Introduction

Obesity may be defined as an abnormal growth of the adipose tissue due to an enlargement of offal cell size(Hypertrophic obesity) or increase in fat cell number(hyperplastic obesity) or a combination of both.^[1] Obesity is often expressed in terms of body mass index(BMI). Overweight is usually due to maybe obesity but may also be due to increased muscle mass, fluid retention, and some endocrinological diseases (Eg. Cushing syndrome).^[2] Body mass index is measured in weight in Kgs divided by height in M square (BMI = wt(kg)/Height² CM.The normal range is 18.50-24.99. The National Institutes of Health(NIH) defines a normal BMI as 18.5-24.9; Overweight is defined as BMI: 25-29.9; Class 1 Obesity is 30-34.9; Class II obesity is 35 – 39.9; Class III (extreme) Obesity is BMI greater than 40.^[3] Upper body obesity (excess fat around the waist and flank) is a greater health hazard than lower body obesity (Fat in the thighs and buttocks) in obese patients with increased abnormal circumference (greater than 102Cms in men and 88 Cms in women) or with high waist-hip ratio(greater than 1.0 in men and 0.85 in women) have a greater risk of diabetes millitus, stroke, coronary artery disease and early deaths than equally obese patients with lower rates. And visceral fat within the abdominal cavity is more hazardous to health than subcutaneous fat around the abdomen. The incidence of childhood obesity has increased rapidly in the last decade. Childhood obesity has serious short and long-term medical consequences. Children with a BMI of more than 85^th percentage for age are considered overweight while those that more than 95 % percentile for age is obese.^[4] Weight for the height of more than 120% is diagnosed as obesity. Environmental and heredity factors play a major role in childhood obesity the other causes include Cushing syndrome, hypothyroidism, steroids, genetic syndromes like Prader villi syndrome and leptin deficiency.

Obesity can occur at any age. Generally increases with age. Infants with excessive weight gain have an increased incidence of obesity in later life. About ½ of obese adults have been so since childhood. Women generally have a higher rate of obesity than men. Regular physical activity is protective against increased weight gain. People with a sedentary lifestyle are more prone to develop obesity. There some inverse eating habits also play a major role in obesity. It has been articulated that a child whose energy requirement is 2000 Kcal /day and who consumes 100 Kcal/day extra will gain about 5 kgs a yr.^[5]

Subjects and Methods

We have conducted this study for 8 months from March 2020 to October 2020 in the department of kaminani medical college, Narkatpally. Informed consent has been taken fromthe college ethical committee. After careful history taking and clinical examination height and weight recording were taken by trained paramedical teams. Children with endocrinological abnormalities like hypothyroidism and who are on drugs like steroids were excluded in this study. The children with clear cut overweight and obesity are included in this study. We have not advised any investigations since this study has been aboutthe history and physical examination only. Total members of children included inthis study in 965, boys were 445 girls 520, the common age group between 12 -16yrs Enter data is analyzed systematically and computerized by using cell method.

Result

In this study, we have included a total of 965 children. Out of this 965 boys are 445 and girls are 520 the common age group is between 14 to 16 years over wt and obesity is increasing with age. These results correlate with the studies conducted by Shetty PS Et al.^[6] Overweight and obesity gradually increase with age. In our study in among boys in 8 – 9yrs group the number of boys was were 18 (3.95%) and in 14 -16yrs group, the number is 35(7.68%) In Girls section the number of childrenis 21(4.03%) and 46(8.25%) respectively. These & figures nearly correlating with the study conducted by Chu NF Et al.^[7] In Boys, nearly 10% are having Class I obesity and 5% are in Class III obesity

Discussion

Childhood obesity is a very common problem worldwide. The number of cases is increasing in developed and developing countries. It is emerging convincingly that the geniuses of Type 2. Diabetes and coronary artery disease begin in childhood obesity serving as an important factor. There has been a phenomenal rise in the proportion of children having obesity in the last 4 decades some studies show from India with in the last few years indicating that similar tread.^[8]

In our study average prevalence is about 8.5%of boys, 8.79% of girls are having obesity the studies conducted in the Mahe region by the Kerala govt show the prevalence is 9.25%. In Ex a similar study from Kerala also that there areincreasing trends in the prevalence of obesity from 4.9% in 2003 to 6.57% in 2005(9). In our study obesity is more common in girls than boys out of 965 children, obesity is observed in 125 girls and 105 boys. The studies conducted in Pondicherry shows similar results but whereas the observation in male study is reversed.^[9,10]

The prevalence of overweight and obesity was a little higher in children. Those who are residing in urban areas than rural areas in urban areas, In the urban area, were 3-4 times at greater risk of being overweight and obsessed compared to children in rural areas.^[11] It was observed that the prevalence of overweight and obesity was 2.84% and 2.15% among children studying in govt schools. Whereas it was found to be higher among children studying in private schools. 3.25% and 2.92% respectively.^[12]

The areas of residence socio-economic conditions and age (gender differences were felt to be important contributors towards overweight and obesity.

According to statistics in the united states, more than 64% of adults are having overweight or obese and the prevalence is increasing rapidly in developed countries like the US, UK, and Australia. Multiple health problems are associated with obesity like hypertension diabetes mellitus, dyslipidemia, obstructive sleep apnea. Degenerative joint disease, COPD, CAD, Osteosthritis chalethisis, and certain malicious like breast cancer uterine malignancy. Management of obesity includes diet therapy, physical activity therapy behavioral therapy pharmacotherapy and bariatric surgery lifestyle management results in 3-5 kgs weight lossdiet therapy includes meals of small position size, eating more fruits and vegetables, and whole-grain cereals 2 classes of drugs are used for obesity 1) Appalite, supersets and gastrointestinal blockers. Bariatric surgery is an increasingly prevalent treatment option for patients with severe obesity. Widly used operations are Roux-an-y gastric bypass (RYGB) and gastric bonding. A third operation is sleeve gastronomy.

Conclusion

Childhood obesity is a global problem. In India the prevalence is slowly increasing. Obesity is more in girls than boys. Urban residing children are more affected than rural residing children. Dietary habits and physical activity play a major role and other factors included are social-economic, environmental, and genetic factors.