teens in the USA are severely obese, and yet there are very few effective options for helping these kids reach a healthy weight, says a scientific statement out Monday from the American Heart Association.

The heart group is promoting a definition for severely obese children as those who fall at the very high end of weight charts. This is also called extreme or morbid obesity.

The percentage of severely obese kids is increasing at a time when the percentage of overweight and obese kids seems to be leveling off, says lead author Aaron Kelly, an associate professor in the department of pediatrics at the University of Minnesota.

The heaviest children in this country have higher rates of type 2 diabetes, high blood pressure, high cholesterol, liver disease, sleep apnea, musculoskeletal problems and early signs of clogged arteries, he says. "Those are the immediate consequences, but we also know that severe obesity in childhood is a strong predictor of morbid obesity in adulthood."

The heart association statement "is a call to action," Kelly says. "We are saying this is a problem that hasn't been defined really well until now, and we need to get people to wrap their heads around how serious it is. Severe obesity is an extremely difficult disease to treat. Most of the standard approaches often used successfully in children with milder forms of obesity unfortunately do not work very well in those with severe obesity."

About a third of kids in this country are overweight or obese, according to the Centers for Disease Control and Prevention. Children are classified as overweight or obese based on where they fall on Body Mass Index (BMI) growth charts.

Children are considered overweight if they fall between the 85th to 95th percentile on BMI growth charts. Kids fall into the obese category if they are at or above the 95th percentile on charts. This means their BMI is larger than 95% of the reference population, a group of children from the 1970s and '80s.

The AHA committee defined kids over age 2 as severely obese if they fall at least 20% above the 95th body mass index percentile, which is about the 99th percentile, Kelly says. For example, a 7-year-old girl who weighs about 75 pounds or a 13-year-old boy weighing about 160 pounds — both of average height — would fall in the severely obese category.

The heart association statement, published online in the journal Circulation, says:

• Lifestyle modification/behavior programs for severely obese children and teens have shown only modest improvements in weight, and kids usually remain severely obese and often regain the lost weight after the program ends.

• Only one medication, orlistat, is approved for the treatment of obesity in adolescents. "The medication has pretty limited effectiveness for weight loss and notable side effects," Kelly says. "We need to start doing some studies on the newly approved adult weight-loss medications to test their safety and effectiveness in children and adolescents. But, because of regulatory limitations, no one has been able to step up to do this yet."

• Bariatric surgery, such as gastric bypass, has generally been effective in reducing BMI and improving cardiovascular risk factors for teens, but "we need to know more about the long-term safety in adolescents because many of these surgical procedures are irreversible," he says. Plus, many children and teens do not qualify for surgery, and access to the procedures is limited by lack of insurance coverage.

Exercise physiologist Melinda Sothern, a professor at Louisiana State University Health Sciences Center in New Orleans who has treated more than 3,000 overweight children, including many severely obese kids, over the past 22 years, says, "the underlying biological characteristics that predispose children to severe obesity and the environmental and psychosocial factors that allow it to continue are not well understood.

"Unfortunately standard approaches fall short because severely obese children often have emotional problems and this, along with excess weight, makes physical activity" difficult for them, she says. "Treatments need to be tailored to each child."

Sothern, co-author of the 2001 book Trim Kids, which includes meal plans, healthy recipes and exercise guidelines, offers these tips for parents with a severely obese child:

• Recognize that this is a chronic problem that will require full family support and ongoing medical attention including help from a physician, behavioral counselor, registered dietitian and exercise professional.

• Realize that there may be an underlying emotional issue that should be addressed by a mental health professional.

• Create an environment in and around the home that makes it easier for your child to manage their weight so it doesn't worsen and lead to more serious diseases.

• Keep in mind that responsible weight-management programs include training for parents, giving them skills to help their kids make better food choices, increase exercise and reduce TV and computer time. Children are encouraged to replace sugary beverages with water, eat more healthful protein such as lean beef, skinless chicken, broiled fish; good (monounsaturated) fats instead of saturated (animal) fat; and more high-fiber foods, like fruits and vegetables, while cutting back on sugary ones. The programs reduce the portions and thus the calories eaten. But increasing fiber and maintaining healthy protein intake helps the children to not feel so hungry, she says.