Debra Li

debra_lidan@163.com

WHEN Han Han returned from a month-long summer hiatus back in his parents’ hometown in Henan Province, his mom found that the fifth grader put on 3 pounds (about 1.5 kilograms), backtracking on her months’ efforts giving him a healthier diet and running around the swimming pool in their housing compound with him every evening.

Compared to other children who have to seek treatment for obesity and diabetes with Zhao Xiu, an endocrinologist from Shenzhen Children’s Hospital, Han is lucky. His helath-conscious mom has been trying hard to maintain his weight within the normal range for his age.

Statistics from the U.S. Centers for Disease Control and Prevention show that the prevalence of obesity in the U.S. was 19.7% and affected about 14.7 million children and adolescents in the U.S. between 2017 and 2020. While 10-20% of children and teenagers are generally rated as obese in Western countries, obesity in children was a rare problem in China in the 1980s. Since 1995, however, the number of overweight and obese children and teens has ballooned in urban areas.

Data collected during 2015 and 2019 revealed that according to the standards by Chinese health authorities, 6.8% of all Chinese children below age 6 were overweight, and 3.6% were obese; while 11.1% of 6- to 17-year-olds were overweight, and 7.9% were obese. It’s also projected that by 2030, 61% of adults and 30% of youngsters above age 7 will become overweight or obese in China.

A real problem

The easiest way to judge if a child is overweight or obese is to calculate their BMI (body mass index) and compare it with the WTO scale for different ages and genders.

“Obesity in children should not be taken lightly,” Zhao explained. “One-third of the children and adolescents seeking treatment for obesity at our hospital also suffer from hyperuricemia (high uric acid level); about 20% of them have fatty liver; some also have diabetes.” She also cautioned that the number of obese children with serious complications is on the rise, and there’s the tendency that obesity is now happening at an earlier age.

Being overweight or obese is not just a physical problem, it also poses psychological issues in youngsters, who are more likely to be mocked or even bullied in school. On the other hand, youngsters who have low self-esteem or feel stressed by tension with parents or unsatisfactory academic performance may resort to binge-eating as a coping mechanism, further aggravating their weight issues and leading to a vicious cycle in their relationships with food and weight.

It’s a pity that some parents still don’t view children being overweight as a problem, Zhao said. “One parent took her son to me because she’s worried that his penis is ‘smaller’ than the normal size, while in fact I found that his is within normal size; and because it is surrounded by fat in the lower abdomen, it appears smaller. His real problem is obesity, which his mom didn’t see as a problem.” At 4 years and 11 months old, the boy measures 121 centimeters in height and weighs 33 kilograms, placing him at a similar height to that of a 7-year-old, albeit significantly heavier. Further checkup revealed that his bone age is three years in advance, predicting an early onset of puberty and potentially a shorter-than-anticipated stature in adulthood.

Shenzhen’s efforts

In 2021, Shenzhen started an umbrella program to monitor and control overweight and obesity in public school students. With 2 million yuan (US$277,000) subsidized by the city government, Shenzhen Children’s Hospital has been carrying out an annual survey to monitor students’ weight and nutrition status in 27 public schools. Over 5,000 students are randomly picked for physical checks, and tailored suggestions are given to the subjects.

In another attempt to tackle the problem, the city is rolling out 56 weight control clinics in schools, community health centers, and district-level hospitals, whose doctors will recommend the patients to bigger hospitals when necessary. School physicians are being trained and free lectures for parents and students are given through awareness campaigns on campus. Posters advising “more exercise and less junk food” are also put up on the walls in school corridors to remind students of pursuing healthier habits.

Xiong Jingfan, director of the Shenzhen Center for Chronic Disease Control, is contributing her efforts on another front. She has proposed an “eat healthy” online platform to help schools and their contractors to supply students healthier lunches. Cooperating schools can get free suggestions for meals and recipes with suitable rations and nutrition values for students of different ages.

“All local schools have been required to allocate at least 45 minutes each day for students’ physical exercise on campus,” Zhao said. However, she acknowledges that it remains unclear whether the requirement can be strictly implemented in reality.

It’s not enough that health authorities and schools take steps to prevent overweight and obesity in the young, Zhao said. In addition, families and the whole society need to pitch in.

This August, Shanghai piloted a campaign to ask local supermarkets and groceries to put up posters on shelves that sell snacks and drinks, warning against the risk of high-sugar and high-fat content in the drinks. Elsewhere, Singapore has the most stringent requirements of drink labeling, rating all drinks on sale by four grades according to their sugar and fat content.

“It’s impossible to forbid my kid from drinking milk tea or coke, which is a way of socializing among his classmates,” Zhang Yan, mom of a sixth grader in Luohu District, said. “But certainly, I’d like to see conspicuous reminders in stores, which may serve as deterrents to some extent so that he may consume less sugary drinks.”