Obesity may be described as a physical condition characterised by excessive deposition or storage of fats in adipose tissues. It usually results from consumption of foods in excess of physiological needs. Obesity is a serious health hazard as the extra fat puts a strain on the heart, kidneys and liver as well as the large weight bearing joints such as the hips, knees and ankles, which ultimately shortens the life span.

There is now growing realisation that much adult obesity has its origin in infancy, childhood and adolescence. The prevention of obesity should therfore begin in infancy. The prevalence of obesity in children is estimated to be 25 per cent in the first year, less than five per cent at 5 years and nine per cent at 15 years. It is however, not necessary that fat babies become fat children, but obese five-years-old are more likely to become fat adolscents.

Crawford and co-workers conducted studies in obese infants. They concluded from these studies that the best obesity index for infants six months of age is a weight gain greater than 5.34 kg. during the period from birth to six months of age. It can, however, be generally said that obese children are those whose weight exceeds the expected weight for height by more than 20 per cent.

Symptoms

During infancy and childhood, the disadvantages of obesity are relatively small. A fat child has an increased tendency to acute respiratory infections. Severe obesity can delay motor development. A really fat child of two years may hardly be able to walk and his exploratoin of the environment will be delayed. Knock-knee is common. Emotional disturbances are likely to develop, particularly at adolscence and puberty may occur early.

Causes

Several factors can lead to obesity in children. These include genetic tendency, racial and familial diet habits, a personal habit of overeating, restricted exercise and emotional factors. Another important cause of obesity can be some abnormality in the metabolism of adipose cells or in energy expenditure.

Treatment

A suitably planned course of dietetic treatment, in conjunction with suitable exercise and other measures for promoting elimination, is the only scientific way of dealing with obesity. To begin with, the child should be put on a liquid diet for three to five days. Fresh fruit juices will be especially beneficial. Lemon, orange, pineapple and cabbage may be used for juices.

After the liquid diet, taking three meals a day of fresh juicy fruits, such as orange, grapefruit, pineapple and papaya. Thereafter, he may gradually embark upon a low-calorie well- balanced diet consisting of seeds, nuts and grains,vegetables and fruits, according to his age. The emphasis should be on fresh fruts, raw or lighly -cooked vegetables and fresh fruit and vegetable juices.

As with an obese adult, an obese infant may be overfed or underactive. It is , therefore, essential that the daily food intake and activity and sleep pattern of the infant should regularly be appraised throughout the first year of life in a health care setting. No more than 120 kcal, per kilogram per day is appropriate for the very young infant and no more than 100 kcal. per kilogram, for the older infant. The food intake should be co-related with the activity and sleep pattern. Severe energy-restricted diets are, however, not advised for children prior to the completion of the adolescent growth spurt. An inadequate energy intake before and during the growth spurt can lead to growth retardation. If the actual energy and nutrient intake is greatly in excess of that recommended for age, the diet should be planned in such a way as to contain energy and nutrients appropriate for the age.

The food which should be drastically curtailed or altogether avoided are high -fat foods such as butter, cheese, chocolate, cream, ice cream, meats, fried food and gravies, high carbohydrated foods like bread,candy, cake, cookies, cereal products, legumes, potatoes, sugar and rich puddings and beverages such as all foundtain drinks.

Certain home remedies have been found beneficial in the treatment of the obesity. The most important of these is to spend few days on lime juice-honey water. In this mode of treatment one spoon of fresh honey should be mixed with a juice of half a lime in a glass of lukewarm water and taken at regular interval.

The leaves of jujube or Indian plum (ber) is another valuable remedy for obesity. A handful of leaves should be soaked over night in water and this water should be taken in the morning, preferably on an empty stomach. This treatment should be continued for atleast one month to achieve beneficial results.

Cabbage ( bandgobi) is considered to be an excellent home remedy for obesity. Recent research has discovered in this vegetable a valuable content called tartaric acid which inhibits the conversion of sugar and other carbohydrates in fat. Hence it is of great value in weight reduction. Helping of cabbage salad would be the simplest way to stay slim, painless way of dieting.

Tomatoes ( tamatar) are also valuable in treating obesity. One or two tomatoes taken early morning, without breakfast, for a couple of months is considered a sage method of weight reduction and at the same time it also supplies the essential food elements to preserve the health.

Finger millet ( ragi) is an ideal food for obese people, because its digestion is slow and due to this the carbohydrate takes longer time to get absorbed. By eating ragi preparations, the constant desire to eat will be curbed, reducing the daily caloric intake. At the same time, it supplies abundance of calcium, phosphorous, iron, vitamin B 1 and prevents malnutrition inspite of restricted food.

Exercise also plays an important role in weight reduction plan. It helps to use up calories stored in body fat. Certain yogic asanas beneficial in the treatment of obesity are sarvagasana, halasana, bhujangasana, shalabhasana, dhanurasana, chakrasana, paschimottanasana, vajrasana, yogmudra and trikon-asana. The older children should be encouraged to practice these asanas or undertake some form of exercise. The child-patient should also be encouraged to adopt measures which bring an excessive perspiration such as steam bath and massage. They help to reduce weight.