CHILDHOOD WEIGHT GAIN- AN ELEPHANT IN THE ROOM

From Dr Nikhil Lohiya

Childhood is all about play and being active. The lockdown has led to people being confined to their homes. This had led to almost no physical activity by all of us. More than that parents are so scared, probably rightfully so, that they are not letting their children hang out and play. Even for essential things like vaccination of a child, parents have hesitated. This is just because of the corona terror. 

But is this fear justified? Well, looking at the parent’s perspective the answer is definitely yes. However, as a pediatric endocrinologist, it worries me. The reason is the loss of childhood fun, more eating, less physical activity, and more weight gain. While we are controlling infections, particularly COVID, the lockdown has led to an exponential increase in the weight of a child. Here we will discuss the complications which can happen due to excess weight gain and how one can handle it

1. Diabetes- Type 2 diabetes in adolescents is being seen increasingly. The reason why it can happen is due to lifestyle and familial propensity to it. Once you start gaining weight and it crossed the point beyond obesity the insulin resistance kicks in. This leads to high sugars despite insulin being present in your body. The lifestyle is getting more and more sedentary in COVID times and hence no wonder we are going to see a spike in the incidence of type 2 diabetes in India.
2. Non-alcoholic fatty liver disease- We all are probably familiar with what happens to the liver due to constant alcohol consumption. Believe me or not the same thing can happen with obesity. Yes, because of insulin resistance and changes in fat metabolism, excess fat gets deposited in the liver. This stops your liver to function in its full potential.
3. Acanthosis nigricans- Have you seen any obese child with blackening around the neck and axilla? Well, it is not a skin disease. In fact, it is a sign of insulin resistance which has occurred due to your excess weight. If weight is controlled the skin can resume its previous color.
4. Polycystic ovary disease- Well this is a problem that can occur in chubby girls. Due to obesity, hormonal imbalances occur such that girl’s menses become irregular. This may even progress to an extent that they stop getting their periods. It is one of the reasons for infertility. 
5. Social Issues-Being obese can be really upsetting for some people. While there is no reason for one to be socially embarrassing for weight. An obese child can be a victim of being bullied or can bully other children with him being giant and threatening others.
6. Psychological disturbances- Studies have shown that obese children can have low self-esteem and confidence. This can be due to the peer pressure of being slim and look desirable to others in the adolescent period.

THE POSSIBLE WAY OUT

Every problem comes with a solution. We cannot bypass the lockdown and the restraints but we can find a way to prevent and control obesity.

1. Recognize and Realize- The first step is to recognize whether your child is putting on weight or not. Ask if your child is having weight more than what it should be. One has to voluntarily look for his/ her child’s weight if it rising day by day. If you are not identifying the issue, you will never address it. Recognize that your child is putting on weight.
2. Talk to you child- Whether your child feels he/ she is being bullied or people ridicule him/her this could be one of the thing indicating that attention is necessitated. Also, your child might be under pressure or discouraged with weight issues. You need to talk frankly with them and this may need medical attention.
3. Balanced & optimum diet- As a parent, we always feel that our child is not eating sufficient. We always push him/her to eat more and more as much as we can. This is one of the major challenges we encounter in India. However, you can break this norm by giving him the volume of food he is asking for. Once they say they are satisfied we should not force for more. Also, the selection of food should be simple home-based with less oil, ghee, and sugars.
4. Physical activity- A very indispensable aspect of living healthy is to be physically energetic. With the schools and tuition classes going online, this is a challenge. One of the simple ways is to stand while attending sessions. It will help them burn more calories. Walking for 20-30 min at home itself will help. If you have a garden of society or home jogging or running daily for a minimum of 30 min is advised.
5. Lifestyle change- Eliminate sedentary living from your life. Be active. Be alive. There is no fun in lying down on the bed or couch full day and do nothing. The body is meant to work and hence it should function or remain physically active. Remove that flat-screen television and laptops. Remember, there is nothing as fulfilling like a healthy lifestyle.
6. Family- It’s a healthy family that raises a healthy child. Start having a hobby as family-like gardening, walking on the terrace or park, or nearby street for some time together as a family. Eat the same food healthy together. It is proven that if the senior family members eat and enjoy healthy food, children are more likely to imbibe the same attitude.
7. Consult a Pediatric Endocrinologist- If weight management of your child is an issue then you need to look to a specialist who will not only confirm it but will also guide you for how to go ahead with it. Pediatric endocrinologists do not just treat diseases they also teach you about how to keep an eye on it to avoid the catastrophe.

Dr Nikhil Lohiya is a Pediatric Endocrinologist. a specialist for children having endocrine problems like growth, puberty, obesity, thyroid, diabetes, genital issues, girl's menses, disorders of calcium vitamin D and bones.