Obesity in a child 5 years old how to treat. Obesity in children. Diseases and accompanying obesity

Childhood obesity is a problem that worries doctors and scientists around the world. They conduct numerous studies in order to find a way out of this situation. Every year the number of children with overweight increases significantly, which poses a threat to the younger generation. Obesity in children can develop at any time, but most often the peak of development occurs at 5-7 years, as well as puberty.

How to determine the onset of obesity in a child

What is the danger of childhood obesity?

Depending on the weight of the child, 4 degrees of obesity are distinguished. The first is characterized by an excess of weight from the norm by about 15-25%. At the second degree, the excess is from 26 to 50%. The third stage starts from 51%. The fourth stage of obesity is the excess of the permissible norm by more than 100%.

Often childhood obesity accompanied by a number of diseases that were previously considered purely adults. Adolescents may experience high cholesterol, osteoarthritis, high blood pressure, diabetes. Being overweight negatively affects health with age. Girls may have problems conceiving and bearing a child in the future. Doctors say that childhood obesity in 10-15 years threatens with infertility, diseases of the spine and joints, digestive tract, varicose veins, sexual disorders. There may be others deadly dangerous complications- stroke, myocardial infarction, renal failure.

Scientists give a sad forecast: obese teenagers and children will not live to be 60 years old. Statistics have shown that obese people live an average of nine years less than people of normal weight. Obesity can become one of the main causes of death, many doctors consider obesity even more dangerous than smoking. Therefore, it is imperative to treat childhood obesity.

Leading causes of childhood obesity

Three standard reasons

Overweight in children is associated with many factors. The main reason is the wrong food culture. For a child, food that contains a large amount of fat is very dangerous, and this is what all kinds of fast foods offer. For lovers of sandwiches and baked goods daily calorie content power supply increases up to 30%, and at the same time almost no energy is consumed.

The second reason for obesity in children is sedentary image life. Hypodynamia is a concept that is increasingly found in medicine. Lack of physical activity, muscle contraction, restriction of motor activity entails a metabolic disorder, a decrease in blood supply to tissues, and a decrease in vascular tone. The development of technological progress negatively affects the hobbies of children. The computer and TV are replacing active games in the yard.

The third reason is a genetic predisposition to a metabolic defect. For example, an imbalance of the enzymes of lipogenesis and lipolysis in the direction of increasing the former. In addition, the cause of obesity in children may be the structure and distribution of fatty tissue, which is also inherited. To hereditary obesity include Bardet-Biedl and Alstrom syndromes.

Diseases and accompanying obesity

However, childhood obesity is not always associated with predisposition, sedentary lifestyle and overeating. In pediatrics, the Itsenko-Cushing syndrome is often forgotten. This disease is characterized by elevated levels of corticosteroid hormones, which stimulate the production of insulin, which leads to fat deposition. Children with Itsenko-Cushing's syndrome suffer not only from excess fat mass, but also from growth deficiency. By itself, hyperinsulinism, which lowers blood glucose levels, leads to increased appetite, which is one of the causes of obesity. This condition occurs in children with an overdose of insulin.

It is impossible to identify the cause of obesity on your own. If the child is overweight, it is necessary to contact the pediatrician for tests. General analysis urine and blood can not always answer the question, what is the problem. Nice results in the diagnosis shows a biochemical blood test. Usually with obesity in the blood there is a high amount of hyperlipidemia, hypercholesterolemia and triglycerides. Based on the data obtained, the doctor can prescribe the appropriate treatment.

Treatment of childhood obesity should be comprehensive. If the cause of obesity lies in a sedentary lifestyle, then it is not enough just to give the child physical activity. It is necessary to completely revise the daily routine and nutrition of the child. It is recommended to change the food, excluding fatty foods, baking. It must be remembered that a child is a growing organism that needs required quantity calories.

Children's diet for obesity

The purpose of the children's diet is to inhibit the ongoing process of fat formation around internal organs and in the subcutaneous tissue and the mobilization of deposited fat reserves. This is possible by reducing the calorie content of food. Adult diets are based on a complete or partial rejection of the diet, which is unacceptable in children, as their body needs vitamins, minerals and trace elements.

Any children's diet for obesity should be based on the correct regimen. It is best to feed a child six times a day, preferably following the regime, i.e. at the same time. The interval between meals should be approximately 2.5-3 hours. For example, the first breakfast can be given to a child at 8 am, the second at 10:30, lunch at 13:00, afternoon tea at 15:00-15:30, dinner at 18:00. For children, we allow a light dinner before bedtime at 20:00. Advantage fractional nutrition in that it reduces the appetite, there is always a feeling of fullness in the stomach. In addition, the body ceases to accumulate food, as it can be with three meals a day. Dinner for an overweight child should be light and not too late. The last snack can be after dinner and include one carrot or one apple.

Rules for introducing a children's diet

Children's diet should be introduced gradually. First you need to completely eliminate overfeeding. Most high-calorie foods should fall in the first half of the day, since during this period children are most active. For breakfast and lunch, you can give fish and meat dishes, and in the afternoon it is better to cook vegetable or dairy food for the child. In childhood obesity, preference should be given to lean fish meat (for example, cod species), poultry meat. From dairy products, choose low-fat cottage cheese, low-fat kefir, dietary cottage cheese, but sour cream, fermented baked milk and cream should be sharply limited.

The second step in a safe children's diet is the exclusion of foods with high content carbohydrates. Limit your child's consumption of white bread, sugar, confectionery, canned juices, semolina, pasta.

