Diet In Obesity

Researchers have found that obesity increases the risk of developing a number of cancers,including breast,womb,and prostate cancer.Proffesor Jane wardel,the director of Cancer Research UK's health behaviour unit,said taht being overweight or obese upsets the metabolic environment and accelerates cell damage as well as the fat secreting hormones that could trigger tumours.

Labels: cancer, obesity

There are many obesity treatment strategies. What works for you may not be the best method for someone else. In this section, we will help you learn more about obesity treatment so that you can better discuss the issue with a healthcare professional

Weight Loss Strategies

A good strategy is important to help you lose weight and keep it off. A healthcare professional can help you plan out an appropriate strategy for you to determine how much weight to lose and how to lose it. A recently concluded clinical trial, the Diabetes Prevention Program, revealed how powerful lifestyle interventions can be in delaying the onset of type 2 diabetes.
Achieving Weight Loss
The National Weight Control Registry (NWCR) is a database of people who have self-reported a weight loss of 30 pounds or more and kept it off for at least a year. NWCR participants have chosen to share information about their weight loss and weight maintenance efforts. NWCR data is not a comparison study of populations that have successfully and unsuccessfully lost weight and kept it off, rather a report of successful attempts.
Participants were asked questions about how they achieved their weight loss, and the researchers who maintain the NWCR found that:
89 percent changed their diets and increased physical activity (10 percent used diet modification only and one percent used activity only).
55 percent used a formal program (like Weight Watchers) or professional assistance (dietitian, psychologist, etc.).
87.6 percent limited some type or class of food (especially high-fat and high-calorie foods).
44.2 percent limited the quantities of food they ate.
43.7 percent counted calories.
92 percent exercised at home, 40.3 percent exercised regularly with a friend, and 31.3 percent exercised regularly with a group.
Walking was the most common activity reported.
77 percent said a medical or emotional event triggered weight loss.
42.7 percent described losing weight as hard, 31.4 percent as moderately hard, and 25.7 percent as easy.
Two-thirds were overweight as children (about 46 percent indicated that they became overweight at age 11 years or younger and 25.3 percent at 12 to 18 years).
46 percent had one biological parent who was overweight, and 26.8 percent indicated that both biological parents overweight.
91 percent had tried to lose weight before.
Comparing successful weight loss attempts to previous ones, NWCR researchers found that:
81.3 percent used more exercise.
63 percent used a stricter dietary approach.
As a result of weight loss, 85 percent reported improvements in physical health, quality of life, energy level, physical mobility, general mood and self-confidence.

How Much Weight Should You Lose?
Assess Your Risk
You can do a self-assessment like the AOA's Weight Wellness Profile. The profile takes into account your weight (Body Mass Index (BMI) and waist size), lifestyle pattern (exercise, diet and smoking habits), and medical history. If you find yourself at risk for obesity and its related medical conditions, bring the results to a healthcare professional who can help you plan a treatment strategy.
Before beginning any kind of weight loss program, you should meet with your doctor who can assess your condition and determine what kind of weight loss program is appropriate for you. If you don't have a doctor, check the AOA Provider Directory. The American Society of Bariatric Physicians can also help you Locate a Physician.

Reachable Goals
Leading experts in obesity now recommend that individuals try to lose five to 10 percent of body weight. If you are overweight, losing five to 10 percent of body weight and keeping it off is a realistic goal. It helps to reduce your risk for disease and improves high blood pressure and high blood cholesterol. Once you reach this goal, you can determine if you need to lose more weight and set new goals.
Gradually reducing weight by losing one to two pounds per week is a safe and healthy strategy and may help you keep the weight off for the long-term. A combination of cutting back on the number of calories you eat and increasing exercise can help you achieve a one to two pound per week goal. In general, reducing 500 calories per day results in a 1 pound per week weight loss, and 1000 calories per day, a 2 pound per week reduction.
If you are obese or have serious health problems associated with obesity, you may need a more aggressive approach. In such cases, a doctor's supervision is necessary for safety and effectiveness.

