Childhood Obesity Case Study

Miss NAA is a 16- year old girl with long future ahead of her. Next year, she will be sitting for her SPM, which is a major milestone for her education. Having diabetes means that she will need to miss school to attend her clinic appointments. Even now she is already absent for a week due to admission for diabetic education. Upon discharge, she will need to come again for review at a month time to monitor her sugar control at home. Nevertheless, this admission is necessary to properly educate and empower her on the disease, complication and monitoring. Good adherence is essential to prevent more serious complication that will cost even more absent days of school. Fortunately for Miss NAA, during this admission, she attended the ‘school in hospital’
It is also known that obesity is the most common cause of insulin resistance in children. (20) The third National Health and Nutrition Examination Survey (NHANES III) conducted in United Stated between 1988 and 1994 showed prevalence of 6.8 percent metabolic syndrome among overweight adolescent and a striking 28.7 percent among obese adolescent. (20) In a case control study among children living in Kuala Lumpur, metabolic syndrome was found in 5.3 percent of overweight/obese children. (21) It was also found that Indians have higher odds compared to Malays or Chinese. (21) Causes of childhood obesity can be multifactorial with the most common being unhealthy diet, reduced physical activity and genetic factors. (22) The Malaysia Clinical Practice Guideline for Obesity 2004 outlined four important reasons to detect obesity in children and adolescent and factors determining persistence of obesity into adulthood. (22) Based on the factor laid out in the guideline, Miss NAA’s obesity is likely to persist till adulthood as she started to become increasingly overweight after the age of three and currently in class 1 obesity. In Malaysia, there are already programs in place that can identify these group of children at early age. The program is run by the health clinic as clinic or home visit for children as young as new-born to the age of six years old. Parents must be educated on the importance on continuing with follow up even though immunization schedule already completed as this visit can monitor their children developmental milestones and nutritional status. Thereafter, the service is continued by the school health team. The school health team does physical examination for standard 1, standard 6 and form 3 students which includes anthropometric measurement as well as giving them vaccination. Unfortunately, even with such system in place, Miss NAA