Detrimental role of childhood obesity in adolescence and adulthood: developing nation’s perspective

Abstract

Worldwide, over the years, a significant hike in the prevalence of overweight and obesity has been observed among children, adolescents, and adult age-group individuals. In contrast to the previous beliefs that overweight and obesity are a major public health concern in developed countries alone, gradually the problem has shown its presence even in developing countries. The objective of this article is to assess the magnitude of childhood obesity in developing nations, identify the existing barriers, and then propose interventions to counter the public health menace of childhood obesity. Critical analysis of the existing health strategies has revealed significant lacunae in the current policies and shortcomings in different aspects of the health care delivery system. To conclude, it is high time to address the issue of childhood obesity, as its associated aftermaths are proving detrimental not only for individuals and their families, but even for the society and the health sector.

Keywords:

• childhood obesity
• health
• overweight

Introduction: magnitude and scope

Worldwide, over the years, a significant hike in the prevalence of overweight and obesity has been observed among the children, adolescents, and adult age-group individuals.¹ Findings of a study revealed that a significant increase in the mean level of blood pressure has been recorded in childhood, and the problem has been further complicated by the rise in the prevalence of childhood overweight and obesity.² In fact, more than 40 million children aged under 5 were diagnosed as overweight in the year 2012 alone.³ Furthermore, about 65% of the world’s population reside in those nations where overweight/obesity accounts for a higher number of fatalities than underweight.³

In contrast to the previous beliefs that overweight and obesity are a major public health concern in developed countries alone, gradually the problem has shown its presence even in developing countries.⁴ In fact, in excess of 30% of preschool children from developing countries are either obese or overweight across the globe.³ Acknowledging the magnitude and the alarming rise in the prevalence of childhood obesity, policy-makers have rated it as a global public health concern.⁵

Determinants of childhood obesity

Although genetic attributes have a role to play in the development of childhood obesity, the share of environmental/lifestyle parameters cannot be ignored. Determinants like household income, the habit of eating energy-dense or junk foods or surplus salt or aerated drinks, and habit of missing breakfast or excessive outside foods or physical inactivity have played a crucial role in an exponential multiplication in the problem of childhood obesity.^6,7

Impact of childhood obesity

The concern of overweight/obesity in childhood is not restricted to childhood alone. Childhood obesity has been associated with various acute and chronic diseases and the overall health, development, and well-being of children. Definitive evidence is available to reflect that the problem of childhood obesity has often been linked with various other co-morbidities such as early onset of type 2 diabetes mellitus or hypertension, the phenomenon of insulin resistance, deranged lipid profile, and variable extent of involvement of organs like the liver and kidneys.^3,8,9

From the health economics perspective, especially in low-resource settings, the balance between income and expenditure becomes disturbed owing to the unexpected increase in the cost not only for the management of associated complications but even for the rehabilitation of the affected person.^9,10 On a similar note, even the health sector becomes overburdened and thus policy-makers find it extremely difficult to ensure health for all.^9,10 Finally, the affected person has to deal with social adversity such as stigma in society (being a laughing stock), or serious questions concerning the efficiency of the person in his/her job.^8,10

Identified barriers

Critical analysis of the existing health strategies has revealed significant lacunae in current policies, because of which the results were not encouraging.¹¹ From the policy point of view, the existing strategies fail to offer a holistic approach as most of the areas have not been covered thoroughly.¹² In fact, minimal attention from programme managers has been observed, which is probably because of the absence of acute complications, as the time duration from the onset of disease till the eventual development of complications is very long.^11,12

The problem does not end here, and is further compounded by the restricted involvement of other stakeholders like parents/guardians/teachers etc. in most settings.^13,14 In addition, there are concerns such as no periodic organisation of campaigns to ensure sensitisation of the general population/at-risk people regarding the potential risk factors or adverse impact of childhood obesity.¹² Further issues include limited orientation of outreach workers regarding the magnitude of the problem and their role/responsibility in reducing the prevalence of disease, and lack of sensitisation sessions for physicians to motivate them to adequately counsel parents/children to prevent acquisition of wrong lifestyle practices.^11,12

Proposed strategies and solutions

Acknowledging the existence of various lacunae in health policies and shortcomings in different aspects of the health care delivery system, there is a significant need to develop comprehensive strategies to counter the problem of childhood obesity effectively.¹¹ Under ideal circumstances, the best intervention is to implement strategies under primordial prevention (viz. prevention of the emergence or development of risk factors in population groups in which they have not yet appeared) so that any chance of an untoward complication later in life can either be averted or delayed.^15,16

Important strategies are those such as encouraging the practice of exclusive breastfeeding for six months; promoting minimal intake of energy-dense or junk foods; and inculcating the habit of consuming timely meals, and adequate intake of fruits and vegetables.¹⁷ Findings of a meta-analysis emphasised the restructuring of the school curriculum to cover areas like healthy eating and involvement in physical activity; ensuring a continuous supply of quality food in schools; and orienting teachers and parents regarding health-promotion strategies to encourage children to be more active and to eat more nutritious foods.¹⁸

Furthermore, other interventions such as ensuring sustained political support; exploring the scope to involve the stakeholders concerned; orienting the entire team of health professionals to the cause and consequences of childhood obesity; starting an intensive clinic for reducing the prevalence of childhood obesity; and fostering research work to measure the extent of childhood obesity involvement in various complications or evaluation of the eating behaviour of children can also be implemented in an evidence- and needs-based manner.^{11,12,17–21}

Conclusion

To conclude, although the magnitude of childhood obesity has shown a global rise, the challenges that health professionals from developing nations have to conquer are unique. In fact, it is high time to address the issue of childhood obesity, as its associated aftermaths are proving detrimental not only for individuals and their families, but even for society and the health sector.