What Treatments are Available?
There are several different types of effective treatment options including: dietary therapy, physical activity, behavior therapy, drug therapy, combined therapy and surgery. Health professionals that can assist in determining the most appropriate treatment for you include: physicians, nutritionists, exercise physiologists, psychologists and bariatric surgeons.

Dietary Therapy
Dietary therapy involves reducing the number of calories you eat and learning strategies like how to read nutrition labels and select portion sizes, which types of foods to buy, and how to prepare them.
1) How Much Should You Eat?
Knowing how many calories you eat will help you determine the amount to reduce from your current intake.
Keeping a food diary is a good starting point to determine what you eat and drink, and to calculate the total calories for an average day. Some resources on the Internet to help you do this include:
The National Heart, Lung and Blood Institute's:
Daily Food and Activity Diary
Shopping Guide
Recipes
Sample Reduced-Calorie Menus
Menu Planner
International Food Information Council's, Avoid Tipping the Scales - How to Determine Portion and Serving Sizes
The U.S. Department of Agriculture’s (USDA) Interactive Healthy Eating Index
a) Low and Very-Low Calorie Diets
These diets are designed for individuals whose health would benefit from rapid weight loss. Supervision by a healthcare professional is recommended when calorie intake is below 1000 calories per day. Some side effects such as nutritional deficiencies may occur.
Low-calorie diets are about 800 to 1,400 calories per day. If you have a BMI of 27 or more, or a BMI of 25 or more with co-morbid conditions, this diet may be appropriate for you.
Very-Low calorie diets are less than 800 calories per day. If you have a BMI of 30 or more, or a BMI of 27 or more with co-morbid conditions, this diet may be appropriate for you.
Read the National Institute for Diabetes and Digestive and Kidney Diseases' Weight-control Information Network's pamphlet on Very-Low Calorie Diets.
b) Consult your doctor, dietitian or join a reputable program for help on determining how many calories to reduce. They can follow your progress, and help you make changes as needed.
To find a dietitian or program in your area, the American Dietetic Association can help you Find a Dietitian.

2) What Should You Eat?
Reducing calories involves making sure to balance your diet with a variety of foods. The USDA's Dietary Guidelines for Americans recommends at least five servings a day of fruits and vegetables, choosing whole grains, lean meat and low-fat or non-fat dairy products.
Use the following resources to find out more about planing a healthy diet:
a) Understanding the Food Guide Pyramid and Reading Nutrition Labels:
The USDA Food Guide Pyramid serves as a guide on daily nutrition, and is based on the Dietary Guidelines for Americans.
The Nutrition Facts Panel, developed by the Food and Drug Administration (FDA), provides information about calories, portions (servings) and nutrients of packaged food and beverage products.
b) Recipes and Menus:
The USDA's Recipes and Tips for Healthy, Thrifty Meals has sample menus and nutritional information for each recipe.
c) Food Composition:
The FDA's Consumer's Guide to Fats
Fat Replacers: The FDA's Taking the Fat Out of Food
Fiber Information: The FDA's Bulking Up Fiber's Healthful Reputation
Fruits and Vegetable Information: The FDA's Eating Your Way to 5 A Day
d) Restaurants and Eating Out:
FDA article on eating out, Today's Special: Nutrition Information
Fast Food Nutritional Information from Wake Forest University Baptist Medical Center
e) Fad Diets
International Food Information Council's Fad Diets: Look Before You Leap.

