Leslie A. Gabay, Contributor

Is obesity like beauty - in the eye of the beholder? Do we see our children as overweight or as healthy and pleasingly plump? In several cultures throughout the ages, obesity has been associated with physical attractiveness, strength, fertility, wealth and social status.

Hence, obesity became a symbol of prestige as the type and amount of food eaten were criteria for social class placement. The ancient statues of Venus and paintings of fat women by Rubens indicate cultural approval of the fulsome body of the day. We still hear, in our culture, our parents and grandparents bemoaning the lack of weight of one child while beaming about the chubby, 'well-looking' baby or child who will 'grow out' of their 'baby fat'.

Jamaica, a developing country which not 10 to 15 years ago struggled with severe malnutrition, has now become part of the global epidemic of obesity as designated by the World Health Organisation (WHO) in 1988. The body mass index (BMI), an indicator of fatness, can be calculated by your doctor and a chart used to indicate how fat your child is and whether measures need to be taken to reduce the fat.

Teased and bullied

The consequences of obesity are both medical and psychological. A number of these consequences include type 2 diabetes mellitus, hip and knee pains, early or irregular periodsand infertility in girls, breast development in boys, hypertension, elevated cholesterol levels and sleep apnoea (cessation of breathing during sleep).

Psychologically, these children are teased, bullied and may have low self esteem. These ill-effects accompany poor academic performance at school which impacts on the ability of children to improve their earning capacity as adults.

The management of a child with obesity/overweight must begin with an understanding of both the child's and family's eating habits to identify patterns that may contribute to excess energy/calorie intake as well as factors that trigger eating behaviours. An assessment of food choices and preparation as well as a nutritional consultation are essential for control of caloric intake. Education of the family is important in order to achieve an attitude change.

Regular exercise

Caloric expenditure can be maximised with regular exercise which the child must enjoy both at home and school. Studies have shown a better response to 'decrease inactivity programmes' which reduce TV and computer time rather than vigorous exercise prescriptions.

Studies have shown that in Jamaica, as is happening in the U.S. and other western societies, the incidence of obesity has increased threefold over the past 25 years in all age groups from three to 19 years.

Obesity prevention must begin with acknowledging and addressing the problem at home, school and in the community, recognising that this will reduce the incidence of diseases such as hypertension, diabetes, atherosclerosis (hardening of the arteries) and heart attacks in our children when they reach adulthood.