Mumbai, are you sure your child’s ‘chubby cheeks’ are not because of obesity? Get fitter
Mumbai city news:fitter mumbai Updated: Jul 21, 2017 09:31 IST
Eight years ago, Ketan Parekh, then 16, had a surgery to bring his weight down from 162kg to 72kg.
Ketan had no choice. He had just lost his father, who was obese, to a heart attack and Ketan knew the surgery was necessary, not cosmetic.
But it helped him become more confident. “As an overweight child, sports day in school was traumatic. I couldn’t run or play basketball and was always the last pick for any team,” Ketan says.
Now a content writer, Ketan says while his life changed after surgery, he regrets needing it in the first place. “While I have reached a balance now, those lost adolescent years has created a void.”
Like Ketan, there are a million other obese adolescents in urban India today. At this rate, the country will have more than 17 million obese children by 2025, according to the Paediatric Obesity International Journal.
It’s a slippery slope, say experts, but little attention is paid to it.
In urban India’s small, busy families, what children eat, how much they sleep and whether or not they exercise are seldom monitored.
“In the past decade or two, urban India has also had to deal with mall-nutrition, apart from malnutrition,” said Dr Vijay Yewale, the head of the Institute of Child Health, Apollo Hospital, Navi Mumbai.
“20-25% teenagers in our outpatient wards suffer from obesity. But most parents are proud of what they call “healthy” children, not realising that the child is hosting possible physiological and psychological complications for the rest of his life,” said Dr Yewle.
These complications include high BP and cholesterol, heart ailments and diabetes. Experts call this Adult Onset of Childhood Disorders (AOCD)—medical complications that are masked till adulthood, but only on the surface.
As they stay hidden in children, families tend to ignore the causes. “The onset of non-alcoholic fatty liver, high blood pressure, high cholesterol levels and degenerating heart tissues are serious co-morbid conditions, which force adolescents into a life-threatening adulthood, said Dr Fazal Nabi, consultant paediatrician and intensivist at Jaslok Hospital and Research Centre. “Conditions like diabetes, hypertension or cardiac complications do not surface in a majority of children. So, families tend to ignore damage and indirectly, encourage children to continue leading a harmful lifestyle. It’s only when the child steps into adulthood does obesity take a toll,” said Dr Nabi.
Pressure and obesity
In big cities like Mumbai, children have it worse because of the pressure to perform. “Screen time has increased, academic pressure is extreme and parents find it easy to offer ready-to-eat, easy-to-cook products instead of focusing on nutrition because of their own professional commitments,” Dr Yewle said. The unhealthy lifestyle is being forced on children, Dr Yewle said, and it sets them up for a lifetime of illnesses. “Every parent wants their child to excel, so the child attends numerous classes too,” Dr Yewle said.
Doctors warned that obesity is irreversible when ignored. “When children put on weight, their fat cells first multiply in numbers and then grow in size. Weight-loss only reduces the size of the cells, not the count. The possibility that an obese child might start putting on weight after weight loss is high,” said bariatric surgeon Dr Sanjay Borude.
He said along with cardiac and respiratory problems, adolescents may also develop infertility. “Obesity lowers testosterone levels and lowers the sperm count,” Dr Borude added.
Doctors said parents and schools need to adopt a holistic approach to tackle adolescent obesity. And, the change must start at home. Studies prove obese parents have a greater chance of having obese children. “You cannot ask your child to follow a diet when you are cooking fried food and ordering pizzas at home. The whole family needs to adopt a single diet,” Dr Yewle said.
Experts added that while schools have started reinventing their canteens, many still sell fizzy drinks and junk food.
“Obesity isn’t a singular disease. The signs start from childhood. So, it’s important for the society that revolves around the child to pick up the signs and act on them,” said Dr Borude.
Stop looking at chubby cheeks and bellies with pride, adolescent obesity is a disease: Dr Jayashree Todkar
Contrary to popular belief, obesity is a disease of the body, more than it is of the mind, believes Dr Jayashree Todkar, Asia’s first woman bariatric surgeon and convener of Fight Obesity Task Force of Maharashtra.
In conversation with HT, Dr Todkar stresses on why parents, teachers and the society needs to stop looking at children with ‘chubby cheeks and a fat belly,’ with pride and seek medical help for adolescent obese patients.
How prevalent is adolescent obesity in India?
By 2025, India will stand second in the world, with 17.5 million obese children. International health organisations have approved those figures. When parents of a 12-year-old boy tell me he is stressed about his weight, charting his own diet to try and fight obesity, we know the condition is pretty bad. I have been treating patients as young as four. India is a top ranking country when it comes to heart attacks below 40 years and the cause, majorly, is adolescent obesity.
If medical science recognises obesity as a disease, what will be the benefits?
India is considered the diabetes capital of the world and obesity is a harbinger of diabetes, metabolic disorders and BP. More importantly, the heart of an obese child gets tired as it functions far beyond its capacity. Obesity also affects the pancreas and, thus, the insulin system of the body which fails to fight diabetes.
Other ignored medical consequences are hormonal changes, which lead to PCOD in women and Gynecomastia and infertility in men.
We can’t forget that obese adolescents are still growing, and their skeletal development is hampered by obesity. They will have weaker bones, disrupted joints and the overall development of the body is weak.
Even now, childhood obesity is considered a lifestyle disorder. Is that true?
It is the biggest myth. If it was only caused by lifestyle, good psychiatrists could successfully treat obesity. But the fact is, the body has failed to control calorie consumption and this is threatening the child’s life. International guidelines suggest if a person touches a BMI of 30, he needs medical advice and if it crosses 40, a bariatric surgery is a must, regardless of age or gender.
Doesn’t such a grave issue demand greater changes in health policies and treatment protocols?
Of course. Maharashtra was the first state to launch a fight obesity task force and we have already demanded a number of changes in the system. We have approached the state, central health officials and PMO, to declare obesity as a disease.
We have asked the education department to add obesity management in the curriculum so children, parents and schools understand the importance of prevention. Sadly, we are getting mixed reactions. But we hope something positive comes of it.
What will it take for a course correction?
Awareness, awareness and awareness. We have to convert this morbidity into a productive generation and that demands participation from parents, schools, society and the child.
We need to ban high-calorie food in and around children, be it in school, around residential areas or playgrounds. Maybe, we could start colour coding, like we have for vegetarian and non-vegetarian food. Schools have to understand physical training classes cannot be changed into a math or science class to complete portions.
We can evaluate children based on their physical exercise and give them marks for it.
If we don’t want a sick country tomorrow, the will of every individual around the child needs to be focused on making sure the child eats healthily, sleeps on time and lives a healthy life.
First Published: Jul 21, 2017 09:30 IST