Physical Activity
Americans are less active today than ever before, which contributes to the high rate of overweight and obesity. One reason for the increase of inactivity is that our environment offers many more conveniences than ever before, such as elevators and escalators and remote controls. There are also more people driving cars instead of walking, and a decrease of manual labor in the workforce.
Daily activity (exercise or lifestyle) is important for weight loss, maintenance of weight loss and general good health. The U.S. Surgeon General recommends moderate physical activity on most days of the week of at least 30 minutes per day for adults and 60 minutes per day for children. However, this level is not necessarily sufficient for weight loss.
Read the Surgeon General's Report on Physical Activity and Health.
If you are obese or severely obese, you may find it difficult to begin an exercise program. You may find it intimidating or too strenuous. The Weight-control Information Network's pamphlet, Active at Any Size offers tips to help you get started.
Tips to making physical activity a daily routine:
Let your doctor know if you are starting a new or strenuous exercise routine to make sure that it's safe for you.
Begin your routine slowly. Gradually increase intensity.
Select exercise activities that you enjoy and that can be scheduled into a regular routine.
Add lifestyle activity every chance you get, like taking stairs instead of using elevators or parking farther away from a store entrance than you normally do.
1) Calories In / Calories Out: What is Basal Metabolic Rate?
Basal Metabolic Rate (BMR) is the amount of energy (calories) that you need to live in a state of rest (completely without any type of activity). Getting an estimate of your BMR and adding it to the calories you use from exercise and daily activities can give you an idea of the total number of calories you expend in a day. This is sometimes known as "Calories Out." Knowing this can help you determine if you are keeping a balance with your "Calories In," which is the amount of calories you eat and drink.
Find out more about BMR and find a BMR calculator at Cornell University's Sports Nutrition website. Note: There are several formulas for calculating BMR. Results should be taken as a range of plus (+) or minus (-) 10 percent.
Use the physical activity calculator on the National Association for Health and Fitness website to find out how many calories you would expend for various activities.
Use the National Heart, Lung and Blood Institute's Daily Food and Activity Diary to estimate your "calories in" and to log your "calories out" from exercise.
Behavior Therapy
Behavior therapy involves changing diet and physical activity patterns to new behaviors that promote weight control.
Behavioral therapy strategies for weight loss and maintenance include:
Recording diet and exercise patterns in a diary.
Identifying high-risk situations (such as having high-calorie foods in the house), and consciously avoiding them.
Rewarding specific actions, such as exercising for a longer time or eating less of a certain type of food.
Changing unrealistic goals and false beliefs about weight loss and body image to realistic and positive ones.
Developing a social support network (family, friends or colleagues) or joining a support group that can encourage weight loss in a positive and motivating manner.

Drug Therapy
If you have a Body Mass Index (BMI) of 30 or more with no obesity-related conditions or a BMI of 27 to 29.9 and two or more obesity-related conditions, ask your doctor about drug treatment for weight loss and weight maintenance. Drugs for treating obesity have had a bad track record. Amphetamines and the fen-phen combination produced serious side effects and were discontinued. However, the products on the market now have good safety records, and studies have shown them to be effective. But no products are 'magic bullets." Patients taking drugs still need to work on their diets and physical activity.
Drug treatment should be used in combination with a healthy diet and physical activity. Your doctor may also suggest a combination of behavior therapy and drug therapy, which may improve your treatment outcome. Regularly follow-up visits to your doctor are recommended to monitor progress and to maintain safety of the drug's use.
Weight loss drugs approved by the U.S. Food and Drug Administration (FDA) for treating obesity include: Orlistat (Xenical), Phentermine, and Sibutramine (Meridia).
Orlistat (known as Xenical) works by blocking about 30% of dietary fat from being absorbed, and is the most recently approved weight loss drug.
Phentermine (a generic drug) is an appetite suppressant that has been available for many years. It is half of the "fen-phen" combination that remains available for use. The use of phentermine alone has not been associated with the adverse health effects of the fenfluramine-phentermine combination.
Sibutramine (known as Meridia) is an appetite suppressant approved for long-term use.
For more information, read the Weight-control Information Network's, Prescription Medications for the Treatment of Obesity.
Surgery
Obesity surgery is recommended as a treatment option for persons with obesity that have: 1) a BMI > 40 or 2) a BMI of 35 to 39.9 with serious medical conditions. In 1991, the National Institutes of Health published a consensus statement on Gastrointestinal Surgery for Severe Obesity. It cited studies showing that following bariatric surgery, most patients lost weight rapidly and continued to do so for 18 to 24 months. Patients may lose up to 50 percent of their excess weight in the first six months and 77 percent of excess weight in one year. Patient were able to maintain 50 to 60 percent of their weight loss 10 to 14 years after surgery.
Surgery is a well-established method for long-term weight control for persons with severe obesity. Much progress has been made to develop safer and more effective procedures used in obesity surgery today.
Before surgery, patients should be informed about the risks and benefits.
Patients should be motivated and committed to making a lifestyle change after surgery.
A medical team, including behavioral and nutritional professionals, should be part of a life-long follow-up plan.

