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Discussing Obesity in Children with Bariatric Physician, Dr Raj

Obesity in children is becoming increasingly common in the UK and there are various elements that contribute to why children are obese. The pandemic certainly hasn't helped with families spending more time indoors, but there are also other factors that are impacting children's health such as a poor diet, lack of exercise, domestic problems, bullying among other things.

I'm pleased to share the transcript of my interview with Bariatric Physician, Dr Raj where he talks about obesity in children today and what parents and guardians can do to help manage their weight if they are concerned about being overweight.

Thank you for talking to Dishevelled Dad Dr Raj. Please talk to us about your role and how you help families to cope with obesity in children?

My role is specialising in weight management at the London Obesity Clinic who is affiliated with Simply Weight. Simply Weight is a global service that provides an affordable platform to help people with weight problems. Sometimes dieting is not enough, weight can significantly increase due to various factors. This may include obesity or metabolic related problems like diabetes. We all know we’ve got to eat well and exercise, but not everyone is doing it. Body image is a problem among children, it has become worse during COVID. We are a team of specialists that help families with obese children to help manage their weight problems.

"You’ll see children with type 2 diabetes, sleep apnea. Hypertension, high blood pressure cases going up as a result of obesity. This can get progressively worse over time if nothing is done to manage it"

How do you go about helping children and families?

I speak to the whole family to assess and identify where the problems might be. We also have a team of pediatricians to help address any issues we may identify, like any physical, behavioural, and of course mental problems. I then create a plan once we have gone through the relevant procedures. The child and parents will be supported through close consultation and monitoring of diets, keeping a food diary perhaps, and sticking to a plan to help them to manage their weight. We also have psychologists and dietitians in the team to help with their programme.

What are the risk factors parents and carers need to look out for?

We take a multilayer approach, we look at genetics, hormones & metabolism, psychological and any mental health problems. Comfort eating is also a key factor. Sometimes these underlying issues aren't easy to spot, therefore proper assessment by a professional is required. We find that kids often lock themselves up and in many cases have too much screen time, spending 6-8 hours a day, 8 years old and up. We also see if there are any eating disorders as well. Research shows if one parent is obese, children are 3 times more likely to be obese if both then 10x times likely to be obese. Just assessing the child is not enough, so it’s important to discuss these issues and involve the parents as well.

What complications can children and families put up with if they don’t take action early?

You’ll see children with type 2 diabetes, sleep apnea (where kids stop breathing throughout the night and don’t breath for a few seconds because the brain isn’t getting enough oxygen.) Hypertension, high blood pressure cases going up as a result of obesity. Usually a combination of things that influences their weight. This can get progressively worse over time if nothing is done to manage it. Gut microbiome is also something that we look at as well, to test their intestine health, essentially to see if they have good bacteria. This is altered in people who are obese in their metabolism etc. Diet is very important.

How Do You Approach It?

Being empathetic is important and listening is key. Some kids are shy, they may need time to open up and talk about their issues. Getting into a routine often helps and it’s important to involve parents here. If it doesn’t work, then see a doctor or specialist, it could be a genetic problem that causes them to eat or some other underlying issues like mental health or bullying, etc.

Who should they speak to?

See your GP to test thyroid, BMI, etc. if they can’t get it done then see a specialist. Reaching out to Simply Weight could be a start.

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