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Obese
Kids Have Quality of Life on Par with Cancer
Some obese children and teenagers have a health-related
quality of life as low as that reported by young cancer
patients, researchers report.
The findings suggest that "severely obese children
really are suffering in a way that is perhaps greater than
people recognize," study author Dr. Jeffrey B. Schwimmer
stated.
"We need to, as parents, physicians, teachers, be aware
of just how bad things are for many of these children, particularly
because it's often difficult for them to talk about some
of these issues," he said.
As one of the most common chronic childhood disorders, obesity
is known to affect health-related quality of life, but little
information exists on the subject.
To investigate, Schwimmer, an assistant professor of pediatrics
at the University of California, San Diego, and his team
surveyed 106 children and their parents. The children were
aged 5 to 18 and had an average body mass index (BMI) of
34.7. BMI is a measure of weight in relation to height,
and a BMI of 25 to 29 is considered overweight, while 30
or more is considered obese.
An individual who is 5 feet tall with a BMI of 34 to 35
would weigh 175 to 180 pounds, for example.
Comparing the results to past surveys of children of normal
weight, the researchers found that the study participants
were five times as likely as their healthy peers to have
impaired physical functioning.
In fact, the obese children's quality-of-life scores were
lower than that of their healthy peers in every area assessed,
including their physical, psychosocial, emotional, social
and school functioning, and their health-related quality
of life was similar to that of young cancer patients, the
report indicates.
For example, obese children missed an average of four days
of school in the month before their evaluation, whereas
their healthy peers missed less than one day of school.
About 65 percent of the youngsters in the study had an obesity-related
health problem such as diabetes, sleep apnea or elevated
cholesterol, and 13 percent had psychiatric problems such
as anxiety or depression.
However, neither their physical nor mental problems were
responsible for the differences in health-related quality
of life, according to the report. Even youngsters without
those problems had a poor quality of life compared with
peers.
While both obese children and young cancer patients may
experience teasing and have trouble keeping up with peers
due to their conditions, the authors note, obese children
are usually "not exposed to the intense medical interventions"
that cancer patients go through.
Thus, their similar health-related quality-of-life scores
was "an unexpected and important" finding, Schwimmer
and his team write.
The health-related quality-of-life assessment used in the
study was copyrighted by one of the study authors, who receives
financial compensation from its use. It measured the children's
emotional, physical and social well-being in relation to
their obesity.
A second study, also published in the April 9th issue of
the Journal of the American Medical Association, suggests
that certain weight-loss drugs may help treat adolescents
with obesity.
Currently, there are no Food and Drug Administration-approved
weight-loss agents for children under the age of 16.
Dr. Robert I. Berkowitz, of The Children's Hospital of Philadelphia
and the University of Pennsylvania, and his colleagues studied
82 teenagers, ages 13 to 17, with BMIs ranging from 32 to
44. The teens were randomly assigned to receive either behavior
therapy and sibutramine (Meridia in the U.S. and Reductil
in Europe) or behavior therapy and placebo for six months.
The behavior therapy included 13 weekly and six biweekly
group sessions led by dieticians, psychologists or psychiatrists
in which the teens and their parents -- who attended separate,
although similar, sessions -- were instructed to consume
a low-calorie diet and given exercise goals.
The teens who were treated with sibutramine lost an average
of 7.8 kilograms (17 pounds), reducing their BMI by almost
nine percent. Their peers in the comparison group lost about
three kilograms (seven pounds), reducing their BMI by four
percent.
Further, the study group continued taking sibutramine and
maintained their weight loss for an additional six months,
while those who switched from placebo to sibutramine lost
an additional 1.3 kilograms (three pounds).
Side effects included increased blood pressure and pulse
rate, which led to the drug dosage being reduced in 23 teens
and discontinued in 10.
"These findings suggest that weight loss medication
may be of benefit to adolescents," the researchers
conclude. "Sibutramine, however, must be carefully
monitored in adolescents, as in adults, to control increases
in blood pressure and pulse rate."
Until more studies are conducted, the authors add, the
medication should only be used on an experimental basis.
The study was funded by the National Institutes of Health,
The Children's Hospital of Philadelphia and in part by an
unrestricted educational grant from Knoll Pharmaceutical
Co. and Abbott Laboratories, which provided the sibutramine
and placebo.
SOURCE: Journal of the American Medical Association 2003;289:1805-1812,1813-1819.
Article Source: Reuters Health
Article Author: Charnicia E. Huggins
Net Reference 89
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