As the prevalence of obesity is increasing worldwide, we are sadly seeing an increase in childhood obesity. More parents are now seeking help for their obese children. The prevalence of obesity-related complications like type 2 diabetes, fatty liver disease, gall stones, arthritis, psychological issues and sleep disorders is on the rise. In addition to the physical impact of obesity, children suffer from mental health problems and social discrimination. The recent COVID-19 pandemic has revealed that people who are overweight and have weight-related complications are more prone to develop COVID related complications.
Why do parents send their children to weight loss camps?
Most parents are very concerned that their child is much bigger than the rest of his/her friends. They are keen to help their child and are in a lookout for a quick solution. Most children who attend weight loss camps are enrolled by their parents as they are ashamed and are struggling to get a solution.
Research shows that children with higher body mass index have parents who are either overweight or obese. Parents having themselves been through several diets and weight loss interventions, are keen that their children do not face the same problems they have been through in their life.
As most weight loss camps advertise significant weight loss in the camp attendees, parents enrol their children for rapid weight loss.
What happens in a weight loss camp?
Weight loss camps have a structured programme which is run by fitness trainers and nutritionists. In some plans, there are psychotherapists or psychologists. As these plans are only for a few weeks, the organisers are constrained to pack in a lot of activity and have a rigid meal plan to show a positive outcome, which is weight loss.
It is not always that children are grouped according to their weight. Most of these weight loss camps categorise children according to their age.
The food provided is restrictive as expected and they do get good education on healthy eating. Some camps also teach children portion control and food label reading.
Most camps ensure children are active and a variety of activities and games are included.
Impact of weight loss camp on a Child
Weight loss camps are usually during school holidays or summer holidays when children wish to spend time with their parents and go places. Spending time in these camps may not always be a good experience. When children go back to school after their vacation, they find it difficult to share their experiences with their friends.
In a study published in the International Journal of Paediatric Obesity by Quinlan and co-authors, they showed that children who have spent time with other children with similar BMI had improved psychological well being and self-esteem. However, these children were not followed up. They also mention that, once children return from the camp environment and mingle in their local community, the psychological gains are likely to be challenged.
Why weight loss camps are not effective in the long run?
As weight loss camps are artificial environments, most children do lose weight. However their underlying psychology, hunger pattern and metabolism is not altered. The reason is that these camps are run for a short duration and is usually during weekends and school holidays. There is no follow up programme.
Eating less and exercising more alone does not help sustain weight loss.
Triggers to overeating, neurohormonal changes, family interaction, school interaction, affect of social media and several other factor contribute to weight gain. All these have to be gently incorporated in their weight loss intervention. There should ongoing support after the weight loss camp.
Weight loss camps may inadvertently promote alienation of children from the society. It is extremely important to work with parent and children to boost their confidence and self esteem. Social integration should be one of the key feature in weight loss camps.
Drastic reduction in BMI may lead to alteration in Basal Metabolic Rate(BMR), this may have an impact of their growth. In addition may lead to lowering of BMR in future.
Crash diets are known to lower BMR, which is turn may lead to problems with any future weight loss interventions. People who follow a restrictive diet, do lose significant weight. However if they try the same diet again, they find the outcomes are not as good the first time. This is due to metabolic memory, which makes the body think that it can survive on lower energy. Hence any additional calorie consumed is stored and not used up.
Weight is a symptom of a problem, and the underlying reason for weight gain has to be evaluated before subjecting the child to any weight loss intervention. There are several reasons for weight gain, which are discussed below.
So, what is the solution?
As we all know losing weight is easy but maintaining weight loss is difficult. Before a weight loss plan is offered the child should have a thorough assessment of their metabolism, genetics and endocrine problems. Each child should have individual psychological assessment by a child psychologist.
Any attempt at calorie restriction should be supervised and their growth mile stones should be monitored. In children it is just not about losing weight but also ensuring they have an healthy growth and their sexual maturation is optimal.
Any plan should closely involve the parents so that parents also change their life style. Parents could then be a constant source of support for their children. Weight loss plans should provide opportunity for continued follow up until the child is healthy and confident.
Always consult a team of specialist dealing with childhood obesity and a specialist weight management team.
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Dr C. Rajeswaran FRCP(UK);MSc
Obesity, Diabetes & Endocrinology