Obesity

Question	Answer
TRUE/FALSE? 1a) A BMI of 16 kg/m2 is below the healthy range at age 6y.	FALSE. This is within the healthy range for a child at age 6 y. This is the age when BMI is at its lowest during development. Look at a BMI for age chart to see the normal changes in BMI across age.
TRUE/FALSE? 1b) A BMI of 22 kg/m2 is in the healthy range for a girl aged 15y.	TRUE. This is approximately at the 75th centile for age for a 15 year old. Look at BMI for age charts to see the normal changes in BMI across age.
TRUE/FALSE? 1c) Overweight/obesity is more prevalent in boys than in girls in China.	TRUE. This gender difference is quite pronounced in China, a phenomenon known as “The Little Emperor syndrome”. The World Obesity Federation global obesity prevalence maps show a lower prevalence of overweight/ obesity in girls compared to boys in China.
TRUE/FALSE? 1d) Overweight/obesity prevalence rates are much higher in Australian school-aged children than in children from South America, the Middle East or the Mediterranean countries.	FALSE: Prevalence rates in many of these countries are similar, as can be seen in the World Obesity Federation global obesity prevalence maps.
TRUE/FALSE? 1e) The prevalence of overweight/obesity in pre-school-aged children has plateaued.	FALSE: The global prevalence of overweight/ obesity in under 5s still seems to be increasing.
TRUE/FALSE? 2a) Breastfeeding has a small but protective effect on the development of obesity in children.	TRUE: This still appears to be the case. However, there are many other positive benefits of breastfeeding.
TRUE/FALSE? 2b) The dramatic rise in obesity prevalence in recent decades means that genetic factors play no role in obesity development.	FALSE: Genetic factors play an important role in “loading the gun” for the development of obesity. Environmental factors “pull the trigger”.
TRUE/FALSE? 2c) Genetically predisposed children are more vulnerable to the development of obesity in a given environment.	TRUE: Genetic factors play an important role in “loading the gun” for the development of obesity. Environmental factors “pull the trigger”.
TRUE/FALSE? 2d) Changes in both dietary patterns and physical activity/ sedentary behaviours have contributed to the rise in obesity prevalence.	TRUE: Patterns of both energy intake and energy expenditure have changed in many countries in the past few decades.
TRUE/FALSE? 3a) A BMI of 23 kg/m2 and a waist:height ratio of 0.6 in a child aged 6y is indicative of obesity and increased cardio-metabolic risk.	TRUE: At age 6 years, this BMI is above the 95th centile for age. A waist:height ratio >0.5 is associated with increased cardiometabolic risk (raised insulin, raised triglycerides, decreased HDL cholesterol).
TRUE/FALSE? 3b) Short stature is common in pre-pubertal children with obesity.	FALSE: Pre-pubertal children with obesity tend to have increased pubertal maturation, often going into puberty earlier than their healthy weight peers. They therefore tend to be taller at a younger age. Final adult height is not different, however.
TRUE/FALSE? 3c) All children with obesity should have a fasting blood test performed to check for complications.	FALSE: This is not needed for ALL children with obesity. Fasting blood tests are more likely to be indicated in the following: Adolescents, Severe obesity, Strong family history of cardio-metabolic complications, Higher risk ethnic group, Signs or symptoms suggestive of complications.
TRUE/FALSE? 3d) Acanthosis nigricans in an adolescent with central obesity and a family history of type 2 diabetes suggests insulin resistance or prediabetes.	TRUE: More detailed investigation for cardio-metabolic risk is often warranted in this clinical situation.
TRUE/FALSE? 3e) A raised ALT in the context of an adolescent with obesity, acanthosis nigricans and hypertriglyceridaemia is consistent with fatty liver disease (NAFLD).	TRUE: Non-alcoholic fatty liver disease is more common in those with central obesity and insulin resistance. In this context, a raised ALT can be an early biochemical marker of NAFLD. Other causes of a raised ALT may need to be considered.
TRUE/FALSE? 4a) Family focussed lifestyle intervention in children with obesity can lead to mild to moderate improvements in weight status and cardiometabolic risk.	TRUE: This is shown in several systematic reviews, including a Cochrane systematic review.
TRUE/FALSE? 4b) In treating a 7 year old child with obesity, the child’s active engagement in the therapy program is crucial.	FALSE: The most crucial engagement is that of the parent or major carer of the child. Too active engagement of the child – who is not, of course, responsible at that age for food, sleep or activity routines in the household – may cause stress in the child.
TRUE/FALSE? 4c) Bariatric surgery should be considered in a pre-adolescent child with severe obesity.	FALSE: Most national bariatric surgery guidelines recommend its use in adolescents (approx. age 15 y and up) with severe obesity who have not responded to high quality medical management.
TRUE/FALSE? 4d) Long-term maintenance strategies may be required in children with obesity, even after initial good response to therapy.	TRUE: Obesity is often a severe, chronic relapsing disease. As is the case in adults with obesity, in children some form of long-term maintenance therapy is usually required after initial weight management therapy.
TRUE/FALSE? 4e) School-based interventions are the mainstay of effective obesity prevention.	FALSE: School-based prevention strategies may be very necessary but they are not sufficient for obesity prevention. Multi-sectoral interventions influencing the broader food and physical environments will also be needed.

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	Created by Averil Tam almost 6 years ago