Childhood obesity

the threat to health of the future is here

1. BAYERO UNIVERSITY KANO SEMINAR PRESENTATION ON CHILDHOOD OBESITY : THREAT TO HEALTH BY SAMBO,NICKY MARIAH MSC NURSING, MED-SURGE SPS/19/MNS/00012 COURSE: NUR 8332 DATE 30 TH JULY 2021

2. OUTLINE Introduction Definition Epidemiology Causes of obesity The vicious circle of obesity Relationship between poverty and obesity Relationship between obesity and education Obesity between settlements in Nigeria Health implications Complications

3. OUTLINE cont...; Prevention/control Medical and surgical management Myths and facts about childhood obesity

4. INTRODUCTION Pediatric obesity is currently one of the most important global public health challenges. In fact, the World Health Organization (WHO) describes pediatric obesity as "one of the most serious public health challenges of the 21  st  century."

5. INTRODUCTION CONT;    The prevalence of overweight and obesity in pediatrics has supposedly increased alarmingly, not only in economically advanced countries, but also in developing countries of Africa, Asia, Oceania and South America. A 2012 estimate of the WHO reports that globally 40 million children younger than 5 years are overweight

6. DEFINITION Overweight and obesity are defined as abnormal or excessive fat accumulation that may impair health. Body mass index (BMI) is the index of weight-for-height that is commonly made used of to classify overweight and obesity in adults. BMI It is defined as a person's weight in kilograms divided by the square of his height in meters (kg/m 2 ).

7. DEFINITION CONT.... For adults, WHO defines overweight and obesity as follows: Overweight is a BMI greater than or equal to 25; and Obesity is a BMI greater than or equal to 30.

8. DEFINITION CONT… For children, age needs to be considered when defining overweight and obesity. Children under 5 years of age Overweight is weight-for-height greater than 2 standard deviations above WHO Child Growth Standards median; and Obesity is weight-for-height greater than 3 standard deviations above the WHO Child Growth Standards median.

9. DEFINITION CONT… Children aged between 5–19 years Overweight is BMI-for-age greater than 1 standard deviation above the WHO Growth Reference median; and Obesity is greater than 2 standard deviations above the WHO Growth Reference median

10. Determining BMI Percentiles for Children and Teens (Age 2-20) Weight Status Category Underweight Healthy weight Overweight Obese Less than the 5th percentile 5th percentile to less than the 85th percentile 85th to less than the 95th percentile Equal to or greater than the 95th percentile Percentile Range

11. EPIDEMIOLOGY OF CHILDHOOD OBESITY In 2019, an estimated 38.2 million children under the age of 5 years were overweight or obese. Once considered a high-income country problem, now on the rise in low- and middle-income countries, particularly in urban settings. In Africa, the number of overweight children under 5 has increased by nearly 24% percent since 2000.

12. EPIDEMIOLOGY cont… Almost half of the under 5 who were overweight or obese in 2019 lived in Asia. Over 340 million children and adolescents aged 5-19 were overweight or obese in 2016. While just under 1% of children and adolescents aged 5-19 were obese in 1975, more 124 million children and adolescents (6% of girls and 8% of boys) were obese in 2016.

13. CAUSES OF OBESITY Behavioral Factors   Eating bigger portions, eating foods that are calorie-rich but nutrient poor Spending lots of time in front of the television or computer Spending too little time on physical activities

14. Environmental Factors   Easy access to high-calorie junk foods Few opportunities for physical activity Lack of parks and playgrounds in some communities

15. Genetic Factors  A child is at increased risk for obesity when at least one parent is obese.

16. Certain Medications   steroids, some antidepressants, and others

17. Medical Conditions:  Genetic syndromes like Prader-Willi , and hormonal derangement like  hypothyroidism   can cause obesity

18. Socio-cultural Factors Our society tends to use food as a reward, as a means to control others, and as part of socializing

19. Family Factors The types of food available and the food preferences of family family mealtimes family habits, whether they are sedentary or physically active having an overweight mother and living in a single parent household

20. Psychological factors Depression and anxiety Self-esteem Body dissatisfaction Eating disorder

21. POVERTY AND OBESITY Buy cheaper, less healthy food Poor being less educated Families choose high-fat foods dense with energy The fresh vegetables and fruits and lean meats and fish might be more expensive and don’t last long

