By Eduardo Gonzales, MD How big a problem is childhood obesity in the Philippines. What diseases are overweight children prone to? —[email protected] Decades ago, when malnutrition was highly prevalent in the Philippines, the archetypical healthy child was an overweight one, so mothers enjoyed overfeeding their children. Little did they know that obesity, like malnutrition, is a serious medical condition. Currently, childhood obesity is already a greater public health problem than malnutrition in the Philippines. The 8th National Nutrition Survey showed that the prevalence of overweight among Filipino children zero to five years old has significantly risen from one percent in 1989 to five percent in 2013 while the prevalence of overweight Filipino children five to 10 years old, which was 5.8 percent in 2003, jumped to 9.1 percent in 2013. Additionally, the 2011 Global School-based Health Survey also indicated that about 13 percent of adolescents in the Philippines are overweight or obese. Hence, the current mantra is, “don’t overfeed your children.” HEALTH PROBLEMS OF AN OBESE CHILD An overweight child is prone to myriad health problems. Many of the chronic diseases of adults such as type 2 diabetes, hypertension, high blood levels of cholesterol, metabolic disease, and coronary artery disease start in childhood and one of the greatest contributors to the development of these diseases is obesity. Put simply, overweight and obese children are more likely to develop the chronic diseases that affect overweight adults at a younger age. An obese child also has a high risk for asthma and other respiratory diseases, liver disease, skin infections, sleep and eating disorders, and precocious puberty. In addition, those who carry their condition into adulthood are prone to gallbladder disease, sexual and reproductive problems, sleep apnea, osteoarthritis, varicose veins, and cancers notably of the breast, uterus, cervix, ovary, and gallbladder among women, and colon, rectum, prostate, pancreas, and stomach among men. Obesity in a child also causes social and emotional problems. Many obese children have low self-esteem; are often teased and bullied; are susceptible to depression; and, have a tendency to be maladjusted and become slow learners. WHAT CAUSES CHILDHOOD OBESITY? Childhood obesity is generally due to several factors that work in concert: 1) a high caloric, high fat diet—the sort one gets from fastfood, soft drinks, candies, ice creams, etc. 2) a sedentary lifestyle that is typified by long periods of watching television, playing computer games, and surfing the internet; 3) a family history of obesity; and, 4) psychological and social issues such as emotional stress for which overeating is sometimes used as a coping mechanism. NATURAL COURSE AND TREATMENT OF CHILDHOOD OBESITY Obesity, when left untreated, usually worsens. It is often carried into adulthood—studies show that children who are fat when they are between four and 11 years old are frequently fat as adults. But when treated, obesity can be corrected. For overweight children under age seven who have no other health concerns, the treatment goal may simply be weight maintenance. The child is allowed to gain height but not pounds until he/she gets into the healthy range for his age group. For an overweight over seven years old, however, the goal may have to include weight reduction. The safest and most effective way to reduce obese children is by combining diet and exercise. Remember, however, that children can’t change their physical activity levels and eating habits by themselves. They need the support and encouragement of their family. Parents need to be positive role models—they should eat correctly and not be overweight, too. Sometimes, drugs (i.e., appetite suppressants) can complement diet and exercise in reducing an obese child’s weight. But because of its adverse effects, the use of appetite suppressants should be under the supervision of a physician or a trained professional and limited to, at most, three to four months.   Email inquiries on health matters to: [email protected]