Post on 07-Aug-2018
8/20/2019 Revised Ppt Obesitas Anak Fitria
1/22
Preceptor:
dr. Pulung M Silalahi, Sp.A
Presenter:
Fitria Nurulfath
(1102010105)
Pediatric Department
Raden Said Soekanto Hospital
Yarsi Medical University
Periode u!ust "rd # $cto%er &&th '(&)
REFERAT
Obesity in Children
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Definitin
Definitin f !e"it# $arie" depending n the "ur%e f the
infr&atin !tained.
'n Dorland Medical Dictionary "tate" that !e"it# i" an in%rea"e
in !d# eight e%eed" the li&it" f the ph#"i%al need" f rderand, a" a re"ult f e%e""i$e fat a%%u&ulatin in the !d#.
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The &"t %&&n !e"it# %riteria deter&ined !a"ed n
anthrp&etri% data. Anthrp&etri% &ea"ure&ent" flling
three ðd" %an !e u"ed in the deter&inatin f !e"it#.
• *ei!ht + hei!ht a%ove the ,(th percentile or &'(- a%ove
ideal %ody .ei!ht. *eight greater than 1+0 i" defined a"
"uper !e"e.
• -d# &a"" inde (-M') i" %al%ulated !# eight in ilgra&"
di$ided !# height in &eter" "/uared, if the $alue f the %hild"/M0 is !reater e1ual to the ,)th percentile then in%luded
int !e"it#.
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•
Mea"ure&ent f "u!%utaneu" fat !# measurin! thethickness of skin folds 23456 a%ove the 7)th percentile i"
an indi%atr f !e"it#. Thi% fld" f "in %an !e &ea"ured n
the !i%ep", tri%ep", "u!"%apular, and "uprailia%a.
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Epide&ilg#
Adult !e"it# in %hildren i" a gl!al pr!le& hi%h i" fund nt
nl# in de$elped %untrie" !ut &an# are al" fund in
de$elping %untrie". A%%rding t epide&ilgi%al "tudie", the
pre$alen%e f !e"it# in %hildren in%rea"e" e$er# #ear.
A%%rding t data fr& the #ear 2010 R'SESDAS &entined
the prevalence of over.ei!ht and o%esity in children 89&'
years of a!e is of ,'- ther "tudie" &entined an in%rea"e in
the pre$alen%e f $ereight and !e"it# has dou%led everyyear; e"pe%iall# at the age f "%hl %hildren.
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'n 2010 the prevalence of o%esity nationally in 0ndonesia .as
&
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Etilg# and Ri" Fa%tr
;0 f !e"it# %a"e" are
%au"ed !# idiopathic
factors or primary
o%esity or nutritional;
hile 10 f %a"e" are%au"ed !# endo!enous
factors or secondary
o%esity or non
nutritional; hi%h i"%au"ed !# the hormonal
a%normalities; or !enetic
syndromes
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Idiopathic obesitycaused by the interactionof multifactorial. Ingeneral divided by two:
genetic factors
environmental factors
Genetic factors are known to play a major role is
parental fatness, obese children usually come fromfamilies with obesity. If one parent is obese, theprevalence was 40%. And if both parents are not obese,the prevalence dropped to 14%.
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NutritionalPhysical
activity
Trauma(neurological orpsychological)
Medications(steroids) Socio-economic
En$irn&ental Fa%tr"
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Pen#e!a! endgen !e"ita" pada ana ("indr& geneti)
Sindrom genetik Karakteristik klinis
Prader-Willi Obesitas, hiperfagia, retardasi mental,hipogonadism, strabismus
Laurence Moon/Bardet-Bield Obestias, retardasi mental, retinopati
pigmentosa, hipogonadism, paraplegia
spastik
Alstrom Obesitas, retinitis pigmentosa, tuli, diabetes
melitus
Borjeson-Forssman-Lehmann Obesitas, retardasi mental, hipogonadism,
hipermetabolisme, epilepsi
Cohen Obesitas trunkal, retardasi mental,hipotonia, hipogonadism
Turner Perawakan pendek, ambiguous genitalia,
kelainan jantung bawaan, webbed neck,
obesitas, genotipe 45,XO
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Pathph#"ilg#
1. !e"it# and energ#
!alan%e
2. !e"it# andadip%#te"
di"rder"
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face that isrounded thecheeks arechubby double chin the neck isrelatively short chest out
enlarged breasts due to fattissue
belly bulge withabdominal wallmany times
striae are whiteor purple
Great limb in boththe thigh or upper
arm
the fingers arerelatively small
generallyX-shapedlegs
both attached to the innerthigh and rub together,causing lacerations andulcerations that cause bad
odors
buried penis
• Obesity is clinically apparent at any age, butmost often
at the age of 1 year, 5-6 years and adolescence. • Signs and symptoms typical of obesity are :
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Diagn"i"
*hen a %hild i" pre"ent ith !e"it#, it i" ne%e""ar# t
a"%ertain hether the %riteria are &et %lini%all# !e"e
and anthrp&etri%.
Further rth eplring risk factors for o%esity andthe impact that mi!ht occur
Diet and ph#"i%al a%ti$it# i" i&prtant t eplre.
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Treat&ent
'n general, treat&ent f !e"it# i" di$ided int lifestyle
modification and intensive therapy
9ife"t#le &difi%atin "huld !e "u"tained !efre %h"ing the
inten"i$e therap#. 9ife"t#le &difi%atin" in%lude diet, in%rea"ing ph#"i%al a%ti$it#, !eha$ir &difi%atin and the &"t i&prtant i"
the "upprt and in$l$e&ent f the fa&il#.
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DietaryA !alan%ed diet ith a %&p"itin f )(98(-
car%ohydrate; "(- fat; and &)9'(- protein
"uffi%ient fr nr&al grth and de$elp&ent. =igh>
fi!er diet %an help eight %ntrl thrugh the effe%t" ffi!er %an redu%e hunger, filling and de%rea"e fat "trage.
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-radl# "peaing, the prin%iple" f the diet are4
1. A$iding !e"it# and &aintaining nr&al grth.
2. Put a l>%ar!h#drate diet (+: f ttal energ#).
7. Redu%e fat intae (?70 f ttal energ#), "aturated fat (10 fttal energ#), a" ell a" %hle"terl ?700 &g @ da#.
+. 'n%rea"e high>fi!er fd".
5. Fd" ith enugh "alt %ntent (5 gra&" @ da#).
8. 'n%rea"e the input f irn, %al%iu& and flurine.
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Physical activity
Ph#"i%al eer%i"e i" needed t aid
in .ei!ht loss and redistri%ution
of %ody fat into muscle mass
Training pr$ided &u"t !e "&all
and then graduall# in%rea"ed, t
a$id fear and ree%tin f the
%hild. The !e"t a%hie$e&ent i" '(9
"( minutes of moderate activityper day; regardle"" f ph#"i%al
a%ti$it# in "%hl %hildren.
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Behavior modification1.
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Preventions