Sunday, August 10, 2014

Eat.. Sleep.. No Play

Eat.. Sleep.. No Play

Yesterday an eleven-year-old, Daniel, walked into the clinic with his mother and grandmother. His problem was hypothyroid and central obesity. He had excessive abdominal fat. The mother’s biggest grouse was that he had a voracious appetite and wanted to eat all the time. She also added that he ate big portions and did not play except on his PlayStation and laptop. Now, that was when he wasn't lounging and watching TV.

Voracious Eater
The mother kept harping on the fact that he ate a lot and his portion size was huge. Initially, Daniel listened quietly to the entire conversation. He even heard me out patiently when I explained to him the importance of small portion size. I explained to him the importance of eating healthy and eating smaller portions rather than stuffing himself to the brim.
I further explained how big portion sizes were for athletes and sportspersons who did very intense exercise for one or two hours. With his almost sedentary lifestyle, he would only store all that food as fat, I added. He understood and said he would try to implement it as much as he could.

Get Active
I also asked him to get active and play like 11-year-old boys do. Then he opened up. He said that he went down every day to play but there were just two or three kids in the building. They didn't know what to play, so they ended up just chatting and gossiping away their time. I told his mother to buy him a cycle and asked him to cycle every day for about 30 to 40 minutes. He agreed.
The mother also added that he had the habit of eating an entire bar of chocolate while watching television. He told her he had stopped that but she refused to believe him. He told me that he had abstained from chocolate for almost a week. “That’s good,” I encouraged him.

Icecream Treats
Then the truth came tumbling out. He told me that his father was very fond of chocolates and ice cream. He brought home lots of chocolate and even took him out for ice cream after dinner very often. Daniel admitted that he always ate a double scoop. I told him to restrict it to weekends and just a single scoop. He agreed.
Next, I asked Daniel about his sleeping habit. His mother told me that he slept only at 12 or 12.30 am every day. And he woke up at 6.30 am on schooldays. Now, that's not enough sleep for a growing up child. l asked him if he slept in the afternoon. He slept for 2 hours after lunch. I told him that that was another sure way of gaining weight. Suddenly he turned to his grandmother and said, “See, I told you.” Turning to me, he said, “She forces me to sleep. She promises me a chocolate if I sleep in the afternoon.”

Chocolate Bribe
Now, this was getting too much for me to handle. Of course, the grandmother had the best intentions for the boy and wanted him to catch up on his sleep. I admonished the mother, “Everything is about food in your house. How do you expect your son to have control on his food intake? After all, he’s a child. You have to inculcate healthy food habits in him. If you tempt or pamper him with food, you can’t expect him to develop healthy eating habits.
The mother looked guiltily at me. She admitted that since she was also working, her husband and she tried to compensate by showering Daniel with eat treats and allowing him to do exactly what pleased him. I pointed out that her love was only leading him to develop health complications.

Working Mothers
This is where parents go wrong. Working mothers permit their kids to eat fast food as evening snacks, at times even as meal replacements during lunch or dinner when they are hard-pressed for time or are too tired to cook. It’s not surprising that kids develop a taste for these foods and regard it as real food. The concept of junk just doesn’t come in. It’s only when the child becomes overweight or develops a health problem connected to his weight that the parents will turn around and blame the child’s eating habits. 
Now the big danger in overweight kids is developing insulin resistance. Along with childhood obesity, Insulin Resistance Syndrome (IRS) has begun to emerge. Insulin Resistance is aggravated by obesity and inactivity and could be a precursor to Type 2 Diabetes (Non Insulin Dependent Diabetes). Earlier, also called Adult Onset Diabetes, this developed with age. But now it’s common in obese kids courtesy their unhealthy lifestyle.

Implications Of Obesity
I explained to Daniel that if he didn’t take charge of his life now, soon there would be a time when he would have to take medication and there would be complete restriction on his sweets, rice, burger, pastry and ice cream intake. It would stop completely.
I explained to him that obesity is associated with long lasting physical and mental health consequences resulting in Hypertension, Dyslipidemia, increased incidence of Non-Insulin Dependent Diabetes, Menstrual Abnormalities and Psychosocial Morbidities.

All this made him sit up. He looked quite scared and definitely thought his lifestyle was not worth these risks. He promised me that he would change his ways. I hope he does.

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