Growing Little Humans | Transcript: Childhood Obesity: Causes, Impacts and Solutions

March 11, 2025 • 15 Minutes

Childhood Obesity: Causes, Impacts and Solutions

Transcript
ENGLISH AND ARABIC
Child Obesity

Guest: Dr Rajeev Tomar Senior consultant of Pediatrics, Clinical Director of the Women and Children Institute and Padiatric Liver Transplant Program at Kings College Hospital London, Dubai.

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I'm Melissa.

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And I'm Lea and we are busy mums, company founders and all round early learning nerds. Welcome to our podcast, Growing Little Humans. Kids aren't born with a user manual so each week we'll try and cover many topics that you guys encounter and worry about each and every day while you're raising your little humans. Dr. Rajeev Tomar is a Senior Consultant of Pediatrics and the Clinical Director of the Women and Children's Institute at King's College Hospital, London, Dubai

00:31
Pediatric liver transplant program. Dr. Rajeev trained at two of the world's premier institutes, Great Ormond Street Hospital for Children and the King's College Hospital in London. His area of special interest is pediatric gastroenterology and hepatology. Hi Dr. Rajeev. Thank you so much for joining us. Thank you very much for inviting me. It's nice to be here.

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So I know that

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obesity especially in adolescents, is on the increase. So today we were hoping to have a conversation with you about obesity in children and the trends moving forward. So, can you tell us where we are at with child obesity and is it looking like it's going to be a problem? First of all, I should congratulate you for picking this topic because it's a very important topic to be discussed upon.

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I think obesity, as you rightly said, is a global phenomenon. If you look at the current stats for pediatrics especially, the trend is alarming. So, although the obesity in adults has doubled, it's almost quadrupled in children. Oh, wow. So, if you go by the numbers, then we can say it's around 37 million children who are below the age of five years are now obese or overweight. And if you include the entire pediatric age group to

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16 years old it's mind-boggling. It's around 390 million children who are overweight or obese. And coming especially to our region, I must say we're around 5.4 million, which is around 2022 data. It is alarming. It was only 3.4 million just a couple of decades ago. So, it's an alarming trend. In a nutshell, it's a time bomb which is about to explode.

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A particularly fast-growing problem. Yes, we are labelled as the second highest region in the world with childhood obesity. And what are the primary causes for this childhood obesity? So again, obesity is a very complex phenomenon that's the reason everybody's struggling to tackle it but yes, it's a complex combination of genetics and what we call an obesogenic environment which means the amount of calories a child is taking in and how

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they're burning those calories. It's a fine balance between genetics and this obesogenic environment. And I think too that part of the problem is nutritional education because especially within this region we've you know gone in the UAE for instance in the last 50 years we've gone from nomadic tribes to you know fast

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food and those types of things which has been a novelty and the exposure to a lot of foods that were not eaten here before. I think that education on nutrition is missing. That's absolutely true so in simple terms obesity means you take more calories, and you burn less and of course all these foods from which are junk food are high in calories

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are to be blamed. So yes, it's a fine balance, you're absolutely right. It is on the increase because we're trying to copy and leaving out our traditional ways of eating in this region. And I was reading that we're not only just eating more high-calorific foods, we're also eating more food than we used to. That's correct. So, it's more accessible, so we're eating more of it. That's correct. So obviously that's got to have an impact as well, more processed food. So, talking about that, what are the short and the long-term effects of childhood obesity?

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If you just want to discuss briefly the immediate short-term effects of obesity in children, I think people do understand nowadays because of awareness the harmful effects on your cardiovascular heart system where you tend to have high cholesterol and even high blood pressure within the pediatric age group. This used to happen later in life, but that's happening in the pediatric age group now. You do start having kids who are obese,

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Having an abnormal metabolism of sugar. So, you do have what we call early onset diabetes, which used to be a phenomenon seen later in life. Obese children are now very prone to what we call as a non-alcoholic fatty liver. And you'll be shocked to know that the most common indication for liver transplant in older adults and young adults, is actually your fatty liver disease, which starts in pediatric age group. These kids are also very prone to getting

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heavier, so your joints do have the burden, and they have joint pains. And again, not to forget, which people do tend to ignore, is the mental effect it has on these in this case. Yes, that's very true, Dr. Rajeev. It's not just the physical problems with the body; it's actually very much the mental wellness of the children as well. Correct. That's very common, Absolutely. As a teacher, we can see that a lot of the time children are having trouble focusing and

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trouble concentrating and a lot of that has to do with what children are eating. The food they are consuming is not having the impact that it should be, allowing them to be able to concentrate for long periods of time and then there is the issue you know of being out on the playground less time than they're sitting at a desk. So that's got to have some impact as well! What are some other short-term effects with, I just said concentration and lack of focus, if you come in more of the psychological aspect. As I said it's very quietly very commonly ignored by people

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uncomfortable discussing it, even the parents in our clinic are not very comfortable discussing it. It's only when we try to dig deeper, we understand, yes these are the children who are lacking, they do have this low self-esteem. Yes, lacking self-confidence. They do and they are scared of what you call as you know, social situations, they don't have that confidence, they lack that. A very interesting phenomenon is coming up, what you call as you know, emotional eating. Yes.

