Pathophysiology, comorbidities, and interventions associated with childhood obesity

In a recent study published in The forefront of pediatricsresearchers discuss the psychological and physiological effects of obesity on the pediatric population and intervention strategies that may help prevent problems associated with obesity.

study: Obesity in childhood and adolescence: a review. Image Credit: Africa Studios/Shutterstock.com

Background

Childhood obesity is a growing concern worldwide and has been classified as an epidemic. Research shows that obesity he can’t narrow down to one specific cause. Rather, it is the result of complex interplay between genetic, behavioral, environmental, developmental, and biological factors.

Recent studies have shown that gut microbiota, epigenetic factors, the intrauterine environment, small body size at gestational age, early protein incorporation into the infant’s diet, and reliance on formula rather than breast milk are associated with It has also been found to be associated with an increased likelihood of obesity.

A variety of concomitant problems are associated with childhood obesity, increasing the public health burden.

For example, obese children are at risk for early pubertal development, sleep disturbances, menstrual complications in girls, prediabetes, high cholesterol-related complications, metabolic syndrome, hypertension, type 2 diabetes, and non-alcoholic fatty liver disease. higher risk. Childhood obesity also causes psychological problems such as body image issues, eating disorders, anxiety, depression and low self-esteem.

Despite various behavioral, lifestyle, pharmacological, dietary, and surgical interventions in place, childhood obesity continues to have detrimental effects on the psychological and physiological health of adolescents and children.

Pathophysiology of obesity

Obesity is the result of a complex interaction between various factors at the societal and individual level, with biological, genetic, behavioral and environmental influences on the individual. Not only socioeconomic factors, but also family and community-related influences can contribute to weight gain.

The hormonal and nervous systems regulate satiety and hunger, and the hypothalamus regulates appetite under the control of various hunger-stimulating or appetite-promoting, appetite-suppressing or appetite-suppressing hormones. The stress and disruption of the sleep cycle due to the emotional upheaval associated with psychiatric disorders can dysregulate the balance of appetite-suppressing and appetite-promoting hormones, resulting in emotional eating.

Another major biological factor that may contribute to weight gain is the gut microbiota. This is similarly influenced by a variety of factors, including environment, genetics, lifestyle, diet, gestational age at birth, and infant formula use during the neonatal period and infancy. , feeding method, age of solid diet introduction, and antibiotic use. Dysbiosis, defined as an imbalance in gut microbiota ratio and diversity, can affect energy dynamics and adipogenesis.

Genetic factors for obesity can be classified as monogenic or polygenic, with the latter being more common. Single-gene factors include mutations in specific genes, such as the leptin or tyrosine kinase receptor genes, or inherited disorders such as Prader-Willi syndrome.

Polygenic factors involve interactions between the environment and genetic variants that increase an individual’s susceptibility to obesity. Behaviors that increase the risk of obesity during development include eating larger portions, consuming high-energy and processed foods, and a sedentary lifestyle with limited exercise.

complications

In children, obesity is associated with various complications such as hyperinsulinemia, leptin resistance, precocious puberty, and obstructive sleep apnea with associated neurocognitive dysfunction and behavioral abnormalities. .Non-alcoholic fatty liver disease Misalignment of the femoral head epiphysis is another comorbidity seen in obese children.

Obesity in adolescent girls causes irregular menstrual cycles and increases the risk of polycystic ovary disease. The risk of metabolic her syndrome with hypertension, central adiposity, hypertriglyceridemia, hyperglycemia, and sleep disturbances is also increased in obese adolescents.

intervention

Preventive measures include proactive guidance to children and their families about avoiding unhealthy eating habits, sedentary habits, and increasing physical activity levels. It is particularly effective in treating obesity in children between the ages of 6 and 6. A multidisciplinary approach to weight management involving psychologists, nutritionists, and physicians has also been associated with positive results.

Other interventions include pharmacological options such as orlistat, metformin, glucagon-like peptide 1 agonists, and interventions such as hydrogel technology that targets various levels of the enterohepatic axis. The role of docosahexaenoic acid (DHA), vitamin E, and probiotics in tackling obesity has also been investigated.

Bariatric surgery, including procedures such as Roux-en-Y gastric bypass, gastric banding, and laparoscopic sleeve gastrectomy, is also an effective option for severely obese children, with long-term care from mental health providers. .

Conclusion

Obesity is a complex disorder influenced by numerous biological, genetic, environmental and lifestyle-related factors. In addition to multidisciplinary approaches addressing diet, physiology, and mental health, prior guidance and family involvement in the weight loss process show promise, while pharmacological and surgical interventions are shown in cases of severe obesity. still needed.