2024-01-28 19:15:00
“How to combat overweight and obesity in children and adolescents?” This is the topic that our readers chose for the #solutions service survey of the month. This theme won with 45% of the votes, ahead of the future of ski resorts in the face of climate change and the reintegration of prisoners.
“It’s a real public health problem because these are the adults of tomorrow,” worry.
Indeed, the observation is alarming. In France, among children aged 2 to 7, one in three is overweight or obese. At the start of 2023, a study by the National Institute of Health and Medical Research (Inserm) reveals that the obesity rate among 18-24 year olds has quadrupled between 1997 and 2020, from 2.1% at 9.2%.
“In recent years, we have seen an increase in cases among adolescent girls,” Dr Gilbert Heurley
The PACA region is no exception. “Children and adolescents are affected: Around 17.5% of them are overweight, including 3.5% who are obese.“indicates the Specialized Center for Obesity Paca Est.
“In recent years, there has been an increase in cases among adolescent girls,” adds Dr Gilbert Heurley, specialist in physical medicine, rehabilitation, and coordinator of the Pomponiana Olbia Functional Rehabilitation Institute in Hyères, which notably takes care of obese children.
A worrying progression as the health risks and psychological and social consequences of this disease are significant.
Overweight, obesity… What indicators in children?
In adults, the compass is the Body Mass Index (BMI). Taking into account height and weight, this figure makes it possible to identify overweight (BMI > 25), obesity (BMI > 30) and morbid obesity (BMI > 35).
But be careful, this indicator has no meaning for children, reminds Dr Gilbert Heureley:
“There is no corpulence threshold at these ages due to variations due to growth. It is therefore the curves in the health record which prevail. When children are concerned, we do not set a target for aims to reduce weight but stabilize it. Because during adolescence, a child can gain 7-8 cm in 3 months.”
Multiple factors
Transformed diet, sedentary lifestyle, genetic predisposition, duration and quality of sleep, psychological fragilities… The factors are multiple and complex, as underlined by Doctor Véronique Nègre, pediatrician specializing in the field of overweight in Lenval and at the Nice University Hospital and coordinator of the Specialized Centers obesity (CSO) in the Paca region.
“When children are born into families that overvalue food, this predisposition can lead to overweight or obesity,” Dr. Nègre
“There are elements that predispose to being overweight. Some children are born with an appetite that is a little disproportionate to their needs. This predisposition can be genetic or epigenetic, that is to say that the expression of genes is gently modified by numerous factors such as the mother’s diet during pregnancy.”
“The father’s way of eating at the time of conception also matters. When children are born into families that overvalue nutrition, this predisposition can lead to overweight or obesity”she analyzes.
Sports doctor Dr. Heurley, however, insists: “Above all and above all, it is a sedentary lifestyle that comes into play: sitting too long, not participating in sports at school, no longer moving in the playground with friends but above all, but also screen time which is problematic.”
From 5 to 17 years old, the World Health Organization (WHO) recommends 1 hour of daily physical activity. “In fact, only a third of girls and half of boys respect these recommendations”points out Dr. Heurley.
In the management of overweight and obesity in children, physical activity is essential. Archive photo Valérie Le Parc.
What support in the Alpes-Maritimes and Var?
“In Lenval, a specialized center takes care of complex obesity in children and adolescents. And a resource team, ObEP Paca (childhood obesity and prevention in the Paca region), financed by the Regional Agency for health, coordinates actions in the territory”poses Véronique Nègre who manages the two structures.
“We try to be comprehensive to provide solutions to all situations.“Because,” she insists, “overweight and obesity are not inevitable.
“Deprivation and restrictive diets never work”, Dr Nègre and Heurley
“When we are caring for an obese child or adolescent, we first try to understand their habits: do they eat too much, snack all the time because he is unhappy because he is bullied at school. We rely on what is going well: if he rides a bike with his brother, eats vegetables, and we look at how to lift the brakes.”
There is, however, no question of diet. “Deprivation and restrictive diets never work”point out Dr. Nègre and Heurley together. “If we lose 20 kg, we gain 40 back. With the family we look for solutions, step by step, so that it gains weight less quickly and achieves a more favorable curve and a more suitable corpulence”adds the specialist from Lenval.
The key to success lies in parental involvement
But, parents still need to push the door of professionals. “Many families do not come for consultation because they are afraid of being judged for the way they raise their children and they fear having to put them on dry bread and water. However, we can act without imposing constraints on ourselves. terrible constraints”points out the pediatrician.
The key to success lies in the involvement of parents, but also in the ability to mobilize caring and competent people around them, dietitians, psychologists, teachers of adapted physical activity, etc.
Detect as early as possible
To prevent obesity and overweight, professionals insist, early detection and treatment are essential. How to do it from a young age?
“When he begins to walk and until the age of six, a child must become thinner. If this is not the case, there may be something wrong. The attending physician, in reporting weight and height on the health record curve, can see if there is a dropout”explains Michael Ybanez, adapted physical activity teacher in Lenval.
“It is important to train general practitioners, PMI professionals, pediatricians so that they identify risky situations”, Dr Nègre
Another important area for improving detection and treatment: training. An ambitious program was thus launched in the region. Since 2015, more than 1,000 professionals have participated.
“It is important to train general practitioners, PMI professionals, pediatricians so that they are alerted by signs, identify risky situations, believes Dr. Nègre. For example, if a mother is obese, gained 30 kg during pregnancy and did not breastfeed, we know that the child is at risk. We will be vigilant in supporting parents with nutrition, dietary diversification, making sure to give them reasonable quantities…”
Possible solutions
To better prevent overweight and obesity in children, initiatives and experiments exist. In conjunction with health professionals, territories are tackling the problem. As in the Nice region, in Saint-André-de-la-Roche, for example, where ambitious work has been launched on the “parenthood”.
“A young children’s educator supports parents, this is a major aspect of prevention.” At the La Trinité public health center, workshops on the first 1000 days are organized. “A care pathway is built on the scale of a priority neighborhood, it is the model of what we should be able to do elsewhere.”
In the Var, following the center closed The birdsone of the only ones in France to offer year-round schooling for obese children, the Pomponiana Olbia Functional Rehabilitation Institute has taken over for a year.
The place welcomes more than twenty children in day hospital and offers 2 full hospitalization beds. Grasse, Vence, Nice… several other structures exist. And innovative approaches are sprouting here and there nearby. We have one month to highlight them.
Share your testimony with us
Are you concerned by the issue of our investigation? Detection of your child’s overweight or obesity, treatment, positive or negative points of your care journey… Share your testimony with us. This can be done in the form below.
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