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Obesity, Whats The Big Deal Part 4

In this issue, I am going to focus more on some of the consequences of obesity, especially as it relates to children. Although this is focusing on children, think of how it relates to you. Also, if you have kids, what are you teaching your kids about health?

This growing problem is getting so prevalent; there are even articles which refer to the "obesogenic" environment of schools. What they are saying is that society has come to accept "fatness" in its populace and even in the kids. So much so in fact, that they have stopped building gymnasiums in some schools. Add to this the horrendous quality of some cafeteria foods and/or the vending machines dispensing nothing of quality.

There are movements abreast around the world that are aiming to rid the schools of the pestilence of junk food dispensing machines. Hooray for that! I recently read in the Ecologist that some people are waging a war against a major soft drink company with their own form of embargo. This company is not the only company that should be having an economic war waged against it. In general, we need to move away from the highly processed foods and move towards whole food consumption.

As has been mentioned in earlier articles, obesity contributes to a variety of conditions such as heart problems, high blood pressure, stroke, diabetes, and more. One of these problems, high blood pressure (HBP), is now becoming a growing problem in children. HBP has also been associated with an increased risk of dementia. Studies have demonstrated that a diet rich in fruits and vegetables as well as possibly dairy may be able to help with childhood HBP levels.

Overweight among young people has increased dramatically. Between 1980 and 1994, children and adolescents considered to be overweight increased by 100% in the United States. About 15% of 6 - 19 -year-olds are currently overweight and there are even greater rates of overweight among minorities or those who are economically disadvantaged. Overweight youth are more likely to be overweight as adults, and are more likely to have medical risks associated with cardiovascular disease than other children and adolescents.

Consequences of Overweight in Children and Adolescents

Health consequences related to overweight can begin in childhood or adolescence; overweight children and adolescents are at increased risk for various chronic diseases in later life.

The psychosocial consequences of overweight are also significant. This problem has been linked to social discrimination, a negative self-image in adolescence that often persists into adulthood, parental neglect, and behavioral and learning problems.

Common Medical Consequences of Overweight

? Hyperlipidemia: A group of disorders characterized by increased bad fats and decreased good fats in the blood.

? Glucose intolerance: A precursor of diabetes.

? Hepatic steatosis: The fatty degeneration of the liver. High concentrations of liver enzymes are associated with this and have been found in overweight youths. Weight reduction will help to normalize hepatic enzymes. Hyperinsulinemia also may play a role in hepatic steatosis.

? Cholelithiasis: The presence of stones in the gallbladder.

? Early maturation: Characterized by adolescents with a skeletal age more than 3 months in advance of chronological age, and is associated with increased fatness in adulthood

Less Common Medical Consequences of Overweight in Children

? Hypertension: Persistently elevated blood pressure occurs with low frequency in children. However, elevated blood pressure occurs approximately 9 times more frequently among children who are overweight compared to other children.

Acute Complications of Overweight

Acute complications of overweight are those that require immediate medical attention. Patients should be referred to a center that specializes in pediatric overweight where possible.

? Sleep apnea is the cessation of breathing lasting at least 10 seconds during sleep, characterized by loud snoring and labored breathing.

? Pseudotumor cerebri is characterized by increased pressure in the skull that causes headaches. It is a rare disorder.

? Obesity hypoventilation syndrome, also known as Pickwickian syndrome, may be a cause of sleep apnea, but this relationship remains unclear. Aggressive therapy is warranted for children with obesity hypoventilation syndrome.

? A variety of orthopaedic complications affecting the feet, legs, and hips can occur.

Management of Overweight in Children and Adolescents

Strategies used in a management plan for overweight are based on information obtained from the assessment. Weight loss is recommended only if complications such as hyperlipidemia or hypertension are identified or for children 7 years or older with a BMI-for-age at or above the 95th percentile. Otherwise, weight maintenance is recommended.

Individualized recommendations.

Each family has its own set of supports and stresses. Because success with weight management can be difficult to achieve, recommendations for change must consider the family's readiness for change, family support, financial concerns, and neighborhood characteristics (including access to play areas and grocery stores). Unless the situation is understood fully, recommendations for change may not be targeted appropriately.

Treatment should begin early, involve the family, and institute permanent changes in a stepwise manner. Parenting skills are the foundation for successful intervention, which includes a gradual targeted increase in physical activity and targeted reductions in high-fat and high-calorie foods.

So in the end, we need to focus not only on ourselves but the environments that are promoting this epidemic. As a colleague mentioned to me, to truly heal, the whole community must be involved. If we all sit back and wait for someone else to do something, nothing will ever be done.

Yours in Health,

Dr. Marshal Montgomery @

References1. The Bad News About Prevalence, the Good News About Treatments -- But Pay Attention to the Details, Linda Brookes, MSc ,Medscape Cardiology. 2005; 9 (1): 2005 Medscape. 2. Overweight Children and Adolescents: Recommendations for Screening, Assessment and Management, Authors: Barbara Polhamus, PhD, MPH, RD; Diane Thompson, MPH, RD; Sandra L. Benton-Davis, BS; Christopher M. Reinold, MPH, RD, LD; Comm. Laurence M. Grummer-Strawn, PhD; William Dietz, MD, PhD3. Prevention of Overweight and Obesity: Focus on Children and Adolescents, Patricia Markham Risica, DrPH, RD 4. Obesity, Jonathan Q. Purnell, M.D. 5.American College of Physicians Issues Guidelines for Obesity Management CME News Author: Laurie Barclay, MDCME Author: Charles Vega, MD, FAAFPAll were sourced from

Disclaimer: As always, check with your health care provider to see if this information applies to you. Due diligence is your responsibility. This information is meant to supplement your knowledge, not to replace your own decision making process or take the place of your health care provider.

This is a commercial newsletter provided free by For weight loss and other health care products go to For a quick BMI calculation go to

This newsletter may be distributed in its entirety without alteration. If you wish to use it in your publication, a copy of your publication would be appreciated. Please send it to

Dr. M. Montgomery is the creator of http://www.healthyunderstanding.comand is a practicing Chiropractor in Saskatoon, Saskatchewan - 371 Kenderdine Rd, Saskatoon, SK, S7N 3S5.


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