Childhood Obesity health problems, (and adult obesity problems), are many. It is not only about the cosmetic issue of heavy, hefty appearance. Many physical as well as psychological health disorders are associated with overweight and obesity, not to mention the increased risk for disability and premature death. This article discusses various health risks for overweight children and adolescents. Many of the problems discussed here are relevant for overweight and obesity-affected adults also.
What is Overweight and Obesity? How are they defined or diagnosed in different age-groups?
Overweight and Obesity is not just excess weight. It is abnormal excessive fat accumulation in body that may impair health.
There are various sophisticated methods of body fat measurement but a simple weight to height index known as Body Mass Index or BMI is used in clinical practice to diagnose overweight and obesity in a population.
BMI = Person’s Weight in kilograms divided by the Square of Person’s Height in meters
BMI over 25 defines Overweight, and over 30 defines Obesity in adults.
In children between 2-20 years of age, sex-specific BMI-for-Age charts are used to define or diagnose these conditions. More than 85th percentile on these charts defines Overweight, and more than 95th percentile defines Obesity in children and adolescents.
Check out the Video on Overweight and Obesity.
What are the causes for the global epidemic of Overweight and Obesity?
Overweight and Obesity have become a global epidemic or a pandemic. Heredity, some diseases, and medications can cause overweight or obesity; but most important causes are environmental and lifestyle factors such as unhealthy nutritional habits, sedentary life patterns, lack of sleep, increased screen time, wrong family/parental role models, social food inequity and food industry excesses.
Why are Overweight and Obesity risky for health? How do they lead to various medical problems?
Three main mechanisms put health at risk in overweight and obesity.
A) Endocrine and immune response (Disturbed blood chemistry and internal inflammation):
Increased fat tissue in body disturbs many metabolic processes, triggers immune responses (inflammation) and leads to unhealthy blood chemistry. This includes changes in levels and metabolism of glucose, fats, uric acid, and hormones such as insulin, thyroid hormones, and sex hormones.
B) Physical response (Pressure/Mass/Infiltration effects of increased fat tissue):
Increased fat accumulation in the body can lead to infiltration into different tissues, pressure on various organs, friction between tissues, and weight load on muscles, bones, and joints. All these factors can lead to, or complicate different health issues.
C) Psychologic effects (Reduced quality of life):
Overweight and obesity-affected individuals are often victims of social isolation, discrimination self-doubts and negative self-image, leading to serious mental health issues, and overall reduced quality of life.
What are the different Childhood Obesity health problems?
To understand different medical problems of childhood (and adult) obesity, it is to look at different systems of the body and understand how they are individually affected by these conditions.
Obesity and overweight affects metabolism at multiple levels.
- Dyslipidemia (disturbed fat or lipid levels) in overweight-obesity spectrum reflects through high cholesterol and triglyceride levels. High LDL (Low Density Lipoproteins) and low HDL (High Density Lipoproteins) levels are typically seen.
- Metabolic syndrome is a condition characterized by central obesity (increased waist circumference), hypertension and dyslipidemia. It leads to insulin resistance (ineffective use of insulin at the tissue level) and increased risk of diabetes and coronary heart disease.
- Type 2 Diabetes is characterized by deranged glucose metabolism with hyperglycemia because of insulin resistance and/or impaired insulin production. It damages multiple organs and systems over the period.
- Hyperuricemia or increased uric acid level in blood is often seen in overweight and obesity. It is because of increased production and/or decreased excretion of uric acid and can lead to a painful joint condition called Gout.
- Hormonal changes such as low testosterone in males; high estrogen and testosterone levels in females, and low thyroid and growth hormone levels in both sexes are often seen in obesity.
2. Cardiovascular System
Overweight and obesity increase the risk of accelerated atherosclerosis (thickening and narrowing of the walls of blood vessels because of fatty plaque buildup), coronary heart disease (where the heart tissue gets damaged because it doesn’t receive adequate blood supply through blocked arteries, leading to anginal chest pain or even heart attack) and hypertension (high blood pressure).
3. Central Nervous System
Brain’s structure and function both get affected by overweight and obesity. Brain atrophy (Decrease in brain size), inflammation of important brain nerve circuits, decrease in cognition (ability to learn and understand) and increased risk of dementia are some major problems.
Stroke (brain dysfunction, either because of inadequate blood supply through atherosclerosis-affected blocked arteries, or intracranial bleeding secondary to high blood pressure) is another risk.
4. Respiratory System
The excess fat bulk compressing the airway and the diaphragm, impairs the respiratory mechanics in obesity. The associated circulatory and inflammatory changes in the brain even affect the respiratory center’s function.
These factors lead to important respiratory problems such as Obstructive sleep apnea (periodic short stoppages of breathing during sleep) and Obesity-related hypoventilation syndrome.
