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Obesity in children, time to stop turning blind eye

In the era of social media, many videos of chubby and often obese children are posted and seen as cute, healthy and perfectly normal. This mindset will lead to catastrophic health outcomes in the next 10 to 20 years. #opinion

Diadra Annisa (The Jakarta Post)
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Jakarta
Tue, July 16, 2019

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Obesity in children, time to stop turning blind eye According to the World Health Organization, half of overweight children under 5 years of age live in Asia. (Shutterstock/Sharomka)

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n the era of social media, many videos of chubby and often obese children are posted and seen as cute, healthy and perfectly normal. This mindset will lead to catastrophic health outcomes in the next 10 to 20 years.

Obesity and noncommunicable diseases (NCDs) in youth are growing concerns worldwide. According to the World Health Organization, half of overweight children under 5 years of age live in Asia. A large portion of these NCDs stems from poor eating habits and a sedentary lifestyle from early life. The Basic Health Survey (Riskesdas) in 2018 reported that 8 percent of children under 5 are overweight or obese. Although many view obesity and NCDs as diseases of “rich people”, data prove otherwise: Riskesdas 2018 shows the highest rate of overweight and obese children under 5 occur in Papua, one of the poorest provinces. Hence, obesity affects all layers of society.

The issue of pediatric obesity is not well highlighted as the country still suffers from high rates of undernutrition; as often cited, Indonesia faces the double burden of malnutrition. Our health policies do not yet focus on pediatric NCDs, reflected by a lack of obesity prevention and treatment in national health and school programs, as we are still preoccupied with decreasing stunting numbers. So how big of a problem is pediatric obesity?

Obesity is defined as excessive fat accumulation in the body. The simplest and most common way to determine if one is obese is through the body mass index (BMI). This parameter only requires height and weight measurements. For children, the BMI is plotted in reference charts, the Center for Disease Control and Prevention (CDC) 2000 or WHO 2006 curves.

Many factors contribute to early life obesity, including maternal smoking, birth weight, obesity in parents, screen time, early BMI and weight gain, and short sleep duration. Many researchers report the adverse effects of childhood obesity, such as hypertension, insulin resistance, increased blood cholesterol levels, cardiovascular diseases, sleep apnea and orthopedic problems. Pediatrician Aman Bhakti Pulungan of the University of Indonesia and Cipto Mangunkusumo General Hospital found that 38 percent of obese adolescents in Central Jakarta showed signs of insulin resistance, which can lead to type 2 diabetes melitius (DM) and other metabolic syndromes.

Cases of type 2 DM and metabolic syndromes in children are emerging throughout Indonesia, although the real number is unknown because many patients are not registered and undiagnosed.

Another major concern relating to obesity is mental health, as obese children and adolescents tend to have more psychosocial problems compared to lean peers. Negative stereotypes, low self-esteem and a negative body image may affect daily life, including academic performance. Graver psychiatric complications may include depression, anxiety and eating disorders.

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