In simple terms, obesity is having a body weight that is not symmetrical to the physical height. However, in medical terms, a person having more than 20% of body weight over the ideal weight or having a BMI of 30 and above is considered obese. This precise definition is actually essential in distinguishing between the obese and its precursor the overweight. It is not true that obesity is limited only to the middle-aged or to the geriatrics. We should not deny that in this modern era almost everyone is spellbound by the advertisement of so-called nutrient-dense foods and surprisingly nowadays comfort is a virtue and hard labor is a vice. We do prefer to count our calories in an AC multi gym for limited hours but do not prefer to work hard all day. Just juxtapose the two images. What an irony!
Our school-going children are heavily affected by this 'conducive' atmosphere. I have personally observed in my city the escalating number of obese school going students in this year 2020. I have seen students, previously having normal weight converting into overweight and overweight becoming medically obese in this corona eclipsed 2020. I guess this is not only because the adolescent and minor students easily fall prey to HFSS( High Fat Sugar and Salt) foods but also due to their restricted natural activity during this cataclysmic corona pandemic. My slightest doubts about the rising obesity among our dear students were removed when I came to know the following statistics :
- IASO(International Association for the Study of Obesity) and IOTF( International Obesity Task Force) admits that 200 million i.e 20 crore school children worldwide are either obese or overweight.
- In Asia, India has the second-highest number of obese children 14 million (1.4 crores) after China 15 million (1.5 crores).
- Within 2025 the number of obese children in India will become a 17million or 1.7 crores.
- Experts reckon that at least 50% of obese children becoming obese citizens in near future with all obesity complications is imminent.
The above statistics tell us about the graveness of the situation and warns us of the grim future. Moreover, the restriction imposed due to the corona pandemic which leads to less activity has further escalated the rise in obesity. You will be glad to know that W.H.O is well aware of the childhood obesity problem and framed a three-step solution to it - First, reduce risk of further obesity by addressing essential elements in life, Second, control obesogenic environment and at last start medical treatment of obese children for the betterment of their health condition. The W.H.O's commission for ending childhood obesity(Geneva,2016) states that the problem needs, "a whole government approach in which policies across all sectors systematically take health into account, avoid harmful health impacts and thus improve population health and health equity." However, to understand W.H.O's guideline, we should have a deeper look into the matter dividing it into 3 subtitles: Factors causing childhood obesity, Consequences of obesity, and Solution to the problem.
Factors of Obesity:
Genetics:
It is a half-truth that impulsive eating and a sedentary lifestyle alone are responsible for obesity. More complicated reasons are linked with obesity and one of them could be the genetic tendency to gain weight which may originate from the prenatal conditions of a baby. Prenatal conditions like, mother's malnutrition can lead to epigenetic changes that put these children at a higher risk of obesity when exposed to HFSS type of foods and idle lifestyles in comparison to children whose mothers were not undernourished.
Gender :
It is found that obesity is more common in boys than girls and you will be surprised to know that this is not due to biology instead due to socio-economic gender disparity. In India this can be attributed to greater cultural advantage, greater freedom to go outside, and lesser contribution to household work enjoyed by the boys over girls. But only at the age of 15, a reversal is observed and this is due to an adolescent hormonal surge.
Dietary Factors:
Undoubtedly this could be one of the most influential factors for obesity. In this era of globalization, where children and their parents are relentlessly bombarded by the advertisement of so-called nutrient-dense foods, where our traditional foods like chapati, poha, idli are becoming old fashioned, calorie-dense packet junk foods or HFSS type of foods emerging addictive to children, the relationship between obesity and diet is inevitable. I like to seriously acknowledge a personal observation of mine regarding a drastic behavioural change of students in senior secondary schools. Prior to any competitive examination of carrier importance, these senior students cut physical activity and follow a sedentary lifestyle to enhance their preparation! Some students claimed to me that they are conserving their energy and pouring it into the career build-up! During this highly focused and stressful preparation, they often suffer from an impulsive eating disorder. During their night study, students often start nocturnal snacking with HFSS type of foods to release stress but stay reluctant to have actually nutritious foods. Consumption of snacks high in refined sugar and fat can cause significant weight gain. Moreover, due to addictive flavor and taste, these foods become their habit after the exam also. Some students even develop an impaired control of food intake which affects their future health.
Physical activity and TV watching:
In my City Agartala, the number of students using bicycles to reach school or even tutorial is declining day by day. Students are either dropped by parents or come by Van rickshaw collectively. Some students told me that they like to avoid vehicular traffic and also want to conserve their energy for study. However, I like to mention that in my city this is applicable for a large number of Government schools without any large Volvo buses to pick students. I have already mentioned that senior secondary students also sacrifice their physical activity before any competitive examination. This adopted sedentary lifestyle causing higher adiposity among students which is further accelerated by covid-19 restrictions in 2020. Adiposity is also caused by student's addiction to mobile, Facebook, youtube videos, and TV watching. However active screen watching (computer or video games) is a little healthier then passive screen watching (TV)
Consequences of obesity in school children:
There are some misconceptions among us regarding children's health like heart disease starts at old age, obesity is a problem of adults and you don't have to worry for an obese child. Fat in children is a sign of proper nourishment and fatty children are actually healthy, children cannot develop high blood sugar or cholesterol, etc. This is very wrong and we should know that overweight children suffer not only from physical problems but also from psychological and social problems! Apart from physical ailments, these children psychologically suffer from low self-esteem and interact less with peers or participate less in social activities. Actually, obesity is one of the most stigmatizing conditions of childhood. Obese children may suffer from respiratory problems, sleep disorders, and insulin resistance which may lead to childhood diabetes! Childhood obesity can cause NAFLD (Non-Alcoholic Fatty Liver Disease), Dyslipidemia ( high cholesterol), hypertension, and even cardiovascular diseases!
Action plan and conclusion:
It is not that solution to childhood obesity is elusive. As mentioned earlier, WHO has included controlling childhood obesity as one of its priority areas and advised a three-step action plan: First, address critical elements of life-related to obesity, Second, control obesogenic environment, and last is the treatment of obese children. Following these protocols, we have to first prepare the parents of our school students for lifestyle modification and dietary changes so that they can implement those at home. In school, the basic requirements like the provision of healthy food and beverages for serving during mid-day meals and the provision of safe drinking water should be fulfilled. Children are generally active in nature and we can further encourage them by organising competitive sports tournaments all through the year. The government should also consider making rules to ban the entry of HFSS foods, carbonated or sweetened drinks in schools. We have to understand that for successful control of childhood obesity, the involvement of all related components namely students, parents, community members, non-governmental organisations, private parties, and the government is very necessary. All components should work in synergy to see our beloved students sharper and healthier again.
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