Facts on File Encyclopedia of Health and Medicine

LIPIDEMIA, OSTEOARTHRITIS, and the beginnings of
ATHEROSCLEROSISin an increasing number of chil-
dren, especially adolescents, who have obesity.
These conditions may require treatment with
medications and other interventions, the long-
term health consequences of which remain
unknown. Emotional, social, and self-esteem
issues also are common among children who have
obesity. The stigma of being “fat” is a difficult chal-
lenge for children who are forming their sense of
self and are especially sensitive to peer acceptance
and rejection. Obesity may result in a young per-
son feeling ostracized in school and having diffi-
culty forming friendships.

Health Implications of

Childhood Obesity in Adulthood

Increasing evidence points to long-term health
consequences for people who enter adulthood with
obesity. Childhood obesity correlates with
increased risk for earlier onset in adulthood of
insulin resistance and type 2 diabetes, osteoarthri-
tis, hypertension, hyperlipidemia, atherosclerosis,
CORONARY ARTERY DISEASE(CAD),STROKE, and certain
cancers. An increased risk for these conditions may
exist even among people who had childhood obe-
sity yet achieve relatively healthy weight as adults.
These health conditions account for significant
physical disability and further complications result-
ing from co-morbidities (the cascading conse-
quences of co-existing, multiple health conditions).

Treatment Approaches and Outlook

Prevention of obesity is the first line of treatment.
Routine childhood health examinations monitor a
child’s growth and development. Intervention for
children who have BMI-for-age values near or at
the 85th percentile can head off obesity. Lifestyle
modifications—nutritious eating habits and
increased physical exercise—presented in a posi-
tive context represent the most effective approach

for long-term weight management. However, obe-

sity is a complex condition that requires individu-

alized assessment and a treatment approach that

accommodates the various factors relevant for a

child. Counseling and SUPPORT GROUPSmay help

address DEPRESSION, emotional issues, and family

dynamics.

Positive reinforcement must frame

treatment approaches for OBESITY in

children. Punitive approaches such as

withholding food, criticizing the child,

and forcing exercise are inappropriate

and can have serious emotional and

psychologic consequences for the child.

Established obesity is a more difficult challenge

for treatment, though lifestyle modifications

remain the mainstay of therapeutic approaches.

Nutrition education and BEHAVIOR MODIFICATION

THERAPYare helpful for older children, especially

adolescents. Many health experts recommend

involving the entire family in the effort to shift to

healthful lifestyle habits. Older adolescents who

struggle with obesity may benefit from medica-

tions intended to suppress APPETITE. Many eating

disorder treatment programs offer comprehensive

treatment that targets the child’s individual cir-

cumstances and needs. BARIATRIC SURGERY, a treat-

ment option for adults who are otherwise unable

to treat their obesity, is not usually an option for

young people.

There is every reason to believe the health out-

look for children who achieve healthy weight and

enter adulthood at healthy weight is excellent.

Health experts are hopeful that lifestyle modifica-

tions implemented early in life will carry through

adulthood, helping reduce adult obesity as well.

See also DIET AND HEALTH; EXERCISE AND HEALTH;

OBESITY AND HEALTH; QUALITY OF LIFE; WEIGHT LOSS AND

WEIGHT MANAGEMENT.

292 Lifestyle Variables: Smoking and Obesity