Dietary Supplements and Liposuction
Anyone who has been to a drug store recently or who has picked up a newspaper has seen dozens of advertisements for weight loss products. Many good products have gotten lumped in with worthless products. Items like Slim-Fast and other pre-packaged meals that are nutritionally balanced do help with letting you know exactly how many calories one is consuming. Other products that promise quick, pain-less weight loss are of dubious help. None have sufficient clinical data to be included in the treatment guidelines established by the National Institutes of Health (NIH), the AOA / Shape Up America! guidelines or other reputable statements.
Liposuction involves the removal of fat in one location and the amount of fat is usually too little for serious weight loss. Therefore, liposuction is not recommended for weight loss.

source- American Obesity Association

Healthy Habits

Labels: weightloss

Healthy low-calorie and low-fat diets as well as high levels of physical activity are the foundation for success, according to the researchers who maintain the National Weight Control Registry (NWCR), a database of people who have self-reported successful weight loss and maintenance of weight loss.
Although the criteria for entry into the NWCR is the achievement and maintenance of weight loss of 30 pounds or more for at least one year, the average NWCR participant has lost about 60 pounds and kept it off for about five years.
When participants were asked questions about how they maintained their weight loss, the NWCR researchers found that:
92 percent limited their intake of certain foods (one example: eating at fast food restaurants less than once a week).
They consumed an average of 1400 calories per day, of which 24 percent of calories was from fat, 19 percent protein, and 56 percent carbohydrates.
They ate five times a day, on average.
They burned an average of 2,800 calories a week through exercise (an equivalent of about 400 calories day).
75 percent weighed themselves regularly - at least once a week.
About one-third described weight maintenance as hard, one-third as moderately easy, and one-third as easy.
42 percent reported that maintaining their weight loss was less difficult than initially losing the weight.
Approximately 80 percent of NWCR respondents are women, 97 percent are white, and 54 percent have an undergraduate or graduate degree.

Source- American Obesity Association

Obesity in children and adolescents is a serious issue with many health and social consequences that often continue into adulthood. Implementing prevention programs and getting a better understanding of treatment for youngsters is important to controlling the obesity epidemic.
Many parents are rightly concerned about their child's weight and how it affects them. They look for specific answers for prevention and treatment options. Unfortunately, the state of the science is a lot less precise than we would like. Are kids too concerned about their weight? What are the best strategies for prevention? What treatments work over a long time? Researchers are trying to answer those and many other questions. In many cases, common sense works well.
In situations where there are serious health, psychological or social problems, parents should seek out the best possible advice.
Note: The term "childhood obesity" may refer to both children and adolescents. In general, we use the word, "children" to refer to 6 to 11 years of age, and "adolescents" to 12 to 17 years of age. If otherwise, and when possible, we will use a specific age or age range.

Prevalence and Identification

About 15.5 percent of adolescents (ages 12 to 19) and 15.3 percent of children (ages 6 to 11) are obese. The increase in obesity among American youth over the past two decades is dramatic, as shown in the tables below.

Table 1. Prevalence of Obese Children (Ages 6 to 11) at the 95th percentile of Body Mass Index (BMI)
1999 to 2000
15.3%
1988 to 1994
11%
1976 to 1980
7%

