Attack of the Fatty

This is the 3182nd article of Da Yi Xiao Hu

As the saying goes, you can't make a fat kid in one bite. Some kids are overweight when they are born, and their weight has already "won" them at the starting line. However, those who are born with normal or even underweight weight are not to be outdone, and more and more of them are trying to become "little fat kids". Parents are at a loss as they watch their own kids' bellies and "little buttocks" getting rounder and rounder. Could it be that they really swallowed gold?

I was talking nonsense in a serious tone earlier. Swallowing gold will not cause obesity. Such a large foreign object is really a headache. It does not guarantee weight growth, but it can definitely cause suffocation, gastrointestinal bleeding, perforation, shock and other problems in children. Don't let your child swallow gold for no reason! Now let's take parents to the right path and understand the problem of simple obesity in children.

Simple obesity in children is a nutritional disorder caused by long-term intake that exceeds the body's consumption, resulting in excessive accumulation of body fat and weight exceeding the reference range. It is mainly caused by excessive energy intake, too little activity, disease and genetic factors, especially dietary factors. Everyone has heard of these reasons, but parents still cannot fully understand the "path" of obesity.

01

Physiological and pathological causes of obesity

The total amount of adipose tissue determines the degree of fatness or thinness of the human body. The real physiological and pathological cause of obesity is the increase of adipose tissue.

There are two different mechanisms that can lead to the increase of adipose tissue: an increase in the size of adipocytes (hypertrophy) and an increase in the number of adipocytes (hyperplasia). When the body's energy intake exceeds its energy expenditure, adipocyte hypertrophy precedes adipocyte production.

Due to reasons such as excessive energy intake, insufficient activity, disease and genetic factors, adipose tissue continues to increase, eventually leading to obesity.

Adipose tissue is also the main site for cholesterol storage in the human body. The cholesterol content in it is closely related to the size of cells. Obesity is mainly the result of excessive storage of triglycerides. At the same time, the cholesterol content of obese individuals also increases significantly. So fat people are really the same inside and outside. Not only do they look fat on the outside, but they also have a lot of fat in their bodies.

02

Is fat the bad guy?

After watching the clip above, many parents said they understood: fat is a bad guy! This is totally wrong. Many people now "talk about fat and change color". They get scared when they hear the name of blood lipids, and worry that they will have hyperlipidemia and fatty liver. In fact, adipose tissue is composed of white, brown and beige adipose tissue. White adipose tissue is an important site for the body to store lipids and plays an important role in the body's energy balance. Brown adipose tissue is energy consumption and heat production tissue, which plays an important role in balancing energy metabolism and fighting obesity. However, brown adipose tissue is more abundant in infancy, while in adults it is only distributed in the clavicle, neck and scapular area. Beige adipose tissue has the morphology of white adipose tissue and the functional characteristics of brown adipose tissue.

03

So how do we live in peace with fat?

There are ways to make peace with children and fat. The key is to manage their diet, exercise to lose weight, and take medication. We also need to pay attention to the psychological counseling of children.

① Eat a healthy diet

A reasonable diet is the basic element for preventing and treating obesity. High-fat, high-sugar, high-cholesterol and high-calorie diets should be avoided. Fat intake should be less than 20% to 30% of total energy, especially saturated fatty acids and cholesterol intake. Eat small meals frequently to avoid sudden rise in blood sugar and accumulation of body fat. Reduce excessive calorie intake at dinner to avoid fat accumulation in the body at night when there is less activity and slow metabolism. However, parents must remember to ensure that children's diet is balanced and rich in food.

② Exercise

"Burn my calories" and "Stop eating and move your legs" are not just empty words that come out for no reason. Exercise can consume excess energy. First of all, we need to cultivate children's interest in exercise. The content of sports activities can be diverse and interesting. You can choose skipping, swimming, running, aerobics, etc. Each exercise time should not be less than 30 minutes. It is advisable to exercise 3-4 times a week. As the adaptability continues to improve, the exercise time and frequency can be appropriately increased.

③Drug treatment

At present, there are many kinds of drugs commonly used for weight loss in adults, which can be roughly divided into appetite suppressants, drugs that increase energy consumption, drugs that inhibit intestinal digestion and absorption, insulin sensitizers, plant-based low-energy foods, and traditional Chinese medicine, etc. However, there are not many drugs that can be used for children to lose weight, and they need to be used under the guidance of professional doctors.

Author: Lan Yu, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, standardized training resident physician, master's student. Research direction: precocious puberty, dwarfism and spleen and stomach diseases in children.

Editor-in-chief and tutor: Shen Jian, Department of Pediatrics, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Director of Teaching, Associate Chief Physician. Doctor of Medicine, Master Supervisor. National TCM Innovation Core Talent of the Central Administration of Traditional Chinese Medicine Inheritance and Innovation "Hundreds of Thousands" Talent Project. The popular science monograph "The Wisdom of Traditional Chinese Medicine that Good Mothers Should Know" won the 10th Healthy China Forum and the First Annual Outstanding Popular Science Work Award.