Let’s take a think first whether it is correct to call obesity a disease; it sounds a lot more logical to describe it as a disorder of adapting to an environment with food excess. We should also correct the perception of “children’s” obesity. This is a misperception: with the exception of some types which are conditioned by endocrinological or other medical problems, the problem is always primarily a problem of the parents – and this is where the solution should begin. The metabolism of the most Central-Europeans is set as a saving one (“what I cannot use I will store”); similar rule applies that the child only passively accepts what the family is offering – both mentally and physically.
If the child is brought up in passivity and in wrong dietary habits, the combination of saving metabolism and insufficient physical exercise cannot result in anything other than overweight. Furthermore, the problem of children’s obesity is often complicated by rather intricate psychological ties between the child and one of the parents (usually the mother). Viewed through the eyes of psychosomatic medicine, it often seems like the child is building a protective barrier made of layers of fat between him/herself and the outside world. The solution of child’s obesity must therefore always be complex and the proposed therapeutical plan must be worked out based on a thorough situation analysis in the particular family.
As the father of protein diets Professor Blackburn used to say: “It’s a family affair…” If the family cooperates, we change the dietary habits and we increase the level of physical activity. If the level of obesity is morbid, we recommend inpatient treatment. A lot of discussions have been held recently about what to do with an obese child who grows up in a family which does not cooperate in the remedy. The possibility is also considered and fully justified that the cases of truly severe child obesity, where the parents aren’t willing to resolve the problem, should be a sufficient reason to remove the child from the family.
The daily practice of solving the problem requires especially a good therapist – not necessarily a paediatrician or an obesitology specialist. Establishing a therapeutical tie in this case is of fundamental importance – and achieved expertness does not grant such tie. On the contrary, in many cases, the actual expertness written on the office door might raise feelings of guilt, inferiority or disease. This is therefore a typical problem to be resolved by a family practitioner. The only problem is that such a practitioner no longer exists.
Just like always in medicine, the rule applies that prevention is the best way of preventing health problems. In practice, the mummy-to-be should take all risk factors that even a non-expert can understand into consideration – and adjust her diet accordingly. In principle, the higher the incidence of the “saving metabolisms” within the kindred, the higher the obesity risk of the child. If the mother is corpulent, the father is obese, both grandmothers are dead due to a heart stroke and both grandfathers have had their by-passes, there is a reason to fear that the future offspring will be more prone to overweight and the complications directly resulting from it. The future mummies should also realize that their foetus is nourished by what they are eating. If they eat hot food, their offspring will squirm inside; if they smoke, the baby will choke along; if they eat unhealthy food, they harm both themselves and the baby. That is why, in their pregnancy, they should avoid – besides all the well known harmful substances – consumption of especially the so-called rapid sugars in all forms (all types of sweets), as well as all fatty and inappropriately cooked (fried) meals. The consumed meat should be purely lean and should include regular representation of fish. Fruit and vegetables should form an everyday part of the diet. Stimulating drinks (such as alcohol or coffee) should be replaced by herbal tea.
With the view of the fact that the foetus is made of two single cells – that is, from the mother’s ovum and father’s sperm – the forming tiny human, which grows with unbelievable speed, must be provided with sufficiency of nutrients, especially of those that we call “essential”; those are the substances that the body cannot develop and must acquire them from food. More plainly, these substances are primarily the amino acids from high-quality proteins (which are contained especially in fresh vegetables and fish meat) and polyunsaturated omega 3 and omega 6 fatty acids (these are amply found in quality fish and first press oils, e.g. rapeseed, borage, evening primrose or olive oil). Last but not least, we also have to remember the so-called acido-basic equilibrium of the pregnant women; this means that such food has to be accentuated that does not cause hyperacidity and does not encourage development of inflammatory processes. We especially have to reduce consumption of “red” meat, all types of sausage products, we limit (but not eliminate) cow’s milk and dairy products (about the time we stopped believing the persistently maintained myth claiming that only a person who drinks milk will have sufficiency of calcium!); without exception, we skip all fatty and floury meals, as well as all kinds of sweets. Except fruit and vegetables, we give priority to pulses, dried fruit, dark bread and products of ecological farming.
When the baby is born, the recommendation is to breastfeed for at least 6 months. Both extremes are detrimental. Breastfeeding for 6 weeks is not enough, as much as lactation for 18 months is too much. Once the child starts eating by him/herself, we follow the common sense, which, in relation to obesity, could be summed up in two sentences:
- as much movement as possible
- as little sweets and fast food meals as possible. However, beware of the “forbidden fruit” phenomena: a meal at McDonald’s and one piece of chocolate will not trigger development of obesity at a child with sufficient exercise, but will enable your offspring to handle the peer pressure. This is very important for his/her psyche; seeing a fat child in the medical office is just as sad as seeing an undernourished child who had been unfortunate enough to be born into a family of parents who are dogmatic believers in healthy food, where pollard is a festive meal.