Table 2. Prevalence of Obese Adolescents(Ages 12 to 19) at the95th percentile of Body Mass Index (BMI)
1999 to 2000
15.5%
1988 to 1994
11%
1976 to 1980
5%
A measurement called percentile of Body Mass Index (BMI) is used to identify overweight and obesity in children and adolescents. The Centers for Disease Control (CDC), the supplier of national growth charts and prevalence data, avoids using the word "obesity" for children and adolescents. Instead, they suggest two levels of overweight: 1) the 85th percentile, an "at risk" level, and 2) the 95th percentile, the more severe level.
The American Obesity Association uses the 85th percentile of BMI as a reference point for overweight and the 95th percentile for obesity.
We do so, because the 95th percentile:
corresponds to a BMI of 30, which is the marker for obesity in adults. The 85th percentile corresponds to the overweight reference point for adults, which is a BMI of 25.
is recommended as a marker for children and adolescents to have an in-depth medical assessment.
identifies children that are very likely to have obesity persist into adulthood.
is associated with elevated blood pressure and lipids in older adolescents, and increases their risk of diseases.
is a criteria for more aggressive treatment.
is a criteria in clinical research trials of childhood obesity treatments. Growth Charts - Identifying Obesity in Your Child
Parents and healthcare professionals in the U.S. have used growth charts since the late 1970's to follow the progress in physical growth of infants, children and adolescents. In May 2001, the CDC developed new growth charts to include BMI.

Causes

There are many factors that contribute to causing child and adolescent obesity - some are modifiable and others are not.
Modifiable causes include:
Physical Activity - Lack of regular exercise.
Sedentary behavior - High frequency of television viewing, computer usage, and similar behavior that takes up time that can be used for physical activity.
Socioeconomic Status - Low family incomes and non-working parents.
Eating Habits - Over-consumption of high-calorie foods. Some eating patterns that have been associated with this behavior are eating when not hungry, eating while watching TV or doing homework.
Environment - Some factors are over-exposure to advertising of foods that promote high-calorie foods and lack of recreational facilities. Non-changeable causes include:
Genetics - Greater risk of obesity has been found in children of obese and overweight parents.