All attention of parents should be directed to protein food. 65-70% of all protein foods should come from animal products (fish, lean meat, milk), and 30% from plant foods. For example, an excellent source of protein can be vegetable oil, which can be seasoned vegetable salad. Part sunflower oil includes polyunsaturated fatty acids, which activate the process of fat consumption. Olive oil prevents the accumulation of fat mass in the body.

Distinctive features of the diet for children

Children's diet for obesity should include vitamin-rich fruits and vegetables. The composition of many vegetables includes fiber and pectin, due to which the function of the intestines is regulated, a feeling of fullness is created, and toxins are removed. Such products include leafy greens, tomatoes, pumpkin, cucumbers, radishes. AT winter time as a source of pectin, you can use pickled and Brussels sprouts.

With obesity in large quantities, berries and sour varieties of fruits can be given. The use of canned juices, compotes, jams is not recommended, as they contain a lot of sugar. Dried fruits are very useful: prunes, apricots, raisins, dried apricots. With any diet enough liquids. Observing the drinking regime, it is necessary to completely exclude sweet water. It's better to replace plain water or freshly squeezed juice.

If the weight of the child is no more than 20-25% of the norm, then such restrictions will be quite enough. The diet usually promotes weight loss. To control this process, it is desirable to weigh the child every day, recording and analyzing the results.

With the third and fourth degree of obesity, the diet will be much stricter. From the diet of the child, it is necessary to completely exclude sweet drinks (tea, cocoa, cafes), pasta, cereals and flour dishes, sweet fruits and berries (raisins, bananas, grapes). You should limit the consumption of foods rich in starch, such as potatoes. Any food should be boiled or steamed, frying is not allowed.

The first dishes should be cooked only on vegetable broths. Only 1 per week you can cook soup on a weak fish or meat broth. Milk soup is prepared with a minimum amount of cereals, and it is desirable to add barley or buckwheat, but pasta and rice are not recommended.

You can diversify the menu of an overweight child by preparing aspic meat and cabbage rolls once a week. Breakfast and a side dish for main courses should include vegetable dishes, for example, carrot-apple soufflé, vegetable stew, baked beets. Regardless of the completeness of the child, you can not limit the use of radishes, lettuce, dill and parsley.

Useful for treating childhood obesity wheat bran. They are poured for half an hour, the water is drained. Softened bran is added to any dish 1 teaspoon once a day. After 2 weeks, you can add them in 2 teaspoons.

Children's diet for obesity should include seafood. Squid meat, seaweed, mussels are rich in trace elements and B vitamins, while they are low in fat and carbohydrates. During the period of restriction of certain products, seafood will make up for the lack of substances necessary for the growing body.

All children have a sweet tooth, so they will perceive a severe restriction of confectionery products negatively. In the first two stages of obesity, a child can be pampered 2 times a week with two pieces of marmalade, marshmallows or jam. But remember that you need to give sweets strictly limited quantity. Remember that cakes, cakes and lemonade are strictly not allowed in the diet.

Treatment of childhood obesity

Weight loss doesn't have to be limited to diets. For a child, physical activity is very important, because. this will not only help to use up the calories received, but will also be a good prevention of other diseases associated with physical inactivity. Limit your child's access to the computer and TV. He spends his free time playing active games in the yard: tennis, football, volleyball. Regular physical activity shows good results. Some parents believe that the child will be enough with what he receives at school in a physical education lesson. Actually it is not. Only an experienced trainer will be able to select the necessary physical exercises and elements of exercise therapy. Children with 1-2 degrees of obesity can be given to the sports section or swimming in the pool, where the child will move a lot. Of course, this step should be taken only after consultation with the therapist and the future coach or instructor. Unfortunately, there is a widespread belief that complete baby achieve nothing in sports. Competition statistics show that some sports have higher weight category on the contrary, it will help to win prizes. But for starters, you can limit yourself to a simple morning exercises and more actively life.

If the problem of childhood obesity is in heredity or disease, then radical measures are needed, such as drug therapy or surgery. After the examination, the child will be given accurate diagnosis and prescribe appropriate treatment. Drug therapy is rarely used and is prescribed only in exceptional cases. Children's body reacts more sharply to all components, so only appetite suppressants are used in the treatment. Surgery Childhood obesity is prescribed only in the case when the child's weight exceeds the allowable by more than 51%.

Any disease is easier to prevent than to treat. Always watch your child's diet, do not allow overeating. Even in the first stage of obesity, it is necessary to introduce a restriction on certain products and make the child move more.

This is a chronic metabolic disorder, which entails the accumulation of fat mass under the skin in large quantities. You can talk about it when the weight of the child is 15% higher than the figure that is considered normal at his age, and the body mass index is 30 points higher.

According to studies, about one in 15 children suffer from this problem. According to the same information, children living in cities are more susceptible to it than their rural peers. It is important to note that many adults who are obese develop the disease as early as childhood.

There are 4 degrees of obesity in children:

• In the first case, the body weight deviation exceeds the maximum allowable value by 15-24%. It is at this stage that the disease is most often diagnosed.
• The second degree is set when the norm is exceeded by 25-50%. In such a situation, the child already has tangible discomfort and the first health problems against this background.
• We can talk about the third degree if the weight is more than prescribed at a particular age and with a certain height by 50-100%. At this stage, a serious and complex approach to treatment is required.
• The last, fourth degree of the disease makes itself felt when the norm is exceeded by 100% or more. This stage is characterized by severe complications in the form diabetes, hypertension, etc.

