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Pediatrics > Obesity > Flashcards

Flashcards in Obesity Deck (14):
1

Causes of obesity (3)

1. Nutritional obesity->tall for age, family history of obesity/diabetes/CVD, early puberty, psychosocial
2. Endocrinological->V rare: thyroid, cushings, hypothalmic lesions
3. Genetic: short, learning abnormalities, dysmorphic, hypogonadism, congenital

2

Consequences of obesity for child (10)

1. Psychological: Depression, low self esteem, eating disorders, body image disorders
2. Fertility: PCOS, menstrual irregularities
3. CV- hypertension, cholesterol, chronic inflammation
4. Endocrine: insulin resistance, diabetes
5. Respiratory: asthma, snoring, exercise intolerance, Sleep apnea
6. Orthopedic: dislocated hips, flat feet
7. GIT: Abnormal LFTs

3

Important history

Lifestyle and diet
Growth and development
School, emotional/psychological
Features of underlying endocrinological
Family history
Complications: asthma, OSA, joint, CV, diabetes
Learning

4

Investigations

1. Looking for a cause
TSH
Free urinary cortisol
Karyotyping
MRI
2. Look for complications
Lipids
Glucose->urinary, OGTT
LFTs

5

Examination

1. Growth and devlopment
2. Endocrinology
3. Dysmorphic
4. Complications->acanthosis nigricans, BP, joints

6

Define childhood overweight and obesity

OW= >85th percentile
Obesity= >95th percentile

7

Management overview

1. Support
2. Physical activity, restrict TV/game consoles to 1 hour / day
3. Diet->balanced, not crash dieting
4. Monitoring->weight, growth, diet, PA, psychology, complications

8

Advice to parents->?puupy fat and managing

Cannot be sure it is just puppy fat. AT a risk of adult obesity, diabetes, lipid, high blood pressure. If they can hold weight steady, she is likely to do more growing before reachign adult height.
Needs changing of lifestyle, engage with someone who can encourage healthy eating and activity. Crash diets are discouraged because tends to lead to rebound weight gain, and is potentially damaging.

9

School based health weight promotion

1. Healthy eating
2. Physical activity
3. Reducing sedentary
Teachers are trained, few sessions over several weeks.
Not resulted in significant changes in BMI.

10

Individual family based prevention

Primary care setting
Adopt healthy lifestyle with specific strategies

11

Group family based

1. Child centred physical activity
2. Dietary modification
3. Parental education and support
Children together, couple hours, few weeks
Making physical activity fun
Recognising hungry vs non-hungry eating, rather than dieting

12

Discussing childs weight with parent

Sensitive issues.
Ask the parent their views
If express concern: discuss ideas for changes
If not concerned: raise awareness of the issue->talk about health more broadly, rather than narrowing into weight straight away

13

Parents should fous on behavioural change

1. Increasing physical activity->make part of family life, fun
2. Maintaining healthy consumption of nutritious food and drinks
3. Aware of what constitutes nutritious foods and drink, and encourage healthy lifestyle

14

Adverse effects of television watching

1. Television and video games take over from physical activities
2. Decreased metabolic rate while watching
3. Increased amount of high energy food consumed
4. Frequent advertising of generally high calorie and poor quality foods during children's program

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