Young people are wild and afraid of being fat! The secret to losing weight, doctors analyze it this way...

Most modern teenagers have no worries about food and clothing, so the problem of obesity is becoming more and more important; when the prevalence of obesity is higher, naturally there will be more complications of obesity.

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Definition: Body Mass Index (BMI) is used clinically to assess overweight and obesity in adolescents. The BMI algorithm is weight (kg) divided by the square of height (m). However, BMI cannot directly measure body fat, so for teenagers with more muscles (such as athletes), we will overestimate their obesity; for teenagers with less muscles (such as children who don’t like sports), we will underestimate their obesity.

BMI should be measured at least annually in adolescents and should be plotted on appropriate growth curves to determine BMI percentiles and trends. Strategies to improve obesity vary according to the weight category of adolescents.

Body Mass Index (BMI) = Weight (kg) / Height2 (m2)

The following are weight categories for children and adolescents aged two to twenty years:

• 1. Underweight: BMI percentile < 5

• 2. Standard weight: 5 ≦ BMI percentile < 85

• 3. Overweight: 85 ≦ BMI percentile < 95

• 4. Obesity: 95 ≦ BMI percentile

Severe obesity: BMI ≧120% of the 95th percentile of BMI or BMI ≧35

Evaluation: A complete evaluation will identify treatable causes and comorbidities. A good evaluation includes a complete medical history and physical examination, with blood draws and imaging studies as needed.

Medical history: This should include the age at which excess weight began and the adolescent's eating and exercise habits.

Eating habits

• 1. Assess the caregiver who is the primary provider of food to the adolescent.

• 2. Evaluate foods that are high in calories but low in nutritional value (e.g., fast foods, beverages) that can be reduced and replaced.

• 3. Evaluate eating patterns (e.g., when and what to eat): If adolescents cannot control themselves from eating large amounts of food, they may have a diet-related disease. Adolescents who do not eat regularly are more likely to gain weight.

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Exercise habits

• 1. Identify barriers that prevent you from walking or riding a bike to school.

• 2. Evaluate the time spent playing the game.

• 3. Evaluate leisure activities after school and on weekends.

• 4. Assess the time spent using the computer, watching television, and playing video games.

Family history

The complications of obesity are closely related to family heredity. If one of the parents is obese, we can predict that their children will also be prone to obesity problems when they grow up.

Psychological assessment: The psychological assessment should include the following:

• 1. Depression: such as insomnia, hopelessness, sadness, changes in appetite and other problems.

• 2. Questions about school and social life: Do you have friends at school? Are you the one being bullied and teased?

• 3. Smoking: It increases the risk of long-term cardiovascular disease. In addition, obese teenagers who smoke are afraid to quit smoking for fear of getting fat.

Monitoring and Disposal

Growth BMI trends: If the BMI percentile is initially below 85 but increases at a rate of more than 3-4 units (kg/m2) per year, the adolescent is at risk for overweight and obesity, so it is necessary to discuss weight gain with parents and provide parents with some tips to help adolescents maintain a healthy weight.

Ways to maintain a healthy weight

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• 1. Drink only sugar-free beverages, low-fat milk or boiled water.

• 2. Eat fast food at most once a week.

• 3. Eat three meals a day plus a snack.

• 4. Healthy breakfast: two slices of whole wheat toast, a cup of low-fat milk or skim yogurt, and a piece of fruit.

• 5. Healthy snacks: fresh fruit, nonfat yogurt or low-fat popcorn.

• 6. Avoid eating two portions for three meals.