Prevention

Teaching healthy behaviors at a young age is important since change becomes more difficult with age. Behaviors involving physical activity and nutrition are the cornerstone of preventing obesity in children and adolescents. Families and schools are the two most critical links in providing the foundation for those behaviors.
FamiliesParents are the most important role models for children. Results from an American Obesity Association survey show that:
The majority of parents in the U.S. (78 percent) believe that physical education or recess should not be reduced or replaced with academic classes.
Almost 30 percent of parents said that they are "somewhat" or "very" concerned about their children's weight.
12 percent of parents considered their child overweight.
Comparing their own childhood health habits to their children's, 27 percent of parents said their children eat less nutritiously, and 24 percent said their children are less physically active.
35 percent of parents rated their children's school programs for teaching good patterns of eating and physical activity to prevent obesity as "poor," "non-existent," or "don't know."
Among six choices of what they believed to be the greatest risk to their children's long-term health and quality of life, 5.6 percent of parents chose "being overweight or obese." More parents selected other choices as the greatest risk: alcohol (6.1 percent), sexually transmitted disease (10 percent), smoking (13.3 percent), violence (20.3 percent), and illegal drugs (24 percent).
In terms of their own behavior, 61 percent of parents said that it would be either "not very difficult" or "not at all difficult" to change their eating and/or physical activity patterns if it would help prevent obesity in any of their children. The AOA's survey results indicate that parents understand the importance of regular physical education for their children. Their unfamiliarity or inadequate rating of their children's school obesity prevention program is likely due to the lack of programs across the nation.
Parents appear to underestimate the health risk of excess weight to their children, and the difficulty in achieving and maintaining behavioral changes associated with obesity prevention. Additional studies are needed to develop appropriate public health programs to better educate parents in identifying and understanding changes in their children's weight, to incorporate the family in prevention efforts, and to improve school-based obesity prevention programs that include increasing physical education classes.
Here are some ways that parents can establish a lifetime of healthy habits for their family:
Create an Active Environment:
Make time for the entire family to participate in regular physical activities that everyone enjoys. Try walking, bicycling or rollerblading.
Plan special active family-outings such as a hiking or ski trip.
Start an active neighborhood program. Join together with other families for group activities like touch-football, basketball, tag or hide-and-seek.
Assign active chores to every family member such as vacuuming, washing the car or mowing the lawn. Rotate the schedule of chores to avoid boredom from routine.
Enroll your child in a structured activity that he or she enjoys, such as tennis, gymnastics, martial arts, etc.
Instill an interest in your child to try a new sport by joining a team at school or in your community.
Limit the amount of TV watching.
Create a Healthy Eating Environment:
Implement the same healthy diet (rich in fruits, vegetables and grains) for your entire family, not just for select individuals.
Plan times when you prepare foods together. Children enjoy participating and can learn about healthy cooking and food preparation.
Eat meals together at the dinner table at regular times.
Avoid rushing to finish meals. Eating too quickly does not allow enough time to digest and to feel a sense of fullness.
Avoid other activities during mealtimes such as watching TV.
Avoid foods that are high in calories, fat or sugar.
Have snack foods available that are low-calorie and nutritious. Fruit, vegetables and yogurt are some examples.
Avoid serving portions that are too large.
Avoid forcing your child to eat if he/she is not hungry. If your child shows atypical signs of not eating, consult a healthcare professional.
Limit the frequency of fast-food eating to no more than once per week.
Avoid using food as a reward or the lack of food as punishment.
Schools
Outside of the home, children and adolescents spend the majority of their time in school. So, it makes sense that schools provide an environment that promotes healthy nutrition and physical activity habits. Only a few creative programs are being tested in schools across the country.
Overweight and Obesity
Results of a 1999 national survey showed that 16 percent of high school students were overweight (Body Mass Index (BMI) greater than the 85th percentile and below the 95th percentile) and nearly 10 percent were obese (BMI more than or equal to the 95th percentile). Self-reported height and weight was used. The survey, called the Youth Risk Behavioral Surveillance System (YRBSS), is conducted by the Centers for Disease Control and Prevention (CDC), and uses a nationally representative sample of students in grades 9 to 12.
Here are more results from the 1999 YRBSS:
More male students (17 percent) were overweight than female students (14 percent), and obese (12 percent of males and 8 percent of females).
More black students (22 percent) were overweight than white students (14 percent).
More black and Hispanic female students (23 and 18 percent, respectively) were overweight than white female students (12 percent).
Self-Perception of Weight
When asked to describe their weight, 30 percent of students thought of themselves as overweight.
More female students (36 percent) than male students (24 percent) considered themselves overweight.
More Hispanic students (37 percent) than white and black students (29 and 25 percent, respectively) considered themselves overweight.
Weight Loss Attempts
43 percent of students reported that they were trying to lose weight.
More female students (59 percent) than male students (26 percent) reported that they were trying to lose weight.
More Hispanic students (51 percent) reported that they were trying to lose weight than white students (43 percent) and black students (36 percent).
Methods of Weight Loss:
Exercise
More than half (58 percent) of students reported the use of exercise (during the 30 days before the survey) to lose weight or to avoid gaining weight.
More female students (67 percent) reported the use of exercise for weight loss or maintenance than male students (49 percent). More white female students (70 percent) reported the use of exercise for weight loss or maintenance than black female students (59 percent).
Change of Eating Behaviors
40 percent of students reported that they ate less food, fewer calories, or foods low in fat (during the 30 days before the survey) to lose weight or to avoid gaining weight.
More female students (56 percent) reported that they ate less food, fewer calories, or foods low in fat than male students (25 percent) to lose weight or to avoid gaining weight.
More white students (42 percent) reported that they ate less food, fewer calories, or foods low in fat than black students (34 percent) to lose weight or to avoid gaining weight.
More white female students (60 percent) reported that they ate less food, fewer calories, or foods low in fat than Hispanic female students (51 percent) and black female students (43 percent) to lose weight or to avoid gaining weight.
Fasting
13 percent of students reported fasting ("without eating for 24 hours or more" ) to lose weight or to avoid gaining weight.
More female students (19 percent) reported fasting than male students (6 percent) to lose weight or to avoid gaining weight
Use of Dietary Supplements
8 percent of students reported taking diet pills, powders, or liquids without a doctor's advice to lose weight or to avoid gaining weight.
More female students (11 percent) reported taking diet pills, powders, or liquids without a doctor's advice than male students (4 percent) to lose weight or to avoid gaining weight.
More white female students (12 percent) reported taking diet pills, powders, or liquids without a doctor's advice than black female students (6.9 percent) to lose weight or to avoid gaining weight.
Purging / Laxative Use
5 percent of students reported vomiting or taking laxatives to lose weight or to avoid gaining weight.
More female students (7 percent) reported vomiting or taking laxatives than male students (2 percent) to lose weight or to avoid gaining weight