Causes of obesity in children and adolescents

In general, they are very similar - this is unhealthy image life, low physical activity, the use of high-calorie, fatty foods, passion for food from fast foods. The disease can occur due to an increase in the nutritional value of the diet and a sharp increase in the level of consumed simple carbohydrates, which practically do not transform into energy and are deposited under the skin.

Why is the child obese

Here are some more good reasons:

1. Low physical activity. This is true for children who, for example, do not attend Kindergarten or are at home schooling, walk a little on the street with their peers. If they play sports, the risk is markedly reduced.
2. Abuse of sweet. Children are real sweet tooth, most often they enjoy something every day - sweets, cookies, ice cream, halva and other goodies. Naturally, all this is very high-calorie, and when the nutritional value of the diet is exceeded, subcutaneous fat begins to be deposited.
3. Incorrect power scheme. Not all schools now provide children full breakfast, lunch and afternoon tea. As a result, they are forced to survive on dry sandwiches, cold food or even go hungry before returning home. Such long breaks lead to a sharp jump in blood sugar and metabolic disorders, which is one of the main factors in the development of obesity.

Causes of obesity in teenagers

The following reasons should be considered in more detail:

• unhealthy food. Those who eat a lot of fatty meat, fish, dairy products, are fond of fried and flour products, and love fast food should be careful.
• Metabolic disease. It can be triggered by any diseases of the organs digestive system- pancreatitis, cholecystitis, colitis, gastritis, biliary dyskinesia. In this case, the digestion and absorption of food slows down, which leads to a slow accumulation of fat.
• Inactive lifestyle. Modern children prefer computer games to walks in the fresh air. In this case, the calories eaten are slowly consumed, transforming over time into fat.
• Stress. This reason is relevant due to the fact that it often leads to an increase in blood sugar levels and an increase in hunger. Often, teenagers try to eat sweet emotions when they have unpleasant emotions. And given that this is the most difficult age in life, which accounts for a lot of experiences, the abuse of tasty is a common practice, and how can fat not be deposited here.

Diagnosis of obesity in children and adolescents

Among the most common symptoms are:

1. Overweight. The child develops a thick fat layer, wrinkles appear on the body and even noticeable stretch marks.
2. Shortness of breath during physical activity. When obesity occurs, children often have difficulty climbing stairs and playing sports, even when walking slowly.
3. Increased sweating . It can be explained by hypertension and increased blood sugar, which almost always accompany excess weight. As a result, the child sweats a lot both in winter and in summer, this is especially acute during active movements.
4. Apathy. The patient's working capacity decreases, the desire to play with other children and go in for sports disappears, and there are problems with sleep.
5. Joint diseases. Due to excess weight, the load on them increases significantly, which can activate the process of cartilage destruction, inflammation synovial fluid, pain in the knees, elbows and hips.
6. Puberty disorder. This symptom is typical for adolescents aged 12 to 15 years. It manifests itself in the absence of menstruation or its down cycle, increased body hairiness, if we are talking about girls, numerous ovarian cysts (polycystic), altered hormonal levels.
7. Inguinal hernia. It does not always develop, but for this, a child with overweight there are all the reasons - metabolic disorders, possible constipation, increased load to the intestines.
8. Frequent bouts of binge eating. In this case, children will lean on sweets and pastries, eat larger portions and eat more often.

From 1 month to 3 years, you need to focus on the following numbers:

Features of the treatment of obesity in children and adolescents

Children under 12 try not to prescribe pills. First of all, patients are prescribed proper nutrition and calculate the calorie content, which at this age should be approximately 1950 kcal. The eighth diet for obese children is selected.

In the treatment of obesity in children, the following methods are relevant:

• Food. It is necessary to abandon simple carbohydrates or limit their consumption as much as possible - sugar and products based on it, potatoes, pasta, vermicelli. All sugary drinks and store-bought juices, fatty meats and dairy products should be excluded from the menu. Eat as many fresh fruits and vegetables as possible, with the exception of grapes and bananas, which are too high in calories. You need to eat fractionally, 5-6 times a day, you should definitely drink more water.
• Healing procedures. Regular exercise will help cold and hot shower, physio- and reflexotherapy, massage. These methods are relevant only for grades 1 and 2 of the disease, when the symptoms are not pronounced.
• homeopathic remedies. The most effective drugs are Antimonium Krudum, Hepel, Testis compositum, Graphites Cosmoplex C. The course of treatment is at least 2 weeks, after which a break is taken for several months. Both tablets and drops are taken one hour before meals. Children under one year of age should not be used.

Requires active physical activity, a complex of exercise therapy, evening hiking before bedtime. A great option is to sign up for a sports section, preferably in a pool. Homeopathic preparations are also needed. Given that adolescents often have an unstable emotional state, one cannot do without psychological help. With the permission of the parents, an overeating coding can be carried out.

Drug treatment is also not excluded, which is most often resorted to only with 3 degrees of obesity. The doctor may prescribe Metformin, Orlistat, Sibutramine, Phentermine.

In addition to all this, folk remedies will not be superfluous. A mixture of Alexandrian leaves, dried figs and dried apricots is quite good, each of these ingredients is taken in 50 g. All this is crushed and the finished mass is consumed in 1 tsp. for breakfast and dinner daily. This should be done for a month, after which the course should be interrupted for a week.

Another healthy recipe when there is teenage obesity: mix St. John's wort, Birch buds and chamomile (25 g each). Pour herbs hot water(400 ml), let them brew for a day and give the child 200 ml at bedtime along with honey (1 tsp).

Prevention of obesity in children and adolescents

Nutrition should be fractional, the optimal number of meals per day is 5-6 times, the break between them is 2-3 hours.

