World obesity day: Watch out! Do not pamper your child with that burger!

At the age of four, Jejuri boy Rakesh Sakhare (name changed) would stand out as an oddity amongst children of his age.

Weighing 33 kg, he would get breathless quickly and was unable to play, was pre-diabetic with uncontrollable hunger and hepatomegaly (inflammation of liver). His worried parents brought him to an obesity surgeon who refused to operate him keeping his age in mind.

That was two weeks ago. Diagnosed with a metabolic problem, the doctor put him on diet control, a ‘running’ schedule and metabolic correction medication which has brought his weight down by 2 kg. “The doctor said that he shouldn’t be operated as he is very young. He is undergoing treatment and has lost 2 kg in two weeks,” said Rakesh’s mother.

Sadly obesity surgeons say this isn’t an isolated case with a sizeable number of their patients in the under-16 years age group. Obesity surgeons say childhood obesity would soon reach ‘epidemic’ proportions if not checked.

“Nearly 30 per cent of children in India suffer from obesity. We evaluate the patients’ metabolism through tests and determine if the child needs a surgery. Primary obesity is detected in 95 per cent of cases where diet and exercise is advised to the patient. In very rare cases, there is a need of surgery,” said Dr Jayshree Todkar, bariatric surgeon, Ruby Hall Clinic and Poona Hospital, adding that she has seen over 4,000 cases of childhood obesity across the clinics where she consults in India.

Another of her patient is a 13-year-old girl from Mumbai who weighed 105 kg when she came to her failing all sort of diets, exercises regimes and started having mental health and ‘personal image’ issues due to her weight. She was advised to undergo bariatric surgery.  Post surgery, Sumaya (name changed) now has dropped nearly 35 kg and weighs 80 kg. “When operating on a patient as young as a 13-year-old, a lot of considerations need to be taken into account. A complete and thorough evaluation of the patient is necessary. Besides, family counselling as kitchen habits need to change drastically to accelerate post-surgical weight loss,” said Dr Todkar.

A 2011 report said that 70 per cent of urban youth in India are overweight and more recently, a 2013 study by the National Diabetes, Obesity and Cholesterol Foundation showed that children of overweight mothers were more likely to be overweight.
Pune-based bariatric surgeon Dr Srihari Dhorepatil claimed that the children from families that belong to high income groups are more likely to suffer from obesity.

“Nearly 50 per cent of children from high-income group families are obese and suffer from other heart and metabolism diseases. It is a critical situation as surgery is not advisable in most cases unless it is a life-threatening situation. The children should be counselled for lifestyle modification, behaviour modification, diet and exercise,” he said.

He said that poor lifestyle choices in early years lead to children developing lifestyle-related diseases like high-blood pressure, type-2 diabetes, heart disease and osteoporosis early. Food preferences are established early in life and eating patterns, established by the time children turn 11 years old, usually continue after they attain adulthood.

Practice starts at school

Encourage physical activity.
Adopting healthy eating behaviours in school and devote sufficient time in teaching healthy eating.
Sensitise students to risk of junk food.
Awareness about eating environment
Involve parents in school cafeteria management
Discourage procurement of snacks from outside vendor.
Schools must encourage cultivation of green leafy  vegetables and other seasonal vegetables and fruits on premises
Reasonable pricing of healthier options including fruits and vegetables can significantly help in increasing consumption

Figure this
30% of children in India suffer from obesity
70% of urban youth in India are overweight
50% of children from high-income group families are obese

About obesity
Obesity is one of the most stigmatising and least socially acceptable conditions in adolescence, leading to severe emotional disturbances and several problems can be nipped in the bud through proper eating and early lifestyle choices.

Healthy Meal
Fresh fruits and salads : bananas, oranges, pears, apples, cucumber, sprouts, tomatoes.
Wholegrain wraps, pizzas, sandwiches with high fibre breads
Substitute sweetened sodas with healthier drinks like unsweetened fruit juices, buttermilk, lemon juice, low-fat milk, bottled water, or sugar-free sodas
Roasted whole grain namkeens, grains, popcorns etc.