Teen and Childhood Obesity

Americans are increasingly becoming worried about weight and weight related health problems in of our kids, teenagers, and adults alike. Obesity is becoming more and more common and seems to be spreading much like an epidemic, with more children becoming extremely morbidly obese than ever before. While dietary and behavioral approaches represent the first line of treatment for childhood obesity, bariatric or weight loss surgery is increasingly being considered as an appropriate option for the treatment of teens and even a few children in pre-teen years when they have obesity-related health and quality of life problems. This trend is largely due to the better understanding that we have about surgery. Also, doctors and patients realize lifestyle changes and dieting are fairly ineffective for those with extreme obesity. Furthermore, weight loss surgery is being seen by parents, pediatricians, and even government officials as a beneficial and generally safe way to help younger patients with severe obesity.

In the Childhood and Teen Obesity Forum, we would like to provide information for those parents, children and teens who are concerned about extreme childhood obesity and the health problems they may be facing. The weight loss surgery field is ever changing, and improving in safety and effectiveness. In some cases it is entirely appropriate today to consider invasive treatments for pediatric obesity which would not have been proposed in years gone by.

What is morbid or extreme pediatric obesity?
Morbid or extreme obesity is no longer a disease seen only in adults. Extreme obesity is increasingly affecting children as well. A single BMI measure does not accurately define obesity in children and adolescents since height increases during the pre-teenage and into the mid-teenage years. Instead, BMI is indexed to age and presented as a percentile to determine obesity in children and adolescents. A BMI for age ≥ 95th percentile indicates obesity in pediatric populations while a BMI for age ≥ 99th percentile is deemed “extreme” or morbid obesity; this percentile curve tracks toward BMI values of 35-40 kg/m2 in young adulthood. Four percent of all children and adolescents are considered extremely obese when using this definition, which is interesting, as extreme obesity similarly prevalent in adults. More striking is the fact that nearly 60% of the extremely obese children in the United States have two cardiovascular risk factors. When these same children reach their 30s, their BMI will often average around 43 kg/m2. Bottom line, extreme childhood obesity is directly linked to health problems during childhood and leads to extreme obesity in adulthood.

How did this happen?
Simple answer: Energy in (consumed/ingested) must equal energy out. The more thorough answer however, is far more interesting. During periods of famine our early ancestors depended on formidable physiologic processes to inhibit weight loss. Storing excess fat is one of these protective mechanisms utilized when food was scarce. Now that food production processes have been developed, most industrialized countries do not have the same food scarcity problems our ancestors once had. These same manufacturing processes that have increased food shelf life and increased the amount of food available to us, also remove healthy nutrients such as fiber and leave the tasty salts, sugars, and fats in place. To summarize, with less physical activity required in everyday life due to technological advances and food shortages no longer an issue, energy imbalances accumulate day after day.

Is obesity really a major problem for children?
Obesity is associated with numerous and significant health problems; this also applies to childhood and adolescent obesity. Childhood and adolescent obesity has been associated with a number of significant health problems. This condition significantly increases the risk of hypertension, hypercholesterolemia, hypertriglyceridemia, hyperinsulinemia, and atherosclerosis. Type 2 diabetes mellitus is also becoming more prevalent in adolescents, especially among obese adolescence.The incidence of Type 2 diabetes in children has grown ten fold over recent decades where one third of toddlers are expected to be affected by this condition at some point in their lives. Metabolic syndrome also becomes a concern as 33-50% of obese adolescents have been identified as having metabolic syndrome.

Obstructive sleep apnea syndrome occurs more frequently in obese children and has serious adverse effects on daytime learning and quality of life. More than 50% of all teens seeking bariatric surgery have this condition. Obese children also are at increased risk of pseudotumor cerebri, skeletal complications, and polycystic ovary syndrome. Risk of gynecologic and gastrointestinal malignancies also has been closely linked to obesity, specifically to BMI during the teen years. Non-alcoholic steatohepatitis also occurs in obese youth and may eventually prove to be an important cause of end-stage liver disease for young adults who were obese children.

Obese adolescents are more stigmatized by peers and cite fewer friendships when compared to adolescents without a weight problem. Obesity young adults is associated with higher high school dropout rates, lower rates of satisfaction with life, and lower rates of marriage and later family income.

Obesity confers at least a 2-fold elevation in mortality risk during a 30-year period of follow-up. Racial differences in the risk of premature mortality also has been identified, with black men and women losing over 20 years and 5 years respectively, and white men and women losing 13 years and 8 years respectively as a result of extreme obesity in young adult years.

This information has been provided by Dr. Thomas Inge, Surgical Director of the Surgical Weight Loss Program for Teens at Cincinnati Children’s Hospital Medical Center, a national leader in the pediatric weight loss surgery field. Dr. Inge also serves as the chairman of Teen-LABS, the largest scientific study to date designed to learn more about the risks and benefits of surgery for teenage obesity. Click here to learn more about this study.

Text scams warning to youngsters

Mobile phone users can turn to a new service to check suspicious texts
Thousands of young people have been sent fake scam text messages by the Office of Fair Trading (OFT) to warn them about con-artists.