It is also important to drink at least 1 liter of water, do not lean on sweets and fatty foods.

The key to success is increased physical activity, running, swimming, cycling and other sports will help reduce the risk of obesity.

It is very important to follow hormonal background, metabolism and mental state of the child. It is necessary to weigh yourself in a timely manner and control your body mass index, focusing on the tables indicated in the article just above.

How to treat obesity in children - look at the video:

Chubby babies cause real tenderness in many adults. However, being overweight is not only a matter of aesthetic beauty. For supporting good health weight should be maintained within the normal range. About childhood obesity will be discussed in our article.

When do people talk about obesity?

A pathological condition in which weight changes upwards and exceeds normal age indicators by more than 15% is called obesity. Many specialists use a parameter such as body mass index to establish a diagnosis. This is the ratio of height in meters to twice the weight in kg. The body mass index is expressed in absolute numbers. Exceeding it above 30 indicates that the child has obesity.

Obesity can develop at any age: both in newborns and in adolescents. According to statistics, obesity is slightly more common in girls under 8 years of age than in boys. However, after puberty, this ratio changes. Often, parents of newborn babies confuse obesity and large body sizes.

If at birth the weight of the child exceeds the norm, then this does not give grounds for the diagnosis of obesity.

Obese babies live in different countries. There are more of them in economically developed countries than in developing ones. This feature is largely due to overnutrition, low physical activity, as well as the abuse of fast food. In Asia, the number of overweight babies is several times lower than in Europe and America. This is due to the historical food culture and the lack of an abundance of foods containing saturated fats on the Asian menu.

The incidence rates are increasing every year. This trend is rather unfavorable. Two out of ten babies in Russia are obese. In countries post-Soviet space the incidence is also increasing every year. Approximately 15% of babies living in Belarus and Ukraine suffer from obesity of varying degrees.

In the countryside, several fewer children who have problems with being overweight. In many ways, this feature is due to greater physical activity than in the city, as well as high-quality food, which does not contain numerous chemical additives and preservatives. According to statistics, urban kids are obese in 10% of cases. For rural small residents, this figure is lower - about 6-7%.

The onset of the disease in childhood is extremely unfavorable. Many parents believe that being overweight only adorns the child and makes him pretty, however, they are mistaken. Since early years Babies begin to develop eating habits. After all, you probably noticed that from the first months of life, the child has his own taste preferences. Some children love porridge and chicken, while others cannot do without eating sweet fruit.

Little sweeties can be identified already from the very early age. If parents at this time encourage each achievement of the child with a candy or a sweet high-calorie cookie, then subsequently the baby develops improper eating behavior. During the rest of his life, he will be pathologically drawn to sweets and chocolate. Moreover, an adult person will not be able to find any logical explanation for this.

Treatment and diagnosis various problems children's endocrinologists deal with weight. The danger of obesity is that it can lead to persistent disorders in the work of many vital organs. Subsequently, babies develop cardiovascular, neurological disorders, chronic diseases of the gastrointestinal tract, as well as severe metabolic disorders. Late diagnosis of the disease and non-compliance with the diet contribute to the progression of the disease.

The reasons

The development of obesity in babies can be caused by exposure to the most various reasons. Most of the factors arise as a result of external influences. Such an action should be long and regular. This ultimately leads to the development of obesity.

To causative factors weight problems include:

• Overnutrition. The daily excess of the calorie content of the daily diet contributes to the oversaturation of the body with various nutrients. He begins to store all the surpluses in reserve. Ultimately, this leads to the fact that the child develops morbid obesity.

• Excessive consumption of sweets. Such fast carbohydrates are very dangerous. Once in the body, they begin to be absorbed already in the oral cavity. The glucose (ordinary sugar) contained in such sweets quickly leads to hyperglycemia (increased blood sugar levels). In order to normalize blood sugar levels, the body secretes great amount insulin and hyperinsulinemia occurs. This condition is fraught with the fact that all excess sweets are deposited in special fat depots - adipocytes, which contributes to the development of obesity.
• Insufficient physical activity. Active movement is required to burn excess calories from food. Toddlers who eat a lot of high-calorie or sweet foods, but do not attend sports sections and spend most of their time at home with a tablet or phone, are at risk for possible development they are obese. The balance between incoming calories and their utilization and ensures the maintenance of normal weight at any age.

• Heredity. Scientists have found that 85% of parents who have problems with being overweight have babies who also have problems with being overweight. For a long time, experts believed that there was an “obesity gene”. However, there is no scientific evidence for this to date. Most likely, in families where family members have developed obesity, improper eating habits have formed. High-calorie nutrition in this case leads to weight problems in both adults and babies.
• chronic diseases. Various pathologies of the pituitary gland, adrenal glands, thyroid gland lead to significant metabolic disturbances. Typically, such diseases are accompanied by multiple adverse symptoms. Being overweight is just one of their clinical manifestations. To eliminate obesity in this case, treatment of the underlying disease is indispensable.

• Large birth weight. If a newborn baby has a body weight of more than 4 kg, then this is a significant risk factor in his later life for the formation overweight body. In this case, obesity is not big weight at birth, and further overfeeding of the child. Low physical activity only exacerbates the development of the disease.
• Strong emotional stress. More and more scientists say that various "jamming" leads to the development of weight disorders. This condition is more common in teenagers. Excessive workload at school, the first unrequited love, the absence of friends causes a strong desire in the child to “relieve” stress with a chocolate bar or candy. In children aged 5-7 years, the development of this type of obesity is often caused by a painful divorce of parents or moving to a new place of residence.

