Is overweight and obesity a problem among adolescents?

Yes, it is:

• Rate of overweight and obese children is rapidly increasing.
• Studies show about 15% of children 12-19 years old are overweight and 15% are obese.
• It is higher among children from poorer families.
• Excessive weight is associated with higher risk of medical problems like diabetes and heart disease which may lead to premature death.

How would you know you are overweight?

Your weight over the square of your height (kg/m2) i.e. the body mass index (BMI) is one of the ways to indirectly measure total body fat. Unlike adults the BMI values vary with your age and sex. Please refer to Table for BMI, cut – off Points for Overweight or Obesity by Sex between 9 – 18 Years to know whether you are overweight or obese. Example: If you are a boy aged 14 years old and your BMI is between 22.62 to 27.63, you are overweight. If your BMI is more than 27.63, you are obese.

How do you become overweight or obese?

You gain weight when you eat more than what your bodies burns. These extra calories are stored as fat. The amount of weight gain that leads to overweight and obesity does not happen in a few days or weeks. It is usually accumulated over months or years.

Risk Factors include:

• Your family history.
• Medical problems.
• Psychological factors including stress, anxiety and boredom.
• Socio-cultural influences and surroundings (Your eating habit).
• Environmental factors promoting a sedentary lifestyle.

How do you get detected for this problem?

• You, your friends and your parents may already be aware of the weight issue.
• Picked up at routine check-ups or health screening.
• When you go to clinic for other medical problems.
• Generally you look ‘big’ and ‘heavy’ among your friends.
• Diagnosis confirmed by measuring your weight and height and comparing with the Table for BMI cut – off Points for Overweight or Obesity by Sex between 9 – 18 Years.

Causes of you becoming overweight and obese:

• Poor eating habits e.g. over-eating or eating large amounts of oily and starchy foods.
• Low physical activity or not exercising.

What are the potential complications?

Overweight and obesity in adolescence are associated with :

• Heart related problems e.g. high blood pressure and high cholesterol.
• Diabetes.
• Psychological effects e.g. depression and low self-esteem.
• Respiratory difficulties e.g. asthma, sleep problems.
• Bone and joint complications e.g. osteoarthritis of the knees and painful hips.
• Becoming fat when you grow older.

How can you avoid being overweight?

1. You need to practise a healthy lifestyle.
   • Eat nutritious snacks such as fruits, vegetables and low fat foods.
   • Eat in moderation.
   • Lead an active lifestyle at home and school by exercising and walking more.
   • Limit your TV and video time to no more than 2 hours / day.
2. You should have your BMI calculated and plotted yearly. This can be done as part of your regular health check routine.
3. Seek advice from a doctor or nutritionist / dietician if you have problems.

What are the treatments available?

Treatment should start early. These include:

1. Nutrition
   • Pay attention to what you eat. You should at least have :
     • 5 servings of fruits and vegetables per day.
     • Whole grains with a fibre intake of 20 grams or more daily (1 slice of whole meal bread contains 2 grams of fibre).
     • Less than or equal to 30% of calories from fat.
   • To reduce your weight :
     • You must eat less by decreasing your amount of food and number of servings.
     • Eat less fried food. It is better to steam or grill your food.
     • Eat less starchy food (rice and noodles).
     • Control food intake during festivals and eating out.
     • Reduce fizzy (carbonated) and sweetened drinks.
     • Read food labels regarding calorie content.

   A dietician or nutritionist will help you with specific food and eating recommendations.

2. Physical Activity
   • Increase work of daily activities for e.g. taking stairs, parking farther away and exercising while watching TV.
   • You should do at least 10 minutes of physical activity above what is already done each day and gradually increase.
   • If you are unable to do physical activity due to any physical injuries or illnesses please seek further evaluation and specific treatment.

   A physical therapists will help you plan specific activities to achieve weight loss and long-term weight maintenance and physical fitness.

3. Changes in your habits.
   • Identify problems that may lead to increased weight gain (e.g. stress, emotional eating, boredom etc).
   • Set specific goals to decrease calorie intake and increase physical activity.
   • You should weigh yourself weekly.
   • Monitor the amount and type of food and beverages consumed and physical activity completed.
   • Get the support of family and friends.
4. Medications
   • This is generally not found to be effective.
   • Some drugs may be included by your doctor if needed.
5. Surgery
   • In very selected cases e.g. BMI>40 or presence of risk for severe complications e.g. early death, stomach resection and other surgery may be considered.
   • Specific treatments are necessary for associated complications e.g. diabetes and hypertension.

How long does one need to be treated?

• Regular follow-up is necessary for obesity and this may be life-long in many cases.
• Your doctor will monitor your BMI and manage your complications.

Who can support you to lose weight?

Your success depends on your motivations and support from:

• Your parents, family members, teachers and friends.
• Doctors, nutritionist and other health professionals.

BMI cut – off Points for Overweight or Obesity by Sex between 9 – 18 Years