The campaign saw 25,000 mobile phone users aged between 18 and 24 receive a message telling them they might have won £1,000 in cash.But a second message arrived soon after informing them that the message was a fake and warning them about scams.The OFT estimates that 6% of scam victims are aged between 16 and 24.The Information Commissioner's Office provided the OFT with numbers of 25,000 young people who have opted to receive marketing text messages.

We hope that our innovative approach of sending fake scam text messages will remind young consumers to be on their guard if they receive a suspicious offer Mike Haley, Office of Fair TradingAs part of the OFT's Scams Awareness Month campaign, it sent texts to all these numbers on Friday.The text reads: "Urgent! U may have won £1k cash with '2 Good 2 B True'."A second text followed shortly afterwards that made clear that there was in fact no prize, and that it was simply a warning about scams.

New serviceThe message also highlighted SMSus, a new text message service from PhonepayPlus, the body which regulates services bought by phone. This allows users to text details (to 76787) of a premium rate number or shortcode they are suspicious about.An automatic reply lists the cost of the number, details of the service provider, how to contact them and how to complain if necessary.

The service is free for most people, but will cost no more than 12p.Mike Haley, director of consumer protection at the OFT, said: "Young people can fall for exactly the same types of scam as anyone else, often delivered through the latest technology."We hope that our innovative approach of sending fake scam text messages will remind young consumers to be on their guard if they receive a suspicious offer.

"Trays O'Reilly, director of standards and communications at PhonepayPlus, said: "More and more people are using mobile phones to pay for a range of products and services and in most instances this happens without problems."Our job is to crack down on scams and other misbehaviour when it occurs so that everyone can use phone-paid services with confidence."According to the Mobile Data Association, 95% of 16 to 24-year-olds use text messaging regularly, each sending an average of 100 texts per month.

Black failure in school ? who's to blame?
Posted: July 05, 2006
1:00 am Eastern© 2008 Creators Syndicate Inc.

Let's look at the recent "Nation's Report Card," published annually by the U.S. Department of Education's National Center for Education Statistics. Nationally, in reading, only 13 percent of black fourth-graders and 11 percent of black eighth-graders score as proficient. Twenty-nine percent of black fourth-graders achieve a score of "basic," which is defined as having a partial knowledge and skills necessary to be proficient in the grade. Fifty-nine percent score below basic, not having any of the necessary knowledge and skills. It's the same story for black eighth-graders, with 40 percent scoring basic and 49 percent below basic.

In math, it's roughly the same story. For black fourth-graders, 12 percent score proficient, 47 percent score basic and 40 percent below basic. For black eighth-graders, 8 percent score proficient, while 33 percent score basic and 59 percent score below basic; however, 1 percent of black fourth-graders and eighth-graders achieved an advanced score in math.

Teachers and politicians respond to this tragic state of affairs by saying that more money is needed. The Washington, D.C., school budget is about the nation's highest at around $15,000 per pupil. Its student/teacher ratio, at 15.2 to 1, is lower than the nation's average.

Despite this, black academic achievement in Washington, D.C., is the lowest in the nation. Reading scores for Washington, D.C.'s fourth-grade black students are: 7 percent proficient, 21 percent basic and 71 percent below basic. For eighth-graders, it's 6 percent proficient, 33 percent basic and 58 percent below basic. It's the same sad tale in math. For fourth-graders, it's 5 percent proficient, 35 percent basic and 59 percent below basic. For eighth-graders, it's 3 percent proficient, 23 percent basic and 73 percent below basic. With these achievement levels, one shouldn't be surprised that the average black high-school graduate, depending upon the subject, has the academic achievement level of the average white sixth, seventh or eighth-grader.

Racial discrimination has nothing to do with what's no less than an education meltdown within the black community. Where black education is the very worst, often the city mayor is black, the city council is dominated by blacks, and often the school superintendent is black, as well as most of the principals and teachers ? and Democrats have run the cities for decades. I'm not saying there's a causal connection, just that one would be hard put to chalk up the rotten education to racial discrimination.

There's enough blame for this sorry state of affairs for all participants to have their share: students who are hostile and alien to the education process, parents who don't care, teachers who are incompetent or have been beaten down by the system, and administrators who sanction unwarranted promotions and issuance of fraudulent diplomas that attest that a student has mastered 12th-grade material when in fact he hasn't mastered sixth- or seventh-grade material.

No one can solve the educational problems that black people confront except black people themselves. First, it's foolhardy, and black people cannot afford to buy into the idea, that no black child should be saved from the education morass until all black children can be saved. That means we must find a way to permit the escape from rotten schools for as many black children who want to be educated and have supportive parents as we can. Educational vouchers or tuition tax credits would provide such a mechanism.

At one time in black history, there was a high value placed on education, so much so that blacks risked punishment to acquire education in areas of our country where black education was prohibited. Being 70 years old, I know there was a time when schools and black parents cooperated with one another to see to it that children behaved in school and did their work. In principle, the solution to black education problems is not rocket science. The problem is summoning the will.

Are you the parent of a student athlete? If you are, your life is probably as hectic as your child's. But in your daily rounds of carpools, practices and games, have you taken the time to talk to your child about the dangers of performance-enhancing drugs? Pros and Olympic athletes aren't the only ones lured by the promise of a shortcut to increased strength and stamina. Kids in high school and middle school...

Marketing to Teens: Social Networking

Monday, June 25th, 2007;
-- Jordan McCollum