Child With Obesity - Complications,Weight Management Programs Complications

4th Pediatric Infectious Diseases Conference

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Obesity Causes

Obesity Management

Dr Ira Shah
M.D, DCH(Gold Medalist), FCPS, DNB

What are the complication of obesity ?
Obesity can lead to many complications. Also, history of cardiovascular disease, hypertension or dyslipidemias in first blood relatives increases the risk of complications in the child. The following complications are seen :-

Orthopedic complications :- Slipped capital femoral epiphysis: It presents as hip or knee pain and a limited range of movement at the hip joint.

Blount's disease (tibia vara) - It presents as bowing of the leg.

Pseudotumor cerebri :- The child may complain of severe headaches. The optic discs on ophthalmoscopy may show blurred margins. The child is at risk of visual defect or vision loss.

Sleep apnea/ Hypoventilation syndrome :- The child may suffer from daytime somnolence or breathing difficulty during sleep. They are potentially fatal disorders that require rapid weight loss and may require continuous positive airway pressure until weight loss decreases intra-abdominal pressure, improves chest wall compliance and adequate ventilation is restored.

Gall bladder disease :- The child may have abnormal pain or tenderness. Ultrasonography is useful to detect the condition.

Endocrine disorders :-

Polycystic ovary disease- Obese females may present with oligomenorrhoea or amenorrhoea and hirsutism. It is detected by ultrasonography and LH : FSH ratio.

Non insulin dependent diabetes mellitus (NIDDM) - The child may have coarse hyperpigmented areas in the neck folds or axilla along with polyuria, polyphagia and polydipsia, both fasting glucose and fasting insulin levels should be done to rule out insulin resistance.

Hypertension, dyslipidemias :- A lipoprotein test should be done in every child to detect dyslipidemias. LDL level > 130 mg% but less than 180 mg% is suggestive of obesity and requires diet and exercise modification. LDL level > 180 mg% shall require medical treatment in addition to diet modification.

These children are at a later risk of early onset adult coronary heart disease,myocardial infarction and diabetes.

What are the complications that can occur on these weight-management programs ?
If weight loss is very rapid, then there are chances of developing gall bladder disease and malnutrition. Also, linear growth may start slowing. The effect of rapid weight loss (>0.5 kg/month) in children younger than 7 years is unknown.

Emotional problems may arise in the child. He may develop eating disorders and develop low self esteem.

Next : Obesity Management

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