Childhood Obesity Prevention and Treatment PDF

Preface

The global epidemic of overweight and obesity in adults is now also a major health problem for children and youth (Livingstone, 2001; Kimm et al., 2002; Koletzko et al., 2002; Eriksson et al., 2003b). While childhood obesity has existed since ancient times, there is increasing evidence that prevalence rates today are greater than ever before. This increase in fatness heightens the health risks for later periods of life but also has a substantial impact during the growing years (Klein, 2004).

Over the last decade more research has been devoted to this significant problem. However, the majority of studies have described the various manifestations and consequences of obesity, and few have addressed its causes. Considerable effort has been devoted to the identification of suitable ways to prevent, treat, and manage the condition. However, numerous questions remain unanswered.

This volume summarizes many of the findings on obesity during growth with a particular focus on more recent knowledge and an appraisal of research on treatment and management. Importantly, the volume addresses some potential solutions for the prevention of obesity in childhood. While the major focus of the book considers children and adolescents, some reference is made to relevant research with adults. Significantly more research has been completed with the adult population; therefore, knowledge and understanding of practices with this group may have important consequences for children and youth. Readers are referred to data presented elsewhere — for example, the Proceedings of the International and European Congresses on Obesity (ICO and ECO) that have taken place during recent years.

A number of approaches to prevent, treat, and manage childhood obesity have been presented in the literature to date. The authors of this volume, however, believe that the prevention and management of simple obesity should be promoted with the incorporation of natural factors (appropriate nutrition and physical activity) to rectify energy imbalance and achieve a desirable body composition. This approach has a greater opportunity of success in earlier periods of life when obesity is not fully developed. These comments assume of course, the absence of significant endocrine disorders such as Cushing's syndrome, and hypothyroidism, or genetic syndromes such as Prader-Willi, Bardet-Biedl, and others, which are accompanied by increased adiposity. These genetic anomalies with an impact on body fatness are very rare in children (Chiumello and Poskitt, 2002); however, genetic predisposition plays a significant role and during recent years has been studied extensively. Nonetheless, the contribution of genetics is inconclusive.

Poor lifestyle behaviors are largely responsible for excess fatness in the majority of cases of obesity during childhood. As shown by some authors, for example, Klish (1993), even in such cases an environmental intervention can have a significant impact and help to improve the situation for the child. The management of an appropriate environment for an obese child requires a conscious and consistent attention to diet and physical activity that may be difficult both for the child and his or her family. Importantly, weight loss for an obese youngster is not the sole aim in weight management. Rather, the overall improvement of the physiological, psychological, and social status of the individual should be the goal.

A significant restriction of food intake may be necessary when the degree of obesity is excessive or morbid. Unfortunately, this scenario is necessary for an increasing number of children and youth. This trend may be the result of childhood obesity being underestimated and neglected as a health problem. The best way to manage obesity in the family, school, and the wider environment of the child is to be vigilant and help in the early detection and intervention to minimize excess deposition of fat. The optimal scenario in the management of childhood obesity is not to permit its development at all. Early interventions should be well planned and timely, and follow best practice guidelines to achieve the desired outcomes.

The aim of this volume is to address a broad range of aspects related to the prevention and management of the condition and present current information. The number of studies has increased enormously since the publication of the first edition, and it would be too difficult to analyze and summarize them all at this moment. Definitive analyses and suggestions for the solution of childhood obesity are surely premature. Further research and clinical experience will be needed to contribute to a more positive outcome in the future.