In some cases, the combined effect of several factors leads to the disease. Eating disorders with reduced physical activity always have the most important impact on the fact that the baby has extra pounds.

The intervention of parents in this case should be as delicate as possible. You need to show the child that you are on his side and are trying to help, because you love and care for him very much.

Classification

There are several clinical forms diseases. This influenced the creation of several classifications, which highlight the main options for obesity, taking into account some features. Data nosological groups doctors need to establish a diagnosis and choose the right treatment tactics.

All normal weight indicators by age are usually collected in a special centile table. With the help of this document, you can determine the approximate norm of body weight for a child of different sex and age. All children's doctors resort to these tables to determine whether a particular baby has signs of obesity. The norm is the correspondence to the 25th, 50th and 75th centiles. If the child has a weight correspondence of 90.97 centiles and above, then this indicates that the baby has obesity.

Doctors distinguish several clinical forms of the disease:

• Primary. It can be exogenous-constitutional and alimentary. In violation of eating behavior and nutritional problems, they speak of food (alimentary) obesity. If the baby has some features of the constitution and hereditary characteristics, then this is an exogenous-constitutional option. Obesity is treated in this case by prescribing therapeutic nutrition and with the obligatory selection of optimal loads.
• Secondary. Also called symptomatic. This type of obesity is characteristic of many chronic diseases that cause pronounced violations in metabolism. In girls, this condition occurs when various diseases ovaries, and in boys mainly with pathology of the thyroid gland. Treatment of excess weight in these situations is impossible without eliminating the causes of the underlying disease. The correct tactics of therapy necessarily include a complex treatment of all chronic diseases that are the main cause of obesity.

Pediatric endocrinologists identify several dangerous periods during the development of the child, when the chance of obesity in the baby is highest. These include age up to 3 years, 5-7 years, as well as puberty(12-16 years old). At this time, parents should carefully monitor the appearance of their child. If the baby has signs of being overweight, then you should definitely consult a pediatrician about this problem.

There is also a classification according to the severity of overweight. It was proposed by A. A. Gaivoronskaya. With the help of this classification, obesity can be divided into several categories, depending on the quantitative excess of weight over normal indicators.

According to this division, there are several degrees of the disease:

• Obesity 1 degree. In this case, the weight exceeds 15-24% of age indicators norms.
• Obesity 2 degrees. The excess of body weight over normal values ​​is 25-49%.
• Obesity 3 degrees. The excess of body weight over normal values ​​is 50-99%.
• Obesity 4 degrees. The excess of body weight over the norm is over 100%.

Appearance

Excess weight significantly changes the appearance of the child. Excess fat accumulates in the subcutaneous fat. Normally, its layer is expressed moderately. With obesity fat cells(adipocytes) increase in size and volume, which leads to an increase in the thickness of the subcutaneous fat layer. Its largest accumulation is localized in the abdomen, on outer surface arms and legs, buttocks and thighs.

During puberty, there are specific differences in the distribution of subcutaneous fat. Yes, girls largest cluster excess kilograms is deposited mainly on the hips and buttocks, that is, in the lower half of the body. This type of obesity is also called pear-shaped”, as the volumes of the lower half of the body increase predominantly.

male type obesity is also called obesity by type " apples". In this case, the accumulation extra pounds occurs mainly in the abdomen. This type of disease contributes to the fact that the waist disappears, and the configuration of the child's body becomes excessively rounded. Toddlers look uniformly plump, and in some cases even overly full.

Obesity of 2-3 degrees is accompanied by an increase in the thickness of the subcutaneous fat layer in the face and neck. This leads to a change appearance baby. He has not only cute plump cheeks, but also a short-looking neck. At 4 degrees of obesity, they narrow somewhat palpebral fissures. The appearance of the child becomes sick and no longer causes tenderness, but compassion.

Main symptoms

Obesity causes not only a change in the appearance of the child, but also leads to the appearance of various adverse symptoms in him. So, in sick babies, jumps in blood pressure are observed, the pulse accelerates, resistance to physical exertion decreases, a headache appears, and shortness of breath develops. With prolonged obesity by adolescence, the child may develop metabolic syndrome. This is a dangerous condition caused by persistent hyperinsulinemia. It is dangerous because it can lead to various cardiovascular diseases and diabetes.

With the development of obesity at school age, multiple adverse symptoms appear. So, it becomes more difficult for children to concentrate on mastering new educational material, they quickly get tired, they develop daytime sleepiness, slowness. For a teenager, public opinion is very important.

Often, obese children experience significant communication problems and make new friends poorly. This leads to the fact that a teenager feels useless and closed to communication, including with parents and people close to him.

If obesity is secondary, then, in addition to being overweight, the child also has other, more dangerous symptoms. So, in adolescent girls with pathologies in the ovaries, the following clinical signs appear: hair grows excessively all over the body, acne occurs, strong fallout hair, the menstrual cycle is disturbed, the skin becomes excessively oily and prone to any pustular inflammation. In adolescent boys with secondary obesity, which developed against the background of pathologies of the pituitary gland or reproductive system, disorders such as gynecomastia (enlargement of the mammary glands), cryptorchidism, underdevelopment of the external genital organs and others appear.

Severe obesity leads to respiratory problems. Excess subcutaneous fat in the abdomen and chest leads to the fact that the diaphragm is significantly compressed. This condition causes the child to develop sleep apnea. This pathological condition occurs during sleep. It is characterized by pauses in breathing, which contributes to the development oxygen starvation vital organs.

