Childhood Obesity Dimitrios Stefanidis, MD, PhD, FACS, FASMBS Associate Professor of Surgery, Carolinas Healthcare System Medical Director, Carolinas Simulation

Childhood ObesityChildhood Obesity

Dimitrios Stefanidis, MD, PhD, FACS, Dimitrios Stefanidis, MD, PhD, FACS, FASMBSFASMBS

Associate Professor of Surgery, Associate Professor of Surgery, Carolinas Healthcare SystemCarolinas Healthcare SystemMedical Director, Carolinas Medical Director, Carolinas

Simulation CenterSimulation Center

What is Obesity?What is Obesity?

Obesity is a condition in which Obesity is a condition in which excess body fat has accumulated in excess body fat has accumulated in the body to the extent that it may the body to the extent that it may have an adverse effect on health, have an adverse effect on health, leading to reduced life expectancy leading to reduced life expectancy and/or increased health problemsand/or increased health problems

How is Obesity How is Obesity Measured?Measured?

Body mass index (BMI)Body mass index (BMI) a measurement which compares weight a measurement which compares weight

and height, defines people as and height, defines people as overweight (pre-obese) if their BMI is overweight (pre-obese) if their BMI is between 25 and 30 kg/m2, and obese between 25 and 30 kg/m2, and obese when it is greater than 30 kg/m2when it is greater than 30 kg/m2

How Common Is It?How Common Is It? Childhood obesity has more than Childhood obesity has more than

tripled in the past 30 yearstripled in the past 30 years The percentage of children aged 6–The percentage of children aged 6–

11 years in the United States who 11 years in the United States who were obese increased from 7% in were obese increased from 7% in 1980 to nearly 20% in 2008 1980 to nearly 20% in 2008 In 2008, more than In 2008, more than one third of children one third of children and adolescents and adolescents were overweight or were overweight or obeseobese

Obesity Trends* Among U.S. Adults

BRFSS, 1990(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%



No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%



No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%



No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%



No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%



No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%



No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%



No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%



No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%



No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%



No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%



No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)


BRFSS, 2002

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%



No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%



No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%



No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%



No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%



No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%



No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%



No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

What Causes Obesity?What Causes Obesity?

What Causes Obesity?What Causes Obesity? Overweight and obesity are the result Overweight and obesity are the result

of of “caloric imbalance”“caloric imbalance”—too few —too few calories expended for the amount of calories expended for the amount of calories consumed—and are affected calories consumed—and are affected by various genetic, behavioral, and by various genetic, behavioral, and environmental factorsenvironmental factors

Risk FactorsRisk Factors Diet:Diet: Regularly eating high-calorie foods, such Regularly eating high-calorie foods, such

as fast foods, vending machine snacks, soft as fast foods, vending machine snacks, soft drinks, candy and desserts drinks, candy and desserts

Lack of exercise:Lack of exercise: Watching too much Watching too much television or playing video gamestelevision or playing video games

Family history and habitsFamily history and habits: Obese parents: Obese parents Psychological factors:Psychological factors: coping with problems coping with problems

or to deal with emotions, such as stress, or to or to deal with emotions, such as stress, or to fight boredom fight boredom

Socioeconomic factors:Socioeconomic factors: less expensive or an less expensive or an easier option than fresher, healthier foods.easier option than fresher, healthier foods.

RiskRiskFactorsFactors

Immediate Health Immediate Health Effects Effects

of Obesityof Obesity Obese children are more likely to Obese children are more likely to

have risk factors for heart disease have risk factors for heart disease such as high cholesterol and high such as high cholesterol and high blood pressureblood pressure

Obese adolescents are more likely to Obese adolescents are more likely to have prediabeteshave prediabetes

Immediate Health Immediate Health Effects Effects

of Obesityof Obesity Children are at higher riskChildren are at higher risk

bone and joint problemsbone and joint problems sleep apnea sleep apnea social social psychological problems psychological problems

stigmatization stigmatization poor self esteempoor self esteem

Long-term Effects of Long-term Effects of ObesityObesity

Children and adolescents who are Children and adolescents who are obese are likely to be obese adultsobese are likely to be obese adults

Obese adults are at risk at developingObese adults are at risk at developing diabetes diabetes heart disease heart disease strokestroke cancercancer and other problemsand other problems

PreventionPrevention Healthy lifestyle habitsHealthy lifestyle habits

Healthy eating and physical activityHealthy eating and physical activity Risk factors to be addressed:Risk factors to be addressed:

Socio-economic deprivationSocio-economic deprivation >11 hrs/week TV/videogames>11 hrs/week TV/videogames Low participation in school sportsLow participation in school sports Few interests involving active playFew interests involving active play Few siblingsFew siblings

PreventionPrevention

Treat the family as it has the most Treat the family as it has the most influence on childhood obesity (most influence on childhood obesity (most obese children have obese parents)obese children have obese parents)

Educate at schoolEducate at school Create healthy habitsCreate healthy habits Physical activityPhysical activity Healthy dietary choicesHealthy dietary choices

Prevention Prevention

Weight Loss SurgeryWeight Loss Surgery

Documents

Childhood Obesity Dimitrios Stefanidis, MD, PhD, FACS, FASMBS Associate Professor of Surgery, Carolinas Healthcare System Medical Director, Carolinas Simulation