9-25b Childhood Obesity Flashcards
Recognize the state of pediatric obesity and common definitions and terminology associated with this diagnosis.
Childhood obesity has climbed from 5% of each childhood age group in the 1970s to 15-20% in 6-19 YOs in 2011-2014
15% of kids 10-17 are overweight and 16.1% of kids are obese (females more obese)
Kids with parents with less than high school education/impoverished were more likely to be obese
Discuss potential contributing factors to the etiology of the obesity epidemic.
cafeteria choices, vending machine income, food advertising, food accessibility (good grocery store vs. convience store) /insecurity (lack of access to food), portion distortion, lack of safe places to exercise, limited after school programming, decreased physical education, increased “screen time”
Classify a child as normal weight, overweight or obese using CDC growth charts.
x-axis is age and BMI is on the y-axis
overweight = greater than or equal to 85th percentile for age and sex
obese = greater than or equal to 95th percentile for age and sex
shows the progression of BMI across age
Using a systems review approach, what body systems are affected by obesity?
Musculoskeletal, Cardiovascular/Pulmonary, Integumentary, Neuromuscular/Neurological, GI, Endocrine/Reproductive, and Psychological systems
Identify exercise testing considerations in pediatric patients.
Referral base
Size of equipment
Treadmill safety
Protocols: 2-3 minute increments and constant or incremental load based on height, BMI, or body SA
Maximal effort via OMNI scale of perceived exertion
What are musculoskeletal obesity complications?
SCFE: when the femoral head slips off the femoral neck at growth plate; caused by shear forces on growth plate from alterted obese gait mechanics (increased thigh girth)
Bount’s disease: tibia bowed due to increased loading on medial aspect of growth plate
Spine compression, fractures, and back pain
fracture: increased incidence in obese due to force of fall, decreased bone density
more pains, sprains, and strains (overuse, tendonitis, bursitis, back pain, m./body weight imbalance)
gait impairment from decreased velocity/increased stance time, wider BOS, foot flat weight acceptance; later OA risk
What are cardiovascular/pulmonary obesity complications?
Cardiovascular: early markers of cardiovascular disease (dyslipidemia, hypertension, MetS)
Pulmonary: obstructive sleep apnea, asthma
What are integumentary obesity complications?
Dermatological changes:
Acanthosis nigricans (poor insulin control, dark patch)
Acrochordons (skin tags)
Ulceration and cellulitis (infection of fat cells/increased adipose)
Stretch marks show rapid weight gain
What are neuromuscular/neurological obesity complications?
Migraines?
Increased pressure in bain
What are neuromuscular/neurological obesity complications?
Migraines?
Increased pressure in brain: Psuedotumor cerebri/Idiopathic Intracranial HTN (vision loss
impulsivity, overeating disorders
obesity and diabetes: peripheral neuropathy and AchR changes at NM junction
What are GI obesity complications?
GERD (gastroesophageal reflux disease) Gallstones
Non-Alcoholic Fatty Liver Disease
What are Endocrine/Reproductive obesity complications?
adipokines (leptin): Know when full
Early-onset type 2 diabetes mellitus
Hormonal changes /regulation:
early onset of development and reproductive disorders like PCOS
What are Psychological obesity complications?
Impact on self-esteem and self-image, quality of life, depression, anxiety
What are Psychological obesity complications?
Impact on self-esteem and self-image, quality of life, depression, anxiety
What is some observational screening for obesity?
Altered gait pattern: Biomechanics and Gait speed
Dynamic and static standing balance: Wider base of support?
Endurance with physical activity and in the community (submaximal exercise test or screening of a task)