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A way of them coping with the stress and the anxiety and the more they stress they start eating more and when they eat more, they do understand they're gaining more weight than this when they start feeling guilty, they are ashamed of themselves so the whole cycle goes in the wrong direction. The long-term mental impacts can be enormous. Yes, and we rarely do see some kids in this age group having this

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and they're preoccupied that they look abnormal in body shape. If you have some signals such as that they don't go in front of the mirrors, they are ashamed to see their body. They just completely misunderstand the whole body shape. They don't wear tight clothing, so they start wearing those baggy loose clothes. And they suddenly start avoiding any sports activities which are exposing their bodies. Which is a vicious cycle, isn't it? Yes, it's a vicious cycle.

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And these are worrying signs because these are important points not to be ignored. And I think when you're talking about them looking abnormal when they're getting on social media, and as we know little ones have so much more access to that, then they're seeing that whoever there is on social media is looking different to how they look. And then like Lea said, that's another vicious cycle of I don't look that way. Yes, not to forget bullying doesn't only happen in schools, it happens online too. Yes, it does. So, this is something which is also worrying. Yes, it doesn't help us.

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Definitely I'm seeing a much greater awareness in the community these days and I know that the governments are definitely looking at what measures they can put into place within the community. You know, fitness incentives and initiatives, there's a lot more get fit kind of activities that they're trying to encourage. I know that they're trying to encourage.

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to promote activity in schools like by having jujitsu teaching within schools and you know in different camps and things. Are you seeing a lot more prevalence of that now in the community? Oh yes that's true. Dubai Fitness Challenge started tomorrow is a perfect example. So yes, we do see that and that's very encouraging to build awareness in the public. I think if you see it's not that bad all across the globe. There are a few countries who are

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the worst and these are the countries where we can learn our lessons from. Leading the way, so Japan, Singapore, a few in France and Belgium, they are pretty, and they are actually forcing what you rightly said is about the school because this is where they spend most of their time. Yes. We as Doctors are also being encouraged to say we have like a baby friendly hospital because remember

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the nutrition and the diet of the mother during pregnancy can influence how your these genetic genes can modify. And breastfeeding is strongly recommended. So as a baby friendly initiative, we're encouraging that strong breastfeeding, not to encourage formula feeding in early life. These are very good initiatives to have. And hopefully we'll see the results. Laying the foundation for future habits.

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With mums and during pregnancy but I think too parents have to lead the way with children and show and set a good example essentially don't they and because obviously these things are a big problem in adulthood as well. So, it's great if children grow up in an environment where they understand that physical activity is really important and having a balanced diet.

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It's no brainer, I totally agree. That's a standard practice in my practice. Yes, normally my practice kids are referred with being overweight which have abnormal liver enzymes and they have been bombarded with a lot of information about losing weight, X, Y, Z. Of course they're not winning and one of the primary factors is the family has never been involved. So when I do speak to them, I'm targeting the parents first rather than the child.

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The moment I start talking about weight, which I don't, is I'm losing the confidence of the child because he's bombarded, his self-esteem is low, he's been bullied because of the weight. So the only time I do talk about weight is when I tell the patient, listen, I don't want you to lose weight. So that does raise their eyebrows. But I said, I don't want you to gain either.

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So that is one interest, one comment which does interest the child. This is the first so-called medical professional telling me not to lose weight and that sets the ball rolling, and this is where the family gets involved. You have to be an example. So, when they have a family mealtime. This is a very important family activity time. This is something so important. You cannot blame a child for eating more calories because they don't serve the meal themselves

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Yes. And they actually don't really understand nutritionally which things on their plate are more calorie dense. Yes, this is very important and I do tell my parents listen, rather than refilling your plate all the time, just bring what you want to eat in one portion at a time and try to see whether you can swap something which is less calorie dense and that seems to help. So yes, the family, they have to lead by example.

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I might be wrong here, correct me. Half a plate is your vegetables and then you have, you know, quarter of your plate being protein or quarter of your plate being carbohydrates. But I think it's all about balance really, isn't it? Exactly. A balanced diet, good side portion, not too much sugar in it. That's your mantra for this. Yes, balance. And so, Dr. Rajeev, if we have any parents out there that are concerned about their child's health or nutrition from a weight perspective, who would you suggest that they see to address that?

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In our hospital, and I think that's what the standard practice should be all across the globe, is we work as a multidisciplinary team. So, we do have myself leading the obesity program along with my endocrinologist, we have a very important role together supporting the dietician. And as I said, if we do have collaboration from the school, then we do tend to work with the school too. Oh, excellent. So, this is something which we say we work as a team.

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So, it's definitely a very good start for parents to explore. But it's been so lovely to chat with you today. And I think this is a topic that cannot be over addressed because it's just so much significance. The stress on our hospital system, if we let this problem grow, is going to be enormous. So, it's something that we need to be addressing.

14:27
Surely, spot on. Fantastic. And here come the Legals. Our podcast is purely brought to you for educational and entertainment purposes. We are just two hectic mums and we are certainly not licensed therapists. This podcast is not intended as a substitute for the advice of licensed or qualified professionals. And if you do need some help, please seek out some professional advice.