Fight the future: Juvenile obesity

Kids grow fast these days. For the under-20 age group, overweight and obesity growth rates are disturbing. From 1974 to 2004, the prevalence of overweight kids 6 to 11 years old grew from 4% to 19%. Similar growth patterns were also seen in the 2- to 5- and the 12- to 19-year-old age groups.

The recent generation of children has been fed the wrong messages. First, large food and beverage companies prey on the young and innocent’s craving for sweet, salty, and fatty food and drink. From the time they are able to sit and watch Saturday morning cartoons, they are bombarded with these messages. Second, parents are doing an injustice to their children by letting them get what they want. In an economy where both parents need to work, typically, junk food is easier to prepare, tastes better to most, and is often cheaper than healthy meals.

Sedentary lifestyles don’t help – childhood obesity rates are shocking. Other social norms include a more sedentary lifestyle of watching TV, playing video games, and getting very little daily exercise and physical activity. The average child will watch three hours of television per day. In many cases, children are learning these behaviors from their parents.

Overweight children become obese adults. It is at these young ages that being overweight can lead to an increased number of fat cells that sets the foundation for being overweight in adulthood. According to researchers, 80% of obese 12-year-olds will carry their overweight stature into adulthood. Eating behaviors are established at younger ages and become harder and harder to change as one gets older.

The psychological impact can be long-lasting. The immediate problems will be more psychological, as being ostracized from a group at younger ages can cause serious and sometimes life-long self-esteem issues. Later in life, this can lead to psychological disorders and substance abuse. Ironically enough, the same medium that delivers messages triggering the behavior to consume excess calories is the same one telling them that they should be thin and in-shape.

Obesity increases risks for co-morbidities. The longer someone is obese, the higher the risk for developing the various co-morbidities associated with it. Obese children are found to have 9 times the incidence of persistently higher blood pressure than non-obese children. This means that this population is adding a risk factor for heart disease –hypertension – at an earlier age.

Childhood type 2 diabetes rates are growing exponentially. The number of children with type 2 diabetes has increased significantly in a fairly short period of time. Before 1992, only about 2-4% of childhood diabetes was type 2, and by 1994, it was 16%; today that number is thought to be about the same, perhaps higher. The link can be seen in the fact that, according to investigators from the Bogalusa Heart Study, obese children are 12.6 times more likely to have high fasting blood insulin levels (hyperinsulinemia).

There is no easy solution. So far, effective weapons to combat this problem have been hard to come by. Healthcare providers have been limited with the amount of pharmacological and surgical data on pediatric patients. From 1996 to 2000, there were 700 and 2,000 cases, respectively. As this trend continues and more data comes to light, these numbers are expected to rise. Currently, approximately 4% of juveniles, or around 2 million, are classified as morbidly obese, which would fit the indication for a surgical procedure.

Prevention is important. At this point, the majority of the efforts have come in the form of government programs trying numerous strategies to encourage healthy eating and daily exercise among youngsters. It has become obvious to CMS and other private payors that an exponentially growing bill could await them in the future if action is not taken.

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