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What Health Problems May Overweight or Obese Children Face?
Contents
What Is Obesity?
Obesity is the accumulation of fat in the body due to a person consuming more energy than they expend. Among patients who present to the hospital because of obesity or are found to have obesity during examination, 80-90% have obesity related to excessive eating, known as exogenous obesity.
There are several factors related to why a child develops obesity. The most important of these are those in early childhood.
Factors Associated with Obesity in Children
A- Nutrition-Related Factors
- Not receiving breast milk: The mother being unable to give breast milk to the baby, whether intentionally or unintentionally, or breastfeeding for less than three months; such as absence of the mother, medications used by the mother, maternal illness, or the child having a congenital metabolic disease requiring special nutrition.
- Formula: Starting formula feeding at an early age.
- Starting solid foods early: Starting before 6 months.
- Parental behaviors: Pressure to feed.
- Type of food: Giving energy-dense foods with no nutritional value.
- Low activity time.
- Insufficient sleep: Being awake after 9 p.m.
B- Factors Related to the Child’s Environment
- Smoking: Smoking during pregnancy increases fat accumulation.
- Antibiotics: They change the intestinal flora.
- Stress: Abuse, poor treatment by household members, and neglect.
How Does Obesity Affect the Body?
Obesity affects all systems in our body. As a result, dysfunction begins in these organs. The affected organs can be briefly summarized as follows:
1- Metabolic System
Children with obesity are at risk of increased fasting and postprandial insulin levels, insulin resistance, prediabetes (increased fasting glucose, impaired glucose tolerance), and Type 2 diabetes. Prediabetes and Type 2 diabetes vary according to the child’s age, degree of obesity, race, and ethnic background. When diabetes mellitus appears during puberty, glycemic control may deteriorate rapidly, making it easier for diabetes-related complications to develop, such as albumin excretion in the urine, abnormalities in blood lipids, and hypertension.
2- Cardiovascular System
In children with obesity, enlargement of the heart and impairment in heart functions have been detected on echocardiography. If the patient also has hypertension together with obesity, this risk increases further.
3- Endocrine System
In children with obesity, sexual maturation begins early. Bone age advances. Therefore, a child who is initially taller than peers may eventually become shorter than peers due to early closure of growth plates. In addition, growth hormone secretion is lower in children with obesity compared with healthy children, and this negatively affects height growth. Polycystic ovary syndrome is more common in girls with obesity. This condition may present not only with absence of menstruation, but also with increased body hair and menstrual irregularities such as excessive bleeding or menstrual intervals longer than three months.
4- Respiratory System
Sleep apnea, meaning pauses in breathing during sleep, is directly proportional to the degree of obesity. In other words, as obesity increases, the risk of sleep apnea increases significantly. If a child snores while sleeping, they should definitely be brought to the hospital. In patients with sleep apnea, because oxygen cannot pass sufficiently from the lungs into the blood, constant fatigue, daytime sleepiness, decline in school success, impairment in heart functions, and heart rhythm disorders may be seen.
The risk of asthma increases in patients with obesity. If the patient also has gastroesophageal reflux, this may further increase the risk.
5- Liver-Stomach-Intestinal System
Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease of childhood. Fatty liver is often seen as simple fat accumulation. However, over time, it may progress to cirrhosis, and even liver cancer may develop over the years.
Gallbladder inflammation and gallstones are frequently detected. In addition to gallstone inflammation, abnormalities in blood lipids may rarely lead to pancreatitis.
Gastroesophageal reflux is more commonly detected in adults, but it can also be seen in children. As a result of reflux, chest pain after meals may occur. In the long term, reflux may lead to anemia, inflammation of the esophagus, and pneumonia.
6- Kidneys
As a result of obesity, kidney functions may be impaired. Abnormalities in blood lipids and hypertension contribute negatively to this condition.
7- Musculoskeletal System
Decreased joint movement and pain in the back, feet, legs, and hip joints are frequently seen in children with obesity. Slipped capital femoral epiphysis is seen more often in adolescents with obesity compared with their healthy peers. Aseptic necrosis of the femoral head may be detected in preschool and school-age children between 4 and 8 years of age, while in infants under 2 years of age, a condition characterized by bowing of the legs called Blount disease, also known as tibia vara, may be seen. An increase in the frequency of bone fractures has been detected in children with obesity.
8- Skin Findings
Acanthosis nigricans, fungal infections, hidradenitis, striae, frequent abscesses, keratosis pilaris, and impaired venous return are frequently seen in children with obesity.
Acanthosis nigricans is a brown, velvety appearance especially seen in the armpits, neck, groin, under the breasts, over the finger joints, and on the elbows. It is frequently seen in patients with insulin resistance and diabetes. Rarely, it may also be detected in some cancer patients.
Fungal infections are commonly seen in the groin and under the breasts. Redness and cracks in the skin occur.
Hidradenitis is inflammation of the apocrine glands in the armpit, which give the human body its sweat odor. Striae occur as a result of the skin not being able to expand sufficiently in parallel with the rapid increase in subcutaneous fat tissue. They are initially pink and turn white over time.
9- Nervous System
If headache, nausea, vomiting, and pain behind the eyes are present, increased intracranial pressure syndrome should be considered.
10- Psychosocial Effects
Decreased self-confidence, anxiety, depression, and reduced quality of life are common in children with obesity. Children with obesity are especially exposed to discrimination and bullying by their peers. It has been found that girls with obesity may have lower income levels, higher poverty risk, and lower chances of marriage in adult life.
11- Increased Frequency of Cancer
Colon, rectum, liver, gallbladder, pancreas, kidney, stomach, esophageal, breast, uterine, cervical, and ovarian cancers have been found to be associated with obesity.