Extra pounds put a lot of pressure on musculoskeletal system. It becomes much harder for the baby to walk and move. In the later stages of the disease, the child cannot even perform normal active movements. While walking, the baby feels pain in the joints and muscle weakness. This leads to the fact that the child walks less on the street and is more at home.

Complications and consequences

The long course of the disease has negative long-term effects. Obese children are much more likely to develop cardiovascular, neurological and orthopedic diseases. Persistent violations in the reproductive sphere lead to the fact that in adulthood they cannot conceive a child and experience significant difficulties with bearing.

Pathological fractures are also most common in people who are obese. In this case, bone fragility is due to significant pressure on the organs of the musculoskeletal system of excess weight. According to statistics, boys who are obese in childhood often develop various anatomical disorders in the feet. This can lead to the development of flat feet and valgus deformities in them.

Disturbed eating behavior leads to the fact that the child has numerous chronic diseases of the gastrointestinal tract. The most common are: chronic gastritis and pancreatitis, cholelithiasis with development calculous cholecystitis, enterocolitis and irritable bowel syndrome.

Often these pathologies in babies pass from acute to chronic course. This leads to the fact that the child is prescribed drugs for permanent reception throughout life.

Diagnostics

Often, parents do not pay attention to the presence of obesity in the baby. Especially if the child school age. They think it's cute. Many fathers and mothers believe that all symptoms will go away on their own by adolescence. In some cases this actually happens. However, they do the child a disservice.

Childhood is a very important period of life. It is at this time that the baby forms all the basic habits and behaviors that he will then transfer to adulthood. Eating behavior also formed during childhood. All taste preferences then remain throughout life.

If the baby gets used to eating fast food or too fatty and fried foods, then later this behavior is fixed in him as a persistent eating habit. In adulthood, it will be extremely difficult for him to refuse such products. In order to avoid this, you should carefully monitor the diet from an early age.

When signs of obesity appear, be sure to take the baby for a consultation with the doctor. The specialist will be able to identify the cause of the disease, prescribe a set of examinations to detect secondary obesity, and also recommend to parents what course of therapy is required.

Obesity is a disease that needs to be carefully monitored and treated.

Treatment

According to clinical guidelines, obesity therapy is carried out taking into account the severity of overweight. An integral part of the treatment is the appointment of a diet. If a child has risk factors that provoke the development of obesity, then the diet should be followed throughout life.

Medical nutrition should be low-calorie. Fatty foods, especially saturated fat are completely excluded from the children's diet. In the diet of an obese baby, a sufficient amount of coarse fiber must be present. It is mainly present in fresh vegetables and fruits. Industrial sweets (cakes, pastries, sweets, chocolate, etc.) are completely excluded.

In addition to medical low-calorie food, optimally selected physical activity is required. With a slight degree of overweight, a visit to sports sections is suitable. With a significant excess of extra pounds, playing sports without medical supervision is very dangerous. In this case, physiotherapy exercises are well suited.

The intensity and complex of physical exercises are agreed with a sports medicine doctor or a professional instructor with a specialized education. Excessively active training in obese babies is not acceptable, as they can cause various complications in the child's musculoskeletal system. Physical exercises should be performed at a calm pace and with a certain frequency of repetitions.

To eliminate the symptoms of secondary obesity, treatment of the underlying disease is required. In this case, advanced diagnostics may be required. Usually, the treatment of secondary obesity is carried out by pediatric endocrinologists with the active participation of gynecologists, nephrologists and other specialists as needed. Obesity prevention plays a very important role in preventing overweight in babies.

Rational nutrition, active physical activity and a good psycho-emotional mood contribute to excellent health and maintaining a normal weight throughout life.

Should the weight and height of the child comply with the norms? Dr. Komarovsky answers these and other questions regarding the problems of excess weight in children.

Excess weight, especially in children, adversely affects the health of the body. Every year the percentage of children suffering from obesity is only increasing. Usually the causes of the problem are wrong diet nutrition, eating habits that adults instill, diseases and genetic predisposition. Often, many parents believe that obesity in a child is a sign of a good appetite, and are in no hurry to see a doctor. However this problem needs to be addressed as soon as possible.

The presence of a problem can be judged if the excess body weight is more than 25% of the norm. To determine the degree of obesity in children allows body mass index (BMI), which is calculated as follows: weight in kilograms divided by height in meters squared.

For example, the weight of a child is 40 kg, and the height is 118 cm. Therefore, the body mass index in this case is equal to:

BMI = 40: (1.18 x 1.18) = 28.7

Calculate body mass index on the calculator

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Body mass index table

Effects

Being overweight in a child causes many problems. It is the main cause of the development of hypertension, diabetes mellitus of the 2nd degree, causes increased pressure on the spine and joints, increases the risk of developing coronary heart disease (impaired blood supply to the myocardium), lowers self-esteem, and negatively affects relationships with other children. Some experts believe that the most serious consequences of childhood obesity are psychological and social problems. Very often, people who are overweight do not live to be 50 years old.

