Management of Childhood Obesity 1st Edition by Elizabeth Poskitt, Laurel Edmunds 9780521609777 0521609771

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ISBN 10: 0521609771
ISBN 13: 9780521609777 
Author: Elizabeth Poskitt, Laurel Edmunds

Childhood obesity is one of the most serious problems facing the developed world. It is damaging to the medical and psychological well-being of the child and casts a shadow on their future health, leading to serious illness and ultimately premature death. Management of Childhood Obesity provides practical, realistic and easily implemented advice on sensitive approaches to children and their families in a very accessible form for all practitioners involved in the care of overweight children. Changes to diet and activity are reviewed in detail but also with the whole spectrum of eating within the family and community, including sedentariness and the significance of sleep in preventing overweight.

Management of Childhood Obesity 1st Table of contents:

1. Introduction

• Prevalence
• Why is overweight/obesity so prevalent today?
• Genes versus environment
• Programming
• Family history
• Socioeconomic status
• Energy balance
• Energy intakes
• Energy expenditures
• Early feeding
• Weaning
• What is being done?

2. How fat is fat? Measuring and defining overweight and obesity

• Fattening periods
• Early infancy
• Age 5-10 years: the adiposity rebound
• Males: pre-puberty
• Females: late puberty
• Methods of measuring fatness and defining obesity
• Measuring the proportion of fat in the body
• Possible primary care equipment for measuring body fatness
• Measurement of body density
• Measurement of bioelectrical impedance
• Body fat distribution and measuring fatness in specific areas
• Skinfolds
• Waist circumference
• Weight and height relationships: BMI
• Recommendations

3. Where should overweight/obese children be managed?

• Who should manage these children?
• Who should run what sort of facility?
• Where?
• How?
• Forms of management
• Individual management
• Group management
• Residential management
• Computer-based weight control advice
• Aspects common to all projects for childhood weight management
• Ambience
• Frequency of attendance
• Targets and intended outcomes
• What rates of weight loss should be targeted?
• Targets for infants and toddlers
• Recommendations

4. How do we approach the overweight/obese child and family?

• The parents’ perspective
• What rouses parental concerns about children’s weights?
• What do parents want to know?
• How to approach the children
• Giving advice
• Difficult age groups
• Preschool children
• Adolescents
• Those not interested
• Recommendations

5. The clinical assessment: what are the special points?

• Looking for underlying pathology
• Clinical examination
• Measuring and interpreting blood pressure in the overweight
• Obesity syndromes
• Prader-Willi syndrome
• Recommendations

6. What complications should we look for now and later?

• Orthopaedic problems
• Flat feet
• Blount’s disease
• Genu valgum
• Slipped upper femoral epiphysis
• Skin problems
• Acanthosis nigricans
• Cardiorespiratory complaints
• Asthma
• Sleep disordered breathing
• Obstructive sleep apnoea syndrome
• Central sleep apnoea
• Obesity hypoventilation syndrome
• Hypertension
• Hormonal and metabolic problems
• Type 2 diabetes
• Hyperlipidaemia
• Metabolic syndrome
• Polycystic ovary syndrome
• Hepatosteatosis
• Pseudotumor cerebri
• Recommendations

7. How does psychology influence management?

• Understanding the child in the family context
• Challenges to psychological robustness
• Teasing and bullying
• Self-esteem, self-worth
• School failure
• Unhappiness, isolation, and low self-esteem
• Overindulgence or “spoiling”
• Psychoses
• Eating disorders
• Depression
• Behavioural management in Prader-Willi syndrome
• Recommendations

8. Management: what do we mean by lifestyle changes?

• How much should families be involved in weight control?
• What behavioural changes should take place?
• Sleep
• Television
• Impact of computer and video games on weight control
• Environmental temperature
• Particular groups
• The young preschool child
• Food and love
• Children with disabilities
• Adolescents
• Recommendations

9. How can we reduce energy intake?

• How do we find out what overweight/obese children are eating?
• Twenty-four-hour dietary recall/typical day’s diet
• Food frequency questionnaire
• Interpreting the dietary history
• Specific actions to reduce energy intakes
• Organizing meals and snacks
• Managing hunger and boredom
• Role of low glycaemic index foods
• Managing fluid intakes
• Modifying food energy density
• Providing specific advice
• Food labelling
• Sustainability in dietary change
• School dinners
• Recommendations

10. How can we increase energy expenditure?

• What has changed?
• Urbanization
• Transport
• Security in the community
• Home environment and entertainment
• The complexity of the obesity epidemic
• Health benefits of activity
• Assessing activity levels in children
• What hinders activity in the overweight/obese?
• Strategies for increasing physical activity
• Walking
• School journey
• Vigorous activity
• Parents as role models
• Incremental change in physical activity
• Encouraging reluctant children
• Swimming
• Recommendations

11. What else can be done?

• Drugs
• Orlistat
• Sibutramine
• Metformin
• Bariatric surgery
• What operations are done?
• Complications
• Prader-Willi syndrome and surgery
• Recommendations

12. How can we sustain healthy weight management?

• Reinforcement
• Follow-up
• Incremental changes
• Signing off
• Recommendations

13. What can we do to prevent childhood overweight and obesity?

• Who is at risk?
• Prevention at home
• At-risk ages
• Weaning
• Diet
• Physical activity in young children
• Adolescents
• Schools
• Community involvement
• Role of health professionals
• Evaluation
• Recommendations

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Elizabeth Poskitt,Laurel Edmunds,Management