Obesity is defined as an excessive accumulation of body fat. Obesity is present when total body weight is more than 25 percent fat in boys and more than 32 percent fat in girls. Although childhood obesity is often defined as a weight-for-height in excess of 120 percent of the ideal, skinfold measures are more accurate determinants of fatness.
A trained technician may obtain skinfold measures relatively easily in either a school or clinical setting. The triceps alone, triceps and subscapular, triceps and calf, and calf alone have been used with children and adolescents. When the triceps and calf are used, a sum of skinfolds of 10-25mm is considered optimal for boys, and 16-30mm is optimal for girls.
Obesity treatment programs for children and adolescents rarely have weight loss as a goal. Rather, the aim is to slow or halt weight gain so the child will grow into his or her body weight over a period of months to years. It is estimated that for every 20 percent excess of ideal body weight, the child will need one and one-half years of weight maintenance to attain ideal body weight.
Early and appropriate intervention is particularly valuable. There is considerable evidence that childhood eating and exercise habits are more easily modified than adult habits. Three forms of intervention include:
• Physical Activity - Adopting a formal exercise program, or simply becoming more active, is valuable to burn fat, increase energy expenditure, and maintain lost weight. Most studies of children have not shown exercise to be a successful strategy for weight loss unless coupled with another intervention, such as nutrition education or behavior modification. However, exercise has additional health benefits. Even when children’s body weight and fatness did not change following 50 minutes of aerobic exercise three times per week, blood lipid profiles and blood pressure did improve.
• Diet Management - Fasting or extreme caloric restriction is not advisable for children. Not only is this approach psychologically stressful, but it may adversely affect growth and the child’s perception of “normal” eating. Balanced diets with moderate caloric restriction, especially reduced dietary fat, have been used successfully in treating obesity. Nutrition education may be necessary. Diet management coupled with exercise is an effective treatment for childhood obesity.
• Behavior Modification - Many behavioral strategies used with adults have been successfully applied to children and adolescents: self-monitoring and recording food intake and physical activity, slowing the rate of eating, limiting the time and place of eating, and using rewards and incentives for desirable behaviors. Particularly effective are behaviorally based treatments that include parents. Researchers used problem-solving exercises in a parent-child behavioral program and found children in the problem-solving group, but not those in the behavioral treatment-only group, significantly reduced percent overweight and maintained reduced weight for six months. Problem-solving training involved identifying possible weight-control problems and, as a group, discussing solutions.
• Drug treatment – In 2006, the European Commission approved the sale of Rimonabant in the then 25-member European Union. First country in which Rimonabant was sold is the United Kingdom. Sales began in July 2006. Manufacturer announced that it projects that the drug will be sold shortly thereafter in Denmark, Ireland, Germany, Finland and Norway. It is expected in Belgium and Sweden in 2007. It works by blocking endogenous cannabinoid binding to neuronal CB1 receptors. Activation of these receptors by endoegenous cannabinoids, such as anadamide, increases appetite. It is the most advanced endocannabinoid receptor antagonist in clinical development and offers a novel therapeutic approach to appetite control and weight reduction.
Before you go ahead with Rimonabant or any other medication, prior conversation with your primary health professional and pharmacist is suggested to stay away from any future harmful repercussions. Seek instantaneous medical support, if you undergo these side effects for an extended phase of time or any other critical side effects.