Yeap Jo Wearn
Long term effects of childhood obesity
The World Health Organization (WHO) reported that globally, obesity has tripled from 1975 to 2016.
Here in Malaysia, we already have the unflattering title of the most obese nation in South East Asia. According to our Ministry of Health’s National Health & Morbidity Survey in 2019, an estimated 50 percent of our adult population is either overweight or obese, rising from 45 percent in 2011. Children are not spared from this trend, with the national obesity prevalence rate in 2019 of 5.6 percent among children under the age of five, and 14.8 percent in those aged five to seventeen years; a significant increase from 6.1 percent reported in 2011.
An overweight child is defined as weight of between 85th to 95th percentile for age on the growth chart, and obesity refers to a child above 95th percentile for age. While some degree of genetics plays a part in developing childhood obesity, it accounts for less than 5 percent of total cases. Uncontrolled eating and sedentary inactive lifestyle remain the main factors causing childhood obesity.
Most obese children carry on into becoming obese adults and develop the many negative impacts of obesity on their physical and psychological health.
The consequences of childhood obesity are that the chronic illnesses that we usually associate with older adults are now seen even during childhood.
Among the conditions brought about by childhood obesity include:
There is gradually an increasing amount of children as young as 12 years old who are being diagnosed with type 2 diabetes.
The risk of developing diabetes quadruples among obese children. Diabetes mellitus (high blood sugar) is a long-term health condition which leads to serious complications in many organs of the body. Some of the complications include heart attack, stroke, visual impairment (retinopathy), kidney injury (nephropathy), nerve injury (neuropathy), and delay in wound healing.
Some of the symptoms of diabetes include excessive thirst (polydipsia), excessive urination amount and frequency (polyuria), excessive hunger (polyphagia), and excessive night time urination (nocturia). It is common to see dark spots around the neck and skin fold areas (acanthosis nigricans) which is a sign of insulin resistance.
High blood pressure, the “silent killer”, has no signs or symptoms. Over time, it leads to similar multi-organ complications as diabetes. It is usually detected by chance, such as during hospital admission for other illnesses, or only when complications of hypertension have occurred.
The constellation of high blood pressure, insulin resistance, and high cholesterol make up what is known as the metabolic syndrome. Elevated cholesterol levels are a common finding in childhood obesity. Left unchecked, it further exacerbates the chances of developing cardiovascular diseases.
High amount of fat in the liver is called fatty liver disease. In the long run, fatty liver disease progresses into liver inflammation, liver cell damage, and finally irreversible liver failure.
Cholesterol is a component of bile and high concentration of cholesterol predisposes to stone formation in the gallbladder.
Obesity is a crucial risk factor for obstructive sleep apnoea. A person with sleep apnoea frequently snores loudly during sleep. They develop sudden and multiple periods of not breathing while sleeping followed by a characteristic gasp for air. This impairs their sleep quality and results in excessive daytime sleepiness and poor concentration. The child’s school performance will noticeably deteriorate resulting from their poorer memory and cognitive skills. They are also constantly irritable and may find it difficult to socialise with others.
Poor asthma control
Achieving good asthma control becomes more challenging in children with obesity. Poorly controlled asthma has significant impact to quality of life. Uncontrolled asthma predisposes the child to develop frequent and possibly severe asthma attacks requiring hospital admissions and even treatment in the intensive care unit.
Raised brain internal pressure
A condition named idiopathic intracranial hypertension occurs where there is raised pressure in the brain. Half of the children who develop this condition are found to be obese. The child complains of persistent worsening headache, with some having associated visual impairment.
Children with obesity are more likely to face teasing and bullying which in turn impacts their self esteem and confidence. They are at increased risk for developing depression and anxiety. Some respond to these negative social experiences by emotional eating, worsening the obesity-depression cycle.
Muscle and bone complications
It is common to find children with obesity complaining of muscle aches and pains from the stress upon the muscles, joints, and bones from excess weight. Many develop bone deformities such as bowing of their leg bones and dislocated hip bone.