6. Obesity
Body mass index
(BMI) = BMI = weight in kg/(height in meters)2
.
Obesity:- Children >2 yr old with a BMI ≥95th
Overweight:-BMI between the 85th and 95th percen
7.
8.
9.
10.
11.
12.
13.
14.
15. 1) For adults BMI,
-above 30 is obesity
-between 25-30 is overweight.
2)Levels of body fat change beginning with high adi
3)Adiposity rebound at 5.5 years
16. ETIOLOGY
1) A result of calories intake and energy expenditure
imbalance.
2)Individual adiposity is the result of a complex
interplay among
-genetically determined body habitus
- appetite
-nutritional intake
49. Neonatal hypotonia, slow infant growth, small h
feet, mental retardation, hypogonadism, hyperph
leading to severe obesity, paradoxically elevated
Partial deletion of chromosome 15 or
loss of paternally expressed genes
55. TRAFFIC LIGHT DIET PLAN
FEATURE RED LIGHT YELLOW
LIGHT
GREEN
LIGHT
QUALITY High in calories,
sugar, and fat
Nutrient-dense, but
higher in calories
and fat
Low-calorie, high-
fiber, low-fat,
nutrient-dense
TYPES OF FOOD Fatty meats, sugar,
sugar-sweetened
beverages,
fried foods
Lean meats, dairy,
starches, grains
Fruits,
vegetables
QUANTITY
Infrequent or
avoided
LIMITED UNLIMITED
59. PREGNANCY
-Normalize body mass index before pregnancy.
-Do not smoke.
-Maintain moderate exercise as tolerated.
-In gestational diabetics, provide meticulous glucose contr
-Gestational weight gain within the Institute of Medicine (
67. SCHOOLS
-Avoid financial support for sports teams from beverage and food in
-Educate teachers
-Educate children from preschool through high school on appropriat
-Mandate 60 min of strenuous exercise 5 times weekly.
-“the walking school bus”
68.
69.
70. COMMUNITIES
-Family-friendly exercise and safe play facilities.
-Residential-commercial developments for walkable and bi
-Discourage the use of elevators and moving walkways.
-Provide information on how to shop and prepare healthier
71. HEALTHCARE PROVIDERS
-Explain the biologic and genetic contributions to ob
-Give age-appropriate expectations for body weight
-Work toward classifying obesity as a disease
72.
73. INDUSTRY
-Mandate age-appropriate nutrition (e.g., red light/green lig
-Interactive video games in which children must exercise in
-Use celebrity advertising directed at children for healthful
-Reduce portion size (drinks and meals)
74. GOVERNMENT AND REGULATORYAGENCIES
-Subsidize government-sponsored programs to promote the
-Provide financial incentives to industry to develop more he
-Provide financial incentives to schools that initiate innovat
.
75. -Provide urban planners with funding to establish bicycle, j
-Ban advertising of fast foods, nonnutritious foods, and sug
-Ban toys as gifts to children for purchasing fast foods
80. Childhood Obesity
Physical Activity
● Physical activity essential for weight loss
● Energy costs greater for obese
● Physical activity decreases 50% during adolescence
(girls>boys)
81. Childhood Obesity
Dietary Therapy
●Cornerstone of treatment
●Weight loss determined by #calories consumed relative to
expended
●Healthy diet
–55% carbs
–30% fat
–15% protein
●Avoid fad diet
82. -Fat vs Carbs
Carb converted to fat 30% of energy consumed
Little energy used in absorbing fats
-Glycemic Index
High carb diets
Leads to increased serum insulin
Promotes excessive food intake
83. ●Anti- obesity pills not approved for peds
●None of drugs tested for :
–Long term use
–Pediatric age groups
●Drug options
–Appetite suppressants
–Serotonin agonists
–Inhibitors of fat absorption
–Antihyperglycemic agents
84. Childhood Obesity
Pharmacotherapy: Metformin
● Approved for Type 2 diabetes and hyperinsulinemia
● Decreases hepatic glucose production
● Enhances insulin sensitivity
● Results in modest weight loss
● Side effects: nausea, flatulance, bloating, diarrhea,
lactic acidosis
