What Does Adult Obesity Teach Us About Childhood Obesity?

Yesterday, I had the pleasure of giving presenting pediatric Grand Rounds at the University of Miami Miller School of Medicine. In my presentation, I sought to seek similarities between adult and childhood obesity.

As in adults, simply looking at ‘what’ people are doing (diet and activity behaviours) without trying to understand the ‘whys’, will always lead to simplistic solutions (eat-less-move-more). These approaches do not work in adults – there is no reason why they should be any more effective in kids.

Similarly, in adult obesity we now know that anthropometric measures (BMI, waist circumference, etc.) are rather poor predictors of actual health (or risk). In adults, we now have the Edmonton Obesity Staging System, as far as I am concerned, the new ‘gold standard’ for obesity assessment till someone comes up with a better system. Interestingly enough, my paediatric colleagues in Canada are working on defining a very similar approach to paediatric obesity, which I am sure will likely be as much welcomed by clinicians as EOSS was for adults.

Finally, with regard to treatment approaches, I remain much more optimistic about finding a ‘cure’ for childhood obesity, as within reasonable limits, a child does stand a real chance of ‘growing out of’ their excess weight. On the other hand, severely obese children, who may already weight more than would be considered normal for an adult, may find themselves in a lifelong battle as their biology now ‘defends’ their excess weight.

Judging by the subsequent discussion, I believe that my talk did strike some notes that very much appeared to resonate with my audience.

As I have said before, I do not for a minute believe that the childhood obesity problem can be dealt with in isolation, i.e. without also dealing with adult obesity.

While I fully appreciate the differences and challenges in managing obesity in kids, I do think that fundamental issues regarding environmental determinants as well as the underlying psychology and biology are probably more similar than many of us may think.

Freeman’s Village, Antigua