ดาวน์โหลดงานนำเสนอ
งานนำเสนอกำลังจะดาวน์โหลด โปรดรอ
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Obesity พญ. หทัยทิพย์ ต่างงาม โรงพยาบาลนครพิงค์
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จำนวนผู้ป่วยเด็กโรคอ้วน
2 4 1 5 3 16 15 40 6 จำนวนผู้ป่วยเด็กโรคอ้วน รพ.นครพิงค์ ปี 60 (จังหวัดเชียงใหม่) Total = 114
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ภาวะแทรกซ้อนของโรคอ้วน
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Weight for height (W/H) = body weight (kg) x 100
Diagnosis Severity of obesity Overweight Obesity Morbid obesity W/H > > >200 Weight for height (W/H) = body weight (kg) x 100 Ideal body weight (kg)
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Growth curve Boys and Girls 2-19 yr
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A 8 year-old girl >> Obesity Example Weight for height
W/H = 45 x 100 28 = 160% 45 >> Obesity 28
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A 11 year-old boy >> Obesity Example Weight for height
W/H = 48 x 100 33 = 145% 47 >> Obesity 33
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Etiology Exogenous obesity Endogenous obesity Nutrition
Environment/ Lifestyle Endogenous obesity Endocrine obesity Syndromic obesity
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Prader-Willi Syndrome
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Exo- VS Endogenous Obesity
Exogenous Family history uncommon Common Height Short stature Normal/Tall IQ Low IQ Normal IQ Bone age Retarded Normal Physical exam Abnormal
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Principle of Management
No complications control the weight or increase slowly Severe obesity or complications - Reduce wt urgently 5-10 % within 6 mo - Reduce Kcal/day (not <1200 Kcal/day in 6-12 yrs.old) - Morbid obesity 800 Kcal/day in some institute
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Management: Foods control
< 2 years old: No need for weight reduction > 2 years old - Reduce high caloric foods (Ice-cream, chocolate, cake etc.) School- age: - No fasting - Do not skip meals esp. breakfast - Reduce high caloric foods - Increase vegetables, low caloric fruits
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Management: Exercise - Physical activity : swimming, walking, riding bicycle : 30 minutes : at least 3 days./ wk. - Decrease physical inactivity
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Management: Behavior modifications
- Self monitoring: daily record of food intake, exercise, leisure time - Stimulus control : adjust environment - Reinforcement : rewards, admiration - Cognitive restructuring: positive thinking & internal self support - Buddy system/social support
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Case Scenario
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Weight Height
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