In the last three decades, the global prevalence of childhood obesity has risen consistently – thus, becoming a major public health concern. Obesity is defined as a multifactorial disorder that consists of a phenotype of several pathologies. Güngör (2014) evaluates the prevalence of overweight and obesity within the pediatric age group and the clinically relevant issues surrounding the topic. Clinical and laboratory assessments and treatment problems are discussed.
An obese person is described as one that has excess body fat or adiposity. Thus, obesity is defined according to the body mass index (BMI) – whereby the BMI is measured by dividing the body weight in kilograms by meters squared (kg/m2) (Güngör, 2014). The increasing prevalence of childhood obesity across the world has contributed to the development of obesity-related comorbid illness entities at an early age. Childhood obesity has adverse effects on the organ system and often leads to serious health complications such as; hypertension, dyslipidemia, insulin resistance, dysglycemia, fatty liver disease, and psychosocial issues (Güngör, 2014). Moreover, it is a significant contributor to the increasing rates of healthcare expenditures.
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As a complex and multifactorial disease obesity is influenced by the genetic and non-genetic factors. Pediatric obesity is primarily caused by lack of physical activity, excessive food consumption that leads to excess energy intake or a combination of these two factors. In addition to this, the genetic and social factors such as; socio-economic status, physical surrounding, ethnicity and media and marketing influence (Cantarero et al., 2016). Nonetheless, obesity appears to be as a result of the interaction between the environment and the body's disposition to obesity, based on the genetics and epigenetic contexts.
The ability of the body to inherit body weight plays a significant role in the prevalence of pediatric obesity. Genetic variations contribute to defining the inter-individual variances in susceptibility or opposition to the obesogenic surrounding. For instance, the ability to control appetite and energy homeostasis is dependent on a large number of hormones – which are mainly secreted by the gastrointestinal tract. The gastrointestinal tract is the largest endocrine organ in the body that produces hormones that have essential sensing and signaling abilities in regulating energy homeostasis.
It is, therefore, vital to prevent pediatric obesity as well as identify overweight and obese children when they are still young and introduce treatment. This will assist them in attaining and maintaining healthy body weight. Currently, the pharmacotherapy treatment options for pediatric obesity are minimal (Güngör, 2014). As a result, it is important to develop a comprehensive treatment approach that primarily focuses on nutrition, physical activity, and behavioral setting. Therefore, the role of the physician in the treatment of pediatric obesity should go beyond the clinical setting and into the community to educate and inform the community on ways to prevent obesity as well as identify early treatment options.
Clinical evaluations of obese children should involve a comprehensive physical assessment and medical history. The evaluations should be used as an approach to identify treatable causes and comorbidities. Thus, it is important to involve different screening tests for a generalized metabolic assessment for the patients in order to have an in-depth evaluation. As a result, this will allow the clinician to identify specific traits that are exhibited by the child being evaluated. However, the evaluation assessment should not be solely confined in the assessment of dietary patterns and physical activity. The clinician should also examine how the environmental and social factors cause obesity and the barriers that result in self-efficacy (Skinner and Skelton, 2016). Thus, the clinician is expected to recognize how the characteristics of pediatric obesity interact with psychological complications and involve the patient and caregiver in addressing the issues identified.
Conclusion
Pediatric care has the responsibility of assessing children for obesity to minimize the risk and improve early identification. This can begin from the primary care setting by using the BMI calculation tool and identifying the appropriate reference during the routine clinical assessment among children aged two years and above (Cantarero et al., 2016). Moreover, having a sequential follow-up for the trend is essential as it provides the clinician with relevant and timely information to assess the overweight or obesity trend – which may be used in implementing primary and secondary treatment prevention strategies. For instance, electronic health record programming may be an instrumental tool in calculating, plotting and tracking the BMI of a patient, thus enhancing clinical efficacy.
References
Cantarero, A., Myers, O., Scharmen, T., Kinyua, P., & Jimenez, E. Y. (2016). Trends in Early Childhood Obesity in a Large Urban School District in the Southwestern United States, 2007-2014. Preventing chronic disease , 13 , E74. doi:10.5888/pcd13.150594
Güngör N. K. (2014). Overweight and obesity in children and adolescents. Journal of clinical research in pediatric endocrinology , 6 (3), 129-43. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4293641/
Skinner, A. C., and Skelton, J. A. (2014). Prevalence and trends in obesity and severe obesity among children in the United States, 1999–2012. JAMA Pediatr;168 (6):561–6. 10.1001/jamapediatrics.2014.21