Health Risks, Diagnosis and Treatment

Determining if a child or adolescent has a weight problem can be challenging. How do you know if the excess weight your child has is part of the natural growth process, and will your child just "grow out of?" How do you know if your child's weight may be negatively affecting his or her health?
Health Risks
Along with the rise in childhood obesity, there has been an increase in the incidence and prevalence of medical conditions in children and adolescents that had been rare in the past. Pediatricians and childhood obesity researchers are reporting more frequent cases of obesity-related diseases such as type 2 diabetes, asthma and hypertension that once were considered adult conditions.
Read more about obesity-related health risks for children and adolescents in the AOA Fact Sheet, Obesity in Youth.
Read about the relationship of obesity and type 2 diabetes in children at the CDC's Children and Diabetes web page.
DiagnosisThere are some signs that may help you determine if your child has or is at risk for childhood obesity, such as:
Family history of obesity.
Family history of obesity-related health risks such as early cardiovascular disease, high cholesterol, high blood pressure levels, type 2 diabetes.
Family history of cigarette smoking and sedentary behaviors.
Signs in the child of obesity-related health risks from a pediatrician's evaluation including:
Cardiac Risk Factors. Studies of children with obesity show higher than average blood pressure, heart rate and cardiac output when compared to children without obesity.
Type 2 Diabetes Risk Factors. This involves glucose intolerance and insulin levels that are higher than average.
Orthopedic Problems. Some symptoms include weight stress in the joints of the lower limbs, tibial torsion and bowed legs, and slipped capital femoral epiphysis (especially in boys).
Skin disorders. Some are heat rash, intertrigo, monilial dermatitis and acanthosis nigricans.
Psychological / Psychiatric Issues. Poor self-esteem, negative self-image, depression, and withdrawal from peers have been associated with obesity.
Patterns of sedentary behavior (such as too much television viewing) and low physical activity levels.
Taller height - children with obesity are often above the 50th percentile in height.
Smoking initiation. Research studies show that youngsters use smoking as a method of weight control. Parents, pediatricians and schools should work together to discourage smoking as a weight control behavior for three main reasons: a) smoking is not likely to be successful in controlling weight, b) smoking is itself harmful, and c) smoking is associated with a decrease in sound nutrition and physical activity patterns.
Read the abstract about this study. Smoking and weight loss attempts in overweight and normal-weight adolescents. Strauss RS, Mir HM.
Read the abstract about this study. Weight concerns, weight control behaviors, and smoking initiation. Tomeo CA, Field AE, Berkey CS, Colditz GA, Frazier AL.
Treatment
An important part of treating obesity among children and adolescents is for parents and healthcare professionals to be sensitive to the youngsters and focus on the positive. Small and achievable weight loss goals should be set to avoid discouragement and to allow for the normal growth process.
Involvement of the entire family is also a motivating factor. Weight control programs that involve both parents and the child have shown improvement in long-term effectiveness compared to directing the program only to the child.
There are some structured weight loss programs such as Weight Watchers and Jenny Craig that allow older children and adolescents to participate with parental and medical permission.
Once the need for obesity treatment has been identified, your medical professional may suggest one or more options.
Read Obesity Evaluation and Treatment: Expert Committee Recommendations, guidelines established for healthcare professionals by a committee of pediatric obesity experts brought together by The Maternal and Child Health Bureau, Health Resources and Services Administration, the Department of Health and Human Services.
1. Dietary TherapyAccording to the U.S. Department of Agriculture (USDA), there is a steady decline in the diet quality of children and adolescents as they get older.
Consultation with a dietitian / nutritionist that specializes in children's needs is often a valuable part of obesity treatment. Nutrition consultants can outline specific and appropriate nutritional needs for healthy growth.
As with adults, a nutrition consultant may or may not recommend reducing the number of calories the child eats and implementing strategies like learning to read nutrition labels and the food guide pyramid, selecting proper portion sizes, and prepared foods. Some eating behaviors that nutrition consultants typically encourage include taking smaller bites, chewing food longer, and to avoid eating too quickly by putting the utensil down between bites.
2. Physical ActivityThe U.S. Surgeon General recommends moderate physical activity for children every day for at least 60 minutes. If a child is unable to meet that goal, than an individualized program should be designed according to fitness level, using the general guideline as an ultimate goal.
3. Behavior Therapy Behavior therapy involves changes in diet and physical activity habits to one that promote a healthy weight. Some behavioral therapy strategies for children and adolescents should include parent and family involvement.
Some behavioral therapy strategies for children are to:
Record diet and exercise patterns in a diary to keep track of types and amount of foods eaten and exercise performed as well as the location and time that foods are eaten and exercise takes place. The diary useful to determine any problem areas in eating and exercise behavior.
Use the National Heart, Lung and Blood Institute's Daily Food and Activity Diary.
Identify high-risk situations (such as having too many high-calorie foods in the house), and consciously avoid them. Watching TV during meal times is another high-risk situation that encourages eating every time the TV is on.
Reward specific positive actions. Examples of such actions include meeting an exercise duration goal or eating less of a certain type of food.
Rewards for achieving goals can be decided by children and parents together, and should revolve around something that encourages positive behavior. For example, giving sporting equipment as a reward may encourage more physically active behavior.
Avoid using food as a reward, especially high-calories foods. Making them a reward may only make them more desirable. Parents and health professionals should regularly use verbal praise.
Change unrealistic goals and false beliefs about weight loss and body image to realistic and positive ones.
The family can work as a team to set weekly activity goals. Making a contract and having every family member sign it encourages commitment to a goal. Parents can also help a child adopt or maintain a positive attitude about new behaviors in addition to helping the child cope with any negative remarks from peers.
Develop a social support network (family, friends or neighbors) that can encourage weight loss in a positive and motivating manner.
4. Drug TreatmentThe U.S. Food and Drug Administration has not yet approved the use of any drugs to treat obesity in children. However, clinical trials are under way.
5. SurgerySurgical procedures such as gastric bypass have been performed successfully on adolescents. However surgery for adolescents is usually considered only when severe medical conditions are present that can improve with the surgery.