Why does

There are several factors that can affect weight gain. Consider them:

• Improper nutrition is one of the main causes of obesity in children. Usually their diet is dominated by easily digestible carbohydrates(sweets, bakery products), solid fats (french fries, hamburgers, hot dogs), sugary drinks (soda, juices) with insufficient intake of protein, fiber, water. Obesity in infants in most cases is caused by improper introduction of complementary foods and as a result of overfeeding with milk mixtures.
• Sedentary lifestyle. Many children lead a sedentary lifestyle - do not play sports, do not play outdoor games, spending all your free time at the computer, tablet, video set-top box or TV. And the lack of physical activity leads to the accumulation of excess weight, since the burning of calories is very slow.
• Genetic factors . There are some gene mutations that contribute to the development of obesity. They control the metabolism of carbohydrates and fats, the production of leptin (a hormone of adipose tissue), and the expenditure of energy by the body obtained from food. It has been established that if both parents have overweight, the probability of its occurrence in a child is 80%, if only the father has it - 38%, only the mother - 50%.
• Diseases. Obesity in a child may be due to serious illnesses(hypertension, coronary heart disease, diabetes mellitus, liver cirrhosis, brain tumor).

Treatment

An overweight child without fail requires consultations of a nutritionist, cardiologist, endocrinologist, gastroenterologist, orthopedist, neurosurgeon, and also a psychologist.

The goal of treating obesity in children is to reduce weight to normal levels and prevent weight gain. An individual diet is selected for the child and 5 meals a day are prescribed. It is recommended to feed him at the same time, in small portions (first breakfast at 8:00, the second at 10:30, lunch at 13:00, afternoon tea at 15:30, dinner at 18:00). Such a diet helps to reduce appetite, as the next portion of food “catches up” with the next, creating a feeling of fullness in the stomach. Dinner should not be later than 19:00. If the child cannot fall asleep due to hunger, then you can offer him kefir, some fruit or vegetable.

Treatment of obesity in children must begin gradually, eliminating overeating. The main part of high-calorie food should fall on the first half of the day - during the period of increased physical activity. For breakfast and lunch, it is recommended to give the child meat and fish meals, and for afternoon tea and dinner - vegetable and dairy foods. In doing so, preference is given to low-fat varieties poultry, fish, meat, fat-free kefir, milk, low-fat cheese, cottage cheese. Cottage cheese should be consumed only in its natural form.

Important components of the diet for obesity are fruits and vegetables that provide the body with vitamins and minerals. Vegetables are useful in any form - boiled, stewed, however, most of them should be consumed raw, in the form of salads. Especially useful are vegetables and fruits that contain a lot of fiber, due to which a feeling of fullness is created, toxins are removed from the body, and bowel function is regulated. These include: cucumbers, cabbage, tomatoes, radishes, pumpkins, carrots, beets, green beans, potatoes, corn, green pea, zucchini, avocado, apples, apricots, bananas, oranges, pears, peaches. Dried fruits are also useful - prunes, dried apricots, raisins, which contain a lot of potassium salts.

Do not forget about seafood - mussels, squid, shrimp, sea kale, containing a large amount of B vitamins, micro - and microelements, low fat and carbohydrates. Marine products contribute to the normalization of fat metabolism.

Sweets, in the form of marshmallows, marshmallows, marmalade, can be given to a child only 1-2 times a week. Sugar is replaced by sorbitol or xylitol. It is also allowed to use sweets, but in very limited quantities, made with the addition of xylitol - chocolate, waffles, cookies.

From the diet of an overweight child, sour cream, mayonnaise, cream, fermented baked milk, baked milk, White bread, sugar, confectionery, condensed milk, sweets, jam, pasta, semolina, butter, ice cream, juices, carbonated sweet drinks.

The main component in the fight against obesity is regular physical activity: long walks in the fresh air, outdoor games, running, swimming, roller skating, cycling, skateboarding.

Obesity in children and adolescents is a serious problem that has not lost its relevance for many years. In most cases, overweight in a child occurs due to the fault of the parents. Improper nutrition and a passive lifestyle are the two main reasons that provoke a pathological condition.

It is important to take timely action to correct the situation. In children, the problem of obesity causes not only an aesthetic complex, but also pathologies of internal organs. Modern combined treatment will help bring the child's weight back to normal, but for a long time it will be necessary to observe certain preventive measures. Exists Great chance return to the previous state.

The most common causes of obesity in children are malnutrition and a sedentary lifestyle.

What is obesity and why does it occur in children and adolescents?

Obesity is a chronic pathology accompanied by a violation metabolic processes in the body, resulting in increased accumulation of adipose tissue. Excess body weight leads to disorders in the functioning of the gastrointestinal tract, heart, endocrine gland and other internal organs.

Main growth subcutaneous tissue occurs in the first year of life. By the age of five, these processes should be completely stabilized. Doctors identify several critical periods when the likelihood of obesity is highest:

• from 0 to 3 years;
• from 5 to 7 years;
• from 12 to 17 years old.

There are many factors that provoke a pathological condition, of which the most common is poor nutrition. Many parents do not see anything wrong with the fact that their child eats a lot of sweets, pastries, fast food and often drinks carbonated drinks.

Excessive consumption of the above products inevitably leads to the accumulation of extra pounds, as the body receives nutrients more than is required. Other causes of childhood obesity include:

• genetic factor. Scientists say that in families where one of the parents is obese, the risk of inheriting this pathology by the child is 40%. If both parents have the disease, then the probability increases to 80%.
• Hypodynamia - a sedentary lifestyle or its complete absence, long pastime at the computer / TV. Many children copy the behavior of parents who spend their leisure time incorrectly.
• Hormonal disruptions. Chronic diseases often provoke the development of obesity. This is especially true for pathologies of the glands. internal secretion(in particular, the thyroid gland), childhood hypothyroidism.
• Itsenko-Cushing syndrome (hyperinsulinism). It is characterized by high production of corticosteroid hormones that affect insulin levels. The content of glucose in the blood decreases, and appetite, on the contrary, increases. Children with this syndrome are overweight and short in stature.
• Body weight over 4 kg at birth.
• Pathologies that cause pituitary dysfunction (craniocerebral trauma, inflammatory processes / neoplasms of the brain, surgery) (we recommend reading:).
• Down Syndrome.
• Adiposo-genital dystrophy.
• Constant psycho-emotional stress - depression, problems in communicating with peers and parents, serious psychological trauma.

