Childhood obesity can cause complications in many organ systems. These obesity-related medical conditions include cardiovascular disease; type 2 diabetes mellitus, and degenerative joint disease.
Orthopedic complications include slipped capital femoral epiphysis that occurs during the adolescent growth spurt and is most frequent in obese children. The slippage causes a limp and/or hip, thigh and knee pain in children and can result in considerable disability.
Blount’s disease (tibia vara) is a growth disorder of the tibia (shin bone) that causes the lower leg to angle inward, resembling a bowleg. The cause is unknown but is associated with obesity. It is thought to be related to weight-related effects on the growth plate. The inner part of the tibia, just below the knee, fails to develop normally, causing angulation of the bone.
Overweight children with hypertension may experience blurred margins of the optic disks that may indicate pseudotumor cerebri, this creates severe headaches and may lead to loss of visual fields or visual acuity.
Research shows that 25 out of 100 overweight, inactive children tested positive for sleep-disordered breathing. The long-term consequences of sleep-disordered breathing on children are unknown. As in adults, obstructive sleep apnea can cause a lot of complications, including poor growth, headaches, high blood pressure and other heart and lung problems and they are also potentially fatal disorders.
Abdominal pain or tenderness may reflect gall bladder disease, for which obesity is a risk factor in adults, although the risk in obese children may be much lower. Children who are overweight have a higher risk for developing gallbladder disease and gallstones because they may produce more cholesterol, a risk factor for gallstones. Or due to being overweight, they may have an enlarged gallbladder, which may not work properly.
Endocrinologic disorders related to obesity include noninsulin-dependent diabetes mellitus (NIDDM), an increasingly common condition in children that once used to be extremely rare. The link between obesity and insulin resistance is well documented and which is a major contributor to cardiovascular disease.
Hypertension (high blood pressure), and dyslipi-demias (high blood lipids), conditions that add to the long-term cardiovascular risks conferred by obesity are common in obese children.
Childhood obesity also threatens the psychosocial development of children. In a society that places such a high premium on thinness, obese children often become targets of early and systematic discrimination that can seriously hinder healthy development of body image and self-esteem, thus leading to depression and possibly suicide.
In all of these examples, it is recommended that the primary clinician should consult a pediatric obesity specialist about an appropriate weight-loss or weight maintenance program.