Obesity worsens Asthma and Chronic Obstructive Pulmonary Disease (COPD). It also complications during anesthesia and other medical procedures such intubation, extubation and mechanical ventilation
5. Gastrointestinal System
Obesity, especially of abdominal visceral type, increases the risk of Gastro-Esophageal-Reflux-Disease (GERD), which causes regurgitation of acidic stomach contents into food pipe. It can lead to erosive esophagitis and Barrett’s Esophagus (precancerous narrowing of lower food pipe).
Non-alcoholic Fatty Liver Disease (NFLD), Cirrhosis, Gall Stones, Cholecystitis (Gall bladder inflammation), Pancreatitis, Colonic Polyps, and increased risk of GI cancers (esophageal, stomach, liver, gall bladder, pancreatic and colorectal cancers) are some more serious GI consequences of obesity.
Dysbiosis (altered concentration of different species of gut bacteria), and General GI symptoms (heartburn, burping, bloating, diarrhea, abdominal pain, or constipation) are also common.
6. Musculoskeletal System
Obesity negatively affects the bones, joints, and muscles. It affects through a mix of mechanisms like weight overload, genetics, dietary factors, inflammation, and metabolic changes.
Some of the important musculoskeletal problems associated with obesity are
- Osteoarthritis of joints in hips, knees, and palms
- Chronic back pain
- Gait disturbances
- Diffuse Hyperostosis (Bony spurs)
- Compression syndromes (Carpal Tunnel Syndrome, Plantar Fasciitis)
- Osteoporosis (Decreased bone density)
- Association with connective tissue disorders such as Rheumatoid Arthritis and Systemic Lupus Erythematosus
7. Excretory System
Overweight and obesity increases excretory workload of kidneys. Over a period, the function of glomeruli (work units) of such overworked kidneys gets impaired. This leads to progressive consequences such as Albuminuria, Chronic Kidney Disease (CKD) and End-Stage-Renal-Disease (ESRD).
Kidney Stones and Kidney Malignancies are also more common in such cases.
8. Reproductive System
In overweight and obesity-affected females, there are multiple problems such as early onset of puberty, Poly-Cystic Ovarian Syndrome (PCOS), menstrual irregularities and sexual dysfunction. Such females also have increased risk of abortions and pregnancy complications. They are also at more risk for cancers of breast, ovaries and endometrium.
In overweight and obesity-affected males, also there are multiple issues such as early onset of puberty, erectile dysfunction, decreased sperm count and motility, and infertility.
Overweight and obesity result in many skin conditions such as
- Striae or stretch marks on breasts, abdomen, thighs, and buttocks
- Skin tags
- Keratosis pilaris
- Plantar hyperkeratosis (thickened skin of feet)
- Acanthosis Nigricans (dark velvety patches on skin folds like neck, armpits, groins and under the breasts)
- Hirsutism (Excess male pattern hair-growth in females)
- Intertrigo (fungal or bacterial infection of skin folds)
- Increased skin infections
- Increased risk of skin cancer like Melanoma
- Worsening of skin conditions such as acne, atopic dermatitis, psoriasis, lichen planus and Systemic lupus erythematosus
10. Mental Health
Overweight and obesity can cause serious mental health issues such as depression, anxiety, eating disorders such as Binge Eating or Night Eating, and Substance abuse.
Such individuals are more prone for child abuse (Physical, Sexual or Emotional), bullying, social discrimination, social isolation, low self-esteem, negative body image and low quality of life.
Do Overweight-Obesity affected people have higher risk of premature death?
- A major study by Harvard and Cambridge researchers found that a healthy BMI 22-24.9 kg/m2has the lowest mortality rate.
- Each 5 unit increase above BMI of 25 kg/m2 increases overall mortality by almost 31 percent.
- The same study observed that for each 5-unit increase in BMI above 25 kg/m2, the corresponding increases in risk were 49% for cardiovascular mortality, 38% for respiratory disease mortality, and 19% for cancer mortality.
- Researchers also found that the hazards of excess body weight were greater in younger than in older people and in men than in women.
Does Childhood Obesity increase risk of Adult Obesity and other health problems?
Childhood Overweight and Obesity moderately increases the risk of Adolescent Obesity, Adult Obesity and serious health problems such as Diabetes, Coronary Heart Disease and some types of cancers.
- Overweight and obesity are complex medical conditions with excessive abnormal accumulation of body fat that may impair health.
- Overweight-Obesity-affected individuals are at increased risk for many serious diseases and premature death.
- Overweight and Obesity-related medical problems practically involve every body system, and the mind.
- Type 2 Diabetes, Coronary Heart Disease, Obstructive Sleep Apnea, Non-alcoholic Fatty Liver Disease, Osteoarthritis, Infertility, many Cancers and many Psychosocial issues are some main health problems associated with overweight and obesity.
- Childhood obesity raises the risk of Adult obesity and serious health issues such as Diabetes, Heart disease and Cancers.