By Josephine Agbonkhese & Chris Onuoha
WHEN Mrs. Esther Ojo (not real names) had to start buying men’s t-shirts labeled XL for her 11-year-old daughter Omotola, she didn’t think there was a problem. To her, her daughter was ‘well nourished’ and a reflection of their affluence. Not until four years later when Omotola was diagnosed with Type 2 diabetes mellitus, as a result of insulin resistance triggered by obesity, did it dawn on Ojo that her daughter’s weight was only a ticking time-bomb.
Omotola, at this juncture, was also already at risk of a group of other conditions including high blood pressure and high cholesterol, commonly associated with insulin resistance.
A growing epidemic, childhood obesity is becoming a global problem, with one in five 10-11 year olds in the United Kingdom being currently overweight or obese. One in three children, statistics say, are also affected in the United States.
Unfortunately, as it is with many other diseases, official statistics aren’t exactly available for Nigeria. The bottom-line remains, however, that more children worldwide are becoming overweight and obese than under-nourished and stunted. Paradoxically, under-nutrition seems to be attracting all the attention even though obesity has the potential of leading to billions of new cases of diseases in years to come.
Determining obesity: Only your doctor can tell whether your child is obese or not. However, Dr. Francis Faduyile, an experienced Pathologist at the Department of Forensic Medicine at Lagos State University Teaching Hospital, and former Chairman, Nigerian Medical Association, Lagos State Chapter, said determining obesity depends on certain figures.
“It is weight divided by the square of the height of the child. That is what is used to define obesity. However, in layman’s terms, obesity is when the child is too fat for either her age or height,” he told Woman’s Own.
Why are so many children overweight?
According to a pediatrician with one of the General Hospitals in Lagos State who preferred to be identified simply as Dr. Lawal, children become overweight and obese for a variety of reasons. “The most common causes are lack of physical activity, unhealthy eating patterns, genetic factors or a combination of these factors. Only in rare cases is being overweight caused by a medical condition such as are hormonal problems. Although weight problems run in families, not all children with a family history of obesity will be overweight.
“Children whose parents or brothers or sisters are overweight may be at an increased risk of becoming overweight themselves, but this can be linked to shared family behaviors such as eating and activity habits. More importantly, a child’s total diet and activity level play an important role in determining the child’s weight. Today, many children spend a lot of time being inactive. For example, the average child spends several hours watching television. As computers and video games become increasingly popular too, the number of hours of inactivity increase,” she said.
Juxtaposing the rise in childhood obesity with the economic dip in the country, Lawal said even in the middle classes, it is also very possible for a child to have too much of a ‘good’ thing. This means that obesity which was once termed the disease of the affluent, is now a burden of numerous poor and rich households. “Children who don’t eat their meals will often be given refined fruit juices, crisps or sweets, or cooked separate meals. In my house, the children have always eaten the same as us and if they don’t like it, they will go hungry. I have come to realize that saying ‘no’ doesn’t make one a bad parent. Some parents have also formed the habit of giving larger portion sizes of meals to children, and research says this is also directly linked to obesity,” she explained.
Blockage of blood vessels: While the burgeoning weight of children ordinarily does not put pressure on many parents but rather fills them with the illusion of nourishment, Dr. Faduyile, on his part, explained the health implications of obesity. He said: “This condition can pose a lot of dangers. One is arteriolosclerosis; the blockage of the vessels of human beings right from childhood. If a child is obese from childhood, it means the child will have more of these within the blood vessels when he or she is grown. Secondly, because of the level of obesity, the child’s heart may have to work more than it would work naturally. And this can be a prelude to having hypertension in adulthood.
“Thirdly, there are some chemicals released which are related to the amount of food that one eats. And for obesity, it is because one eats more food than required. So, what usually happens is that they develop this high reactive oxygen specie which destroys a lot of things in the body. In future too, it can result in diabetes mellitus and some form of hypertension. Also, obesity can lead to any form of cancer. This may not manifest in childhood but of course, it is a precursor to having it as an adult.” In summary, obese children are at risk of a number of other conditions, including early heart disease, bone problems, skin conditions such as heat rash, fungal infections, and acne.
Socio-economic implication: Aside the numerous health implications, far more scary are the socio-economic implications of obesity because the affected young people, instead of being characterized with increased physical activity, may become constrained by their body sizes. In the long-term, they also risk having a reduced quality-of-life, which can be quite costly economically. Emphasizing the need for lifestyle changes, Faduyile explained that while weight is a balance between calories taken in and burned, parents must also take into consideration other factors if obesity must be addressed.
Sedentary lifestyle: “As it is now, obesity is on the increase because we are having our children living more sedentary lifestyles unlike in the 80s or 70s when children were heavily engaged in sporting activities and outdoor games. Now, they are engaged with television or their telephones, and they spend more time on social media. We now have children who sit in front of television for hours without exercising regularly. If you eat and you don’t burn it out, it stays in the body. And you know we have a lot of junk food around. So, all of these increase the risk of obesity,” he said. This apparently translates to more children not getting the recommended 60 minutes a day of activity that can help burn calories.
Making the changes: Dr. Faduyile, in his submission, therefore, suggested the need for increased physical activity that would ensure fats are burned rather than stored in the body; less screen time, reduced consumption of refined foods; age-appropriate meal portions; increased engagement of children in sports and a mandatory ownership of sporting facilities by schools, for the overall health and wellbeing of children.