Symptoms and degrees of obesity

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The clinical picture of the pathology directly depends on the age of the child. As a rule, each age group is characterized features which gradually become more pronounced. Symptoms of obesity in children are shown in the table:

Adolescents who are obese develop psychological problems in addition to physiological ones. They are embarrassed by their appearance, many guys hear rude words from their peers in their address because of being overweight, so they consciously stop communicating with friends. Such children need not only special treatment, but also psychological help.

The disease has 4 degrees of severity. The classification is based on the height-weight indicators of the WHO norm. Degrees of obesity in accordance with deviations from the norm:

• Grade 1 - excess body weight is 15-20%. Visually, the child seems well-fed, parents ignore this condition, as they consider slight fullness a sign of excellent appetite.
• 2 degree - the deviation of the actual weight increases to 25-50%. There are initial manifestations of the disease. Pathologies of internal organs develop, light physical activity causes shortness of breath. The child develops depression.
• 3 degree - the percentage of overweight is 50-100%. The state of health worsens, unreasonable headaches and joint pain. The first symptoms of diabetes are observed (we recommend reading:). The child is in constant depression, refuses to communicate with peers.
• Grade 4 - the real weight is 2 times higher than the norm.

Table of weight and height norms for children under 17 years old

In addition to classification by degrees and types, obesity in children can be determined using the table. It presents WHO analytical data on the norms of growth and body weight of children from 1 year to 17 years. Please note that the figures for girls and boys are different. This is due to certain physiological characteristics.

Why is the disease dangerous?

Excess weight negatively affects all systems of internal organs. Late treatment of childhood obesity leads to serious consequences in the future.

Even if the pathology is completely eliminated or there is a positive trend in its course, complications can occur that significantly spoil the quality of life:

• diseases of the gastrointestinal tract (cholelithiasis, fences, cholecystitis);
• high blood pressure;
• high risk of developing type 2 diabetes;
• cardiovascular pathologies (atherosclerosis, ischemic disease, stroke, angina pectoris);
• sleep disturbance (apnea, snoring);
• infertility;
• weak immunity;
• frequent colds;
• neuritis;
• oncological formations;
• anomalies musculoskeletal system(change in gait/posture, flat feet, scoliosis, arthritis, osteoporosis);
• fatty depletion of the liver (cause of cirrhosis);
• psychological problems;
• menstrual irregularities in girls and men reproductive organs not fully developed
• social isolation.

Diagnosis of pathology

To identify childhood obesity, you should initially consult a pediatrician. The specialist conducts a survey regarding the child's lifestyle and dietary habits. After that, a series of examinations is assigned:

• anthropometry - measurement of body weight and height, waist circumference, hips, BMI;
• indicators of the thickness of the skin tissue in relation to the fat fold are recorded;
• to set the reason pathological condition consultations of narrowly specialized specialists are required (nutritionist, endocrinologist, neurologist, geneticist, psychologist, cardiologist, gynecologist, otolaryngologist);
• blood chemistry;
• hormone analysis;
• Magnetic resonance imaging;
• electroencephalography;
• rheoencephalography.

Complex treatment

What should I do if my child is obese? There are many effective ways to fix the problem. All medical methods must be used in a complex under the strict supervision of a pediatrician.

With the right approach, you can remove excess weight with conservative treatment. It includes:

• taking medications;
• physical activity and massage;
• adherence to a special diet;
• psychological help.

Diet

Diet is an integral part of the fight against childhood obesity. A dietitian is in charge of correcting the child's nutrition. Its main goal is to stop the growth of body fat and achieve the withdrawal of already formed ones. For children under three years old, this method of losing weight is contraindicated.

The nutrition of the child during treatment should be varied and balanced. Meals are consumed in small portions 6-7 times a day. It is desirable that the break between meals should not be more than 3 hours.

• bran bread - 100-160 g;
• lean dairy products(cottage cheese, kefir) - 200–250 g;
• lean meats and fish - 170-200 g;
• vegetable soups with a small addition of potatoes - 220 g;
• cereals on the water from barley, buckwheat and millet - 220 g;
• fresh vegetables and fruits are not limited in use;
• tea, freshly squeezed juices, compote.

This diet includes several plans daily menu. The proposed dishes fully provide the body with the necessary substances. One of the options for the daily menu, see the table:

To prevent the child from feeling hungry, it is allowed to give fruits and fresh vegetables between meals. What foods should be removed from the daily diet:

• semi-finished products;
• carbonated drinks;
• fried, fatty, spicy dishes;
• cocoa, coffee;
• bakery, wheat products (pasta is allowed to be consumed once a week);
• spices;
• grapes, bananas;
• semolina;
• sweets;
• potato.

Physical activity and massage

Treatment of the disease must necessarily include daily physical activity. Small children are encouraged to walk more often, it is advisable to replace strollers with walking. Try to play outdoor games with the kids, if possible, provide him with various sports attributes (Swedish wall, roller skates, bicycle, scooter, etc.)

At the age of 4–5 years, it is already possible to attend sports sections and a swimming pool. Small physical activities (running, skating, gymnastics, volleyball, wrestling, etc.) help to strengthen the protective functions of the body and have a positive effect on the process of losing weight.