Childhood obesity: A public health problem

Weight gain of a child is celebrated in our country by many parent-at least in the beginning of a child's life. Culturally, we love food; it provides us with a sense of warmth and well-being. But as a parent, many of us don't see the negative impacts of weight gain. If a child crosses a certain weight range, they are at risk of being overweight and eventually, may suffer from obesity. 

We conducted a study in two English Medium schools in Dhanmondi with 169 students of class VI to class X in January 2016. It appears that the prevalent rate of overweight/obese students is around 19 percent, which means that 19 out of 100 students were found to be either overweight or obese. This is an increasing concern on the health and well-being of the child. Increased prevalence of childhood obesity may have adverse disturbing and unpleasant implications in the adult life of the child. 

The American Heart Association noted that if you are severely overweight or obese at 16, there's an 80 percent chance that you will be obese as an adult. With obesity comes a list of life-threatening ailments: hypertension, Type 2 diabetes, heart disease, cancer, respiratory problems, bone conditions and several other problems. Health problems related to obesity are not only physical but psychological and social as well. Children who are obese can later on have a negative body-image, which leads to lower self-esteem. They tend to feel depressed and are conscious about their weight, and this may have an impact on their behaviour. Some scientists have also predicted that with the increased rates of childhood obesity, today's kids will be the first generation to live shorter lives than their parents. 

The weight gain of a child is due to the imbalance between caloric intake and the calories utilised (for growth, development, metabolism, and physical activities). Typically, the amount of calories a child consumes through food or beverages, if not used for energy activities, leads to weight gain in children. It is seen that children and teens nowadays lack the required amount of physical activity; hence, the calories are not used properly, leading to children being severely overweight or obese. A sedentary lifestyle is also an important factor in abnormal weight gain, as many children nowadays spend most of their time in front of television sets, video games or computers. Children tend to snack more when they are watching a show on TV or browsing the internet, and the fact that they spend little time engaging in physical activities can lead to unnatural weight gain. 

Moreover, television advertisements depicting energy-rich and sugar-rich foods influence children to make unhealthy choices. These unhealthy food choices may lead to weight gain and obesity. 

At home, a productive parent-child interaction is very crucial, as parents can influence children's food choices and motivate them to have a healthy lifestyle. Effective interventions in a family setting can be beneficial in changing a child's behaviour of overeating and their unhealthy choice of food. 

Children spend a significant portion of their time at school. They have at least one meal at school. Hence, schools can encourage kids to make a healthy food choice, like reducing the intake of carbonated drinks or sugary foods, encouraging kids to regularly drink water and healthy fruit juices, and motivate them to increase their consumption of vegetables and fruits. Schools which provide meals in their canteens can have healthy nutritious food items with an emphasis on a balanced diet. Schools can involve kids in mandatory physical activities like sports or dance, with focus on enjoyment rather than competitiveness. Classroom-based health education can make older children aware of eating a nutritious diet, and engaging in a regular physical activity. Weight-loss programmes like dietary management (eating more fibre-rich foods), and physical activity are recommended for children above seven years of age who are at risk of secondary complications from obesity. 

Our community also has insufficient sidewalks, parks, and bike riding facilities. Taking these limitations into consideration, physical activity can be stressed upon through the adoption of simple strategies like walking alongside your children to school or parking cars at a distance from the destination, so that kids can walk there or encouraging them to take the stairs instead of elevators or escalators. 

Childhood obesity needs attention as a major public health issue in Bangladesh. The complications caused due to childhood obesity can be severe and as stated earlier, can continue into adulthood. Hence, there is a need to address this problem at every possible step through effective interventions and motivation strategies. Unfortunately, in Bangladesh, the government, along with other health care organisations, have thus far failed to take appropriate actions, such as changing policies and adopting environmentally safe interventions for children to engage in physical activities. Children need to adopt healthy behaviours as a lifelong practice so that they can lead a healthy life. Timely actions from adults can lead to a nationwide healthy future for our kids. 

The writers are Associate Professor at the Department of Public Health, North South University, and MPH student at the Department of Public Health, North South University and research fellow at USAID, respectively. E-mail: ahmed.hossain@northsouth.edu