Taking Aim At Childhood Obesity

(HealthScout) -- For many parents, giving birth to a chubby-cheeked, rotund infant is a sign that a healthy, happy baby has come into the world. And a new study published last month revealed that infants considered "heavyweights" at birth may actually grow up to be smarter adults -- another indication that a chubby baby may be better off.

But there's a darker side to the images these plump little cherubs represent. That side is childhood obesity -- a problem some experts contend can begin in the earliest stages of infancy.

"Can you imagine a family standing around the crib of a newborn baby and saying, 'Let's raise this child so that when she's 20 years old she weighs 200 pounds and has difficulty with social situations, and her self esteem just falls to the ground.' Why would you actively do that to a child? Yet that is what we are doing when we overfeed our children," says Dr. Bruce Bagley, chairman of the board of the American Academy of Family Physicians (AAFP).

One-in-five U.S. children is currently classified as overweight -- with a body mass index of 30 or higher -- and the number affected has been rising steadily, according to the AAFP.

"The studies show that in 1974, 5 percent of young people were obese. By 1997 it was up to 15 percent, and it could reach 20 percent if we don't do something about it soon, " Bagley says.

One somewhat controversial solution involves the use of adult prescription diet drugs to help kids lose weight. In ongoing yearlong studies at 14 medical centers around the United States, groups of up to 400 obese children between ages 12 and 16 are taking one of two of the newest prescription diet drugs on the market -- Xenical, which reduces dietary fat absorption, and Meridia, an appetite suppressant.

Although these drugs are different and much safer than diet drugs of the past, the studies are a dramatic and, some say, even desperate move. Doctors involved in the studies, however, believe they're on the right path.

"While it may seem a bit more aggressive, it is necessary because at this point in time there is nothing else to really offer these kids. And we simply can't let them go into adulthood facing these health threats," says Dr. Ken Fujioka, director of the Nutrition and Metabolic Research Center at The Scripps Clinic in San Diego, one of the study sites.

Obese kids face lifelong health risks

Indeed, studies indicate overweight children are highly likely to grow into overweight adults, most with a slew of potentially life-threatening problems in tow, including increased risk of heart disease, diabetes, hypertension, kidney disease and even some forms of cancer.

Some children are experiencing such problems even before they reach adulthood.

"I'm starting to see Type II diabetes in overweight children. And if pediatricians continue to ignore the fact that these kids are overweight, [these kids] are going to be in really serious trouble," says Dr. Ileana Vargas, a pediatric diabetes specialist and assistant clinical professor of pediatrics at Columbia Presbyterian Medical Center in New York City, another of the study sites.

While no one is certain why children are getting heavier, experts say there are several likely factors. American kids are eating more food, eating more calorie-laden foods and exercising a whole lot less -- a deadly triple play as far as their weight and future health is concerned.

"All of the patients at our center have failed at other methods -- regular diet, exercise and behavior modification -- and all of them continue to have a body mass index greater than 30, most greater than 35," Vargas says.

The studies are double-blind, placebo-controlled trials, meaning neither the children nor the doctors know who is taking the diet drugs. In addition, both groups of children are receiving identical nutritional counseling and are part of an exercise program.

Although results are preliminary, doctors overseeing the studies say they are impressed with what they've seen.

"So far safety has been good -- there are no major problems, and while we don't know for certain which kids are taking the drug, we can see that one group is losing more than the other, and we suspect these are the ones on the medication," Fujioka says.

Safety concerns -- mostly having to do with Xenical -- include diarrhea and a possible loss of certain nutrients, particularly vitamin D. The experts say neither side effect has proved to be a problem, however.

Although early results are promising, some believe the success of the drug therapy can't be measured until after the studies are complete.

"To me, the interesting data will be the follow-up -- which group of children maintains their weight loss, if any. And that would give us the answer as to whether or not medications are really a help or a hindrance in weight-loss programs for children," says Sheah Rarback, director of nutrition for the Mailman Center for Childhood Development in Miami, and a spokesperson for the American Dietetic Association.

Bagley, who has not used diet drugs on his young patients, says he hasn't been impressed with the results in adults and doesn't think children would fare any better. This, he says, is particularly true in regard to "rebound weight gain," which has been a problem for adults using these drugs in the past.

What To Do

If you're concerned about your child's weight and want to avoid diet drugs, there are other things you can try first.

A good place to start, says Vargas, is to pay more attention to what your child is eating, and teach -- not preach -- about the benefits of nutrition.

In addition, says Bagley, don't use food as a reward system, and don't buy into the idea that overfeeding your child equates with loving him or her more.

Perhaps most important, all experts say get your kids involved in plenty of physical activity.

"If you don't get kids moving, you're missing half the picture of what it takes to prevent as well as treat obesity," says Rarback.

Additional Resources

Child Obesity Prevention Program
 
"Public Health Crisis, Prevention as a Cure"

 Related articles on Child Obesity or Childhood Obesity

 Related articles on Overweight Children

For more information on children and obesity, check out the American Academy of Family Physicians' Guide to Helping Your Child Keep a Healthy Weight. Or visit KidSource, a clearinghouse of information about children's health.

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