The incidence of childhood obesity is increasing in Anguilla. The dangers of childhood obesity are real and they are beginning to take their toll. Diabetes, hypertension, orthopeadiac complications and other obesity-related chronic diseases are now becoming more common in youngsters in Anguilla.

Why the concern about childhood obesity?
There is data to suggest that there is increasing numbers of children with obesity in many countries including Anguilla. Obesity is defined as an excessive accumulation of body fat. Obesity is present when total body weight is more than 25% fat in boys and more than 32% fat in girls.

Obese children have a 70% chance of having obesity in adulthood. In addition, we are now seeing many obesity related medical conditions that were extremely rare in children twenty years ago. There are a number of obese children with such conditions as type 2 diabetes (previously called adult onset diabetes), hypertension, coronary heart disease and orthopaedic conditions. Many obese children also have many psychological issues such as poor self esteem, negative self image, depression and withdrawal from peers.

What causes childhood obesity?
The reasons for childhood obesity are complex. There is no doubt that some children have a genetic predisposition to become obese, but genetics alone cannot explain the dramatic increase in the number of obese children seen in the last twenty years.
Lack of regular physical activity is a major issue. Television, computers and video games have led to a decrease in physical activity by children. Many people claim that today’s youths are the most inactive generation ever.
Eating too much junk food is another cause for childhood obesity. Over consumption of high calorie foods and bad eating habits have been a causative factor in many cases of childhood obesity.
The environment also plays a role. Over exposure to advertising of various unhealthy foods, as well as the lack of recreational facilities on the island, may also contribute to childhood obesity.

Prevention
Obesity is easier to prevent than to treat. Parents, health professionals and teachers all have a crucial role to play in the prevention of childhood obesity.
Despite what many parents say, they have a crucial role to play in the prevention of childhood obesity. As early as the first few weeks of life parents can ensure that their children have the best start in life by ensuring that they are breastfed exclusively for the first six months of life. Breastfeeding has been shown to decrease the risk of early childhood obesity.
Teaching healthy behaviours at a young age is important, and parents must instill these values from an early age. Children often do what they see adults doing; therefore parents must themselves practice healthy behaviours.
Parents are the ones who buy the foods and snacks; they are the ones who should insist on buying healthy snacks and avoiding junk foods. Parents must be good role models for their children. If you do not want your children to use excessive potato chips then you should also avoid using excessive potato chips. Parents should not be too critical of their children eating habits but instead focus on the positive. Encourage children to eat only when hungry - not out of boredom.
Parents are encouraged to take part in regular physical activity with their entire family. How about walking with the entire family every afternoon, or playing a game of cricket or football with the entire family? You must make time for physical activity that involves the entire family.
Parents must make an effort to limit television watching and use of the computer and other electronic devices.
Children spend much of their time at school. Schools should provide an environment that promotes healthy nutritious and physical activity habits. Teachers have a positive influence on children. Opportunities must be found at all time to encourage children to be physically active. The recess period should not be used by children to just sit on a bench and gossip. The physical activity programmes must be encouraged and expanded so that our children reap the benefits of physical education while they are in school.

What to do if you have an obese child?
Many parents often throw up their hands in the air when they have an obese child. If you think your child is overweight talk to your doctor so that he or she can be evaluated. Once the need for obesity treatment has been identified, your medical professional may suggest one or more options for treatment.
Options include dietary therapy, physical activity and behavioural therapy. There are other options that can be used with any of these options as well.
Parents must be supportive of their children. Your child already knows he or she is obese and he or she does not need to be constantly reminded of it. Obese children need your encouragement and love and parents must resist using food as a reward or punishment. Treatment of childhood obesity often involves the entire family. Involvement of the entire family is a motivating factor. Weight control programmes that involve both parents and the child have shown improvement in long-term effectiveness compared to directing the programme only to the child. The road to a successful treatment may be long and frustrating but the benefits of preventing the complications of childhood obesity are tremendous.

Conclusion
Childhood obesity is increasing in many countries including Anguilla. The complications of childhood obesity are already occurring. We must address the growing epidemic that, if left unchecked, can become a major public health problem in the very near future. Treating childhood obesity is difficult therefore much of our efforts must be aimed at preventing it.

Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. Dr. Brett Hodge is an obstetrician/gynaecologist and family doctor who has over twenty years in clinical practice. Dr. Hodge has a medical practice in the Johnson Building in The Valley.

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