Source:American Obesity Association

Obesity:
Obesity is a condition in which there is generalized accumulation of excess fat in the body causing more than 20% of increase in the desirable body weight.

Meal Pattern/Management :
*Small frequent meals of normal consistency and palatibility should be consumed.
*Inclusion of whole cereals,legumes and pulses increases the fiber content in diet, which provides bulk to the food but has low calorific value.
*It is a better idea to have small meals at regular intervals as fewer calories are burnt immediately without being deposited in the body as fats.
On the contrary, large meals supply more calories at a time which are not used immedietly by the body and hence gets deposited as fats.
*Eating without hunger or eating when too hungry should be avoided since both conditions increases food intake.
*Eating speed should be maintained slow as this regulates the food intake and gives higher satisfaction.
*The urge to nibble snacks in-between meals is to be curbed!!

Free foods :
Foods that can be consumed frely include-
*Green leafy vegetables.
*Lean meat, fish, poultry (in moderation!!).
*Artificial sweetners.
*Tea/coffee(unsweetened).
*Thin plain soups.
*Other vegetables.
*Fruits - water melon, orange, pear.
*Skimmed milk.

Restricted foods :
Can be consumed but in limited quantity only or once a forthnight.
*Cereals
*Pulses
*Radish, Turnip, Onion, Carrots.
*Potato, Yam, Sweet potato.
*Fruits - Banana, Chickoo, Custard apple, Mango, Grapes, Dates.
*Dry fruits.
*Fats and oils.
*Fatty fish.
*Egg white.
*Jaggery is preferable to sugar.
*Fruit Juices.

Foods to be avoided :
*Sugar
*Nuts
*Oil seeds
*Thick creamed soups
*Butter, ghee, mayonnaise.
*Desserts
*Cheese
*Cottage cheese (paneer)
*Whole milk/full cream milk.
*Egg yellow
*Carbonated bevrages, alcohol, malted drinks.