by dr. Putu Fristy Armatheina
The Covid-19 pandemic has caused many changes in human life, including children. One of them is the increasing number of children who are obese, excess body fat mass.
According to SJ Lange (2021) in 2021, when Covid-19 hit the world, there was a body mass index (BMI) for children aged 3-5 years, 6-11 years, 12-17 years who tended to start rising. In fact, now we call it endemic, there is an epidemic of obesity in children after the Covid-19 pandemic because more and more children come to health care facilities with obesity.
School-age children are more at risk because the Covid-19 pandemic has greatly changed their daily habits, for example, having to get up early, having to walk to school, and having physical activity at school. Due to the Covid-19 pandemic, children are doing more activities at home. Their physical activity is reduced and their calorie intake does not change, so the risk of becoming overweight is higher.
Factors that influence are not only biological, but also psychological and social or environmental factors such as more intake and easier to find food. All they have to do is use their gadgets to order food through the app. Children have more time to use their gadgets to play at home. Obese children are at greater risk of developing obesity in adulthood.
According to data on obesity review (Simmonds M, 2016), around 55% of obese children will become obese as teenagers. Approximately 80% of obesity in adolescents will last into adulthood, then at the age of 30 years 77% are still obese. If it continues into adulthood, what you need to worry about is degenerative disease events such as diabetes, hypertension, progressing to coronary heart disease, kidney failure and others.
The causes of obesity in children vary. The doctor will look for signs or symptoms of a child experiencing or at risk of obesity, then a physical examination and anthropometric evaluation, supporting examinations according to indications, namely diet analysis, simple laboratory tests such as fasting blood sugar, lipid profile, liver function, kidney function. In addition, it also assesses comorbidities whether the child has a habit of snoring or there are problems at school.
In the anamnesis what is sought is the onset of increased body mass index (BMI) before the age of 5 years or obesity during school or as a teenager. Then, if there is a history of developmental delays, it should be considered that obesity is involved with a genetic syndrome, for example, children with Down syndrome are more at risk for obesity. Also the child’s diet and physical activity as well as a family history of obesity and co-morbidities such as diabetes, and the pattern of family living habits such as exercise habits where children will imitate the habits of their family.
Factors that cause obesity are primary or secondary, for primary the cause is a lot of food intake but lack of physical activity, stature is generally normal or taller than age, normal intelligence development, onset can be at any time, sedentary living habits.
Then for the secondary factors, there are organs involved (endocrine, genetic, central nervous system disorders), stature tends to be short, can be accompanied by developmental delays and intellectual disabilities, generally occurring since early childhood, there are similar diseases in families.
Symptoms of obesity in children are generally a double chin, drooping stomach, accompanied by symptoms of complications such as pelvic pain, knee pain, then on the skin, hypertension can also occur.
Children and Adults
Management of obesity prevention in children is different from adults, the target does not always have to be to lose weight. The target is optimal growth and development with a body weight of 20% above the ideal body weight (BB). Holistic management consists of proper eating patterns, physical activity patterns, behavior modification from children and families.
The correct eating pattern must be formed early on starting from solids, therefore there are so-called feeding rules that can be applied to children who are obese, namely feeding rules that are scheduled with a large meal pattern of 3x/day and snacks 2x/day.
Snacks are prioritized in the form of fresh fruit that is cut not in the form of juice. Drink water between main meals and snacks. Then a neutral environment without distraction, often when children eat while watching movies, will usually carry over to school age.
Really need to limit sugar intake in children. Children who consume sugar sweetened beverages (SSB) regularly between meals, namely between meals who should drink water, it turns out that children who drink sweet tea or soft drinks have a 2.4 times higher risk of becoming overweight.
In addition, children must be accustomed to physical activity in the form of running, playing ball, activities that increase muscle strength such as climbing, at least 60 minutes/day 3 times a week. Behavior modification is carried out by encouraging children to carry out self-monitoring of weight, food intake, and physical activity. Awareness changes ideally come from children. If it doesn’t change from the child himself, then the child doesn’t have a target, doesn’t understand that this is something important, then there won’t be much change. Parents must also set an example for their children.
Author, Works as a general practitioner