22. POVERTY AND OBESITY cont… Those adult with low wages had increased BMI as well as increased chance of being obese concluded Kim & Leigh, (2010).” In another study by singh in 2007, children from lower income households had more than two times higher odds of being obese than children from higher income households

23. Relationship Between Childhood Obesity And Obesity In Adults

24. Relationship Between Childhood Obesity And Educational According to a study conducted by Marion Devaux in 2011 he following were her findings Obese children has low self-esteem and poor social connection. They are more prone to being bullied by schoolmates. Poor academic performance is higher among them. Affect academic performance and education attainment later on in life.

25. Relationship between obesity and educational performance

26. OBESITY IN NIGERIAN CITIES AND RURAL AREAS Obes Metab 1983-2013

27. COMPLICATIONS OF CHILDHOOD OBESITY

28. OTHER COMPLICATIONS Economic Consequences : $14.1 billion,29 plus inpatient costs of $237.6 million.3 in USA only Academic consequences Socio‑emotional consequences

29. CONTROL OF OBESITY ( 192KG > 87KG)

30. Exercise lead by example

31. OTHER PREVENTIVE MEASURES Choose nonfood rewards Have healthy snacks available.  Reduced sedentary activity Be sure your child gets enough sleep. Keep the fridge and pantry stocked with healthy foods and drinks   Encourage children to eat only when hungry. Drink Water not carbonated drinks

32. Weight Loss Medications in the Treatment of Pediatric Obesity Sibutramine , an appetite suppressant, is a nonselective reuptake inhibitor. cause vasoconstriction Orlistat is a reversible lipase inhibitor. It binds lipase in the lumen of the stomach and intestine, making it unavailable to hydrolyze dietary fat (triglycerides) and cholesterol to free fatty acids and glycerol. Intact triglycerides and cholesterol cannot be absorbed; they pass through the intestine and are excreted in the feces.

33. SURGICAL MANAGEMENT Bariatric surgeries Bariatric weight loss procedures can be divided into 3 main categories, that is, malabsorptive , restrictive, and combination

34. TYPES OF BARRIATRIC PROCEDURES

35. COMPLICATIONS OF THE PROCEDURES Early complications leaks, stenoses , bleeding, and venous thromboembolic events  Balloon complications reflux, nausea, and abdominal discomfort  Late complications band erosion, acute obstruction, ischemia, and megaesophagus or pseudoachalasia .

36. MYTH AND FACTS ABOUT CHILDHOOD OBESITY

37. SUMMARY Childhood obesity has reached epidemic levels in developed as well as in developing countries. Overweight and obesity in childhood are known to have significant impact on both physical and psychological health.

38. CONCLUSION The growing issue of childhood obesity can be slowed, if society focuses on the causes. A combined diet and physical activity intervention conducted in the community with a school component is more effective at preventing obesity. Parentsshould enforce a healthier lifestyle at home Focusing on these causes may, over time, decrease childhood obesity and lead to a healthier society as a whole.

39. For listening

40. REFERENCES Abdullah , A. et al. (2011), “The number of years lived with obesity and the risk of all-cause and cause-specific mortality”,  International Journal of Epidemiology , Vol. 40/4, pp. 985-996, http:// dx.doi.org/10.1093/ije/dyr018 Anderson, A. and D. Good (2017), “Increased body weight affects academic performance in university students”,  Preventive Medicine Reports , Vol. 5, pp. 220-223, http://dx.doi.org/10.1016/j.pmedr.2016.12.020

41. REFERENCES Bustillo , A. et al. (2016), “Relationship between Low School Performance and Obesity in Adolescents: An Article Review”,  World Journal of Nutrition and Health, Vol. 4, 2016, Pages 10-15 , Vol. 4/1, pp. 10-15, http://dx.doi.org/ 10.12691/JNH-4-1-3 OECD (2017),  Obesity Update 2017 , OECD, Paris, http://www.oecd.org/health/obesity-update.htm OECD (2017),  Obesity Update 2017 , OECD, Paris, http:// www.oecd.org/health/obesity-update.htm