The huge kid: Children with mental stress often sneak comfort foods resulting in eating disorders

Says Pretty Lynn in her blog “I could feel my mother staring at me with such hatred and disgust before she’d remark ‘you’re so fat. I wouldn’t be surprised if you died of a heart attack before you turn 15.’ My mother still refers to my favourite clothing store as “Omar the tent maker”.”’

Lynn is among thousands of such bloggers for whom obesity in childhood is an ever-evolving adult nightmare.

Paediatric and adolescent obesity is now being recognised as a major threat to health — and it’s caused by the excess calories that we merrily tuck in. The body converts these into fat, for future usage. Not spending energy (calories) by physical activity will help generate fat tyres.

Yet the scientific truth is a little more complicated, as usual!

Hormones are now considered to be big time obesity regulators. One, known as ghrelin, tells the hypothalamus of the brain to generate hunger pangs. That explains that crazy craving for chocolate.

The hormone leptin tells the brain that it is sated. So the more the body fat, the more the leptin levels, and less the hunger, right? Then why is it that an obese person still keeps feeling hungry?

It is because fat people develop a resistance to the action of leptin, just like a diabetic develops a resistance to insulin. It has been observed that people who sleep less at night are more prone to being obese as staying awake at night increases the levels of ghrelin in the blood.

Apart from these appetite controlling hormones are our ubiquitous genes. If a genetic defect on chromosome 15 occurs, it can cause massive childhood obesity.

In this ‘Prader-Willi syndrome’, ghrelin levels are very high. Similarly, if there is a genetic defect causing deficiency of leptins, children may be a clear 45 kg overweight by the age of seven.

Interestingly, a vaccine against obesity is now under trial. This vaccine stimulates the immune system to produce antibodies against ghrelin receptors.

Mental stress of any sort can induce a compulsive consumption of ‘comfort foods’. “My mother is obsessed about my weight, and I continued to sneak food — bagels mostly, other breads, chicken noodle soup in a cup, Arizona iced tea, and any candy I could get my hands on. They bought a box of 30 ice cream sandwiches. I ate three or four a day for five or six days running,” writes Beverly a blogger in her mail.

Now that is what is called an eating disorder!

What are the options for parents?

• Diet: Restricting calories seems the logical way of reducing weight. However, in children, one has to keep their need for nutrients in mind.

A new approach is the traffic-light diet, which is used for pre-school and pre-adolescent children. The traffic-light diet groups foods into categories: green foods (go) may be consumed in unlimited quantities; yellow foods (caution) have average nutritional value for those foods; and red foods (stop) have high fat or simple carbohydrate content.

The diet has been successful in reducing the weight of obese children significantly.

• Exercise: Exercise alone does not seem to help in weight loss in this age group. It helps bolster the benefits of diet restriction.

• Surgery: Adolescent bariatric surgery happens to be suitable solution for morbidly obese children suffering from problems like snoring, high blood pressure and diabetes. The stomach is stapled to a very small pouch, to which a part of the small intestine is connected, resulting in partial digestion of ingested food, in one procedure.

In another procedure, called ‘sleeve gastrectomy’, the stomach is converted from a pouch to a long tube, by stapling 80 per cent of its volume. This operation reduces the gastric capacity to less than 100 ml as well as the secretion of ghrelin. The problem with the surgery is not the complications but the cost and the lack of awareness.

• Behavioural therapy: As obesity is considered a disorder of self-control, scientists have tied to alter the behaviour of both parent and child, with encouraging results.