Childhood Obesity Flashcards
what type of energy imbalance results in obesity?
positive energy imbalance
why is measuring overweight and obesity difficult in children?
BMI healthy ranges is different in boys and girls
growth in height not always matched by proportionate increase in weight
growth spurt occurs later in boys than girls
what are the thresholds on a growth chart for overweight, obese and risk?
high risk of overweight = >85th centile
overweight = >91st centile
high risk of obesity = >95th centile
clinical obesity = >98th centile
from what age can BMI be used as a measure?
2 years
how is adiposity measured in children too young for BMI?
children <2 use BMI conversion chart to provide an approximate BMI centile
is waist circumference used as a measure in children?
no
does not offer improved diagnosis of body fat or cardiometabolic risk factors
list 8 risk factors for being overweight at 3 yrs old?
parental overweight black ethnicity greater birthweight smoking during pregnancy lone motherhood pre-pregnancy overweight maternal employment >21 hrs per week solid foods before 4 months old
what is the most common cause of childhood obesity?
Prader-willi syndrome
what are the features of prader-willi?
at birth - very floppy, ability to suck is weak or absent, tube feeding common
childhood - hyperphagia (food seeking and lack satiety) and reduced energy requirements due to low muscle tone
learning difficulties
hypogonadism
short stature
how does bardet-biedl syndrome present?
visual impairment renal abnormalities polydactyly learning difficulties hypogonadism obesity hyperphagia - leads to obesity
what reduction in BMI is associated with a significant decrease in insulin resistance?
> 0.5
what cases of obesity are referred for paediatric review?
serious obesity-related morbidity which requires weight loss
children with suspected underlying medical cause of obesity
children under 24 months who are severely obese (BMI > 99.6th centile)
what are the treatment goals for overweight and obese children?
weight maintenance
what are the treatment goals for severely obese children?
maximum weight loss of 0.5-1kg per month
what are free sugars and what are the dailt recommendations?
added to foods plus those naturally present in fruit juices, syrups and honey
should make up <5% of daily dietary energy intake
what are the physical activity guidelines for under 5s who are walking?
should be physically active daily for at least 180 mins throughout the day
on average 30-60 mins extra per day
how does orlistat work?
inhibits gastric and pancreatic lipase to reduce absorption of dietary fat by 30%
what are the side effect of orlistat?
oily stools
faecal urgency
nausea
abdo pain
who can orlistat be prescribed for?
only prescribed in adolescents with very severe to extreme obesity (BMI >3.5 above median) or severe obesity with co-morbidities
must be prescribed by specialist clinic
what are the 3 methods of surgical management for obesity?
LABG = belt around top of stomach creating a small pouch RYBG = top section of stomach divided off by staples to form a small pouch and new exit from pouch which bypasses part of small intestine LSG = divides stomach vertically from top to bottom to reduce size of stomach by 75%
how effective is bariatric surgery at 1 year?
reduced BMI by 13.5
resolves associated conditions (sleep apnoea, hypertension etc)
