Международный эндокринологический журнал 5 (69) 2015
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Eating disorders as predictors of the development of obesity in childhood
Авторы: T.V.Sorokman - Bukovinian state medical university, Chernivtsi, Ukraine
Рубрики: Эндокринология
Разделы: Справочник специалиста
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Introduction. WHO’s specialists are particularly concerned about the proliferation of excessive body weight among children. In Ukraine the annual record of obesity among children and adolescents is 18-20 thousand of new cases. Approximately in 30-40% of patients with obesity certain nutritional disorders are registered.
Research objective: to study the frequency of eating behavior disorders as predictors of obesity development in childhood.
Material and methods. 325 children aged 10 to 18 years from different districts of Chernivtsi region were examined. The control group consisted of 80 healthy children of the same age. Methods of examination included anthropometry, multipronged questioning with the definition of subsystems "father-mother" and “parents-children” the definition of indicators in the subsystems "father-mother" and "parent-child", Dutch eating behavior questionnaire (DEBQ).
Results. In the surveyed group of children (n = 325) with overweight and obesity boys prevailed - 185 individuals (60%), to 140 girls (40%) (p <0.001). Eating disturbance occurred in almost all patients with obesity. In the group of children without obesity malnutrition was found in 27.8% of patients. According the type of eating behavior disorders, examined patients were distributed as follows: limitative eating behavior was diagnosed in 60 children (18.4%), emotional - in 65 (20%) and external - in 200 individuals (61.5%). The combination of several types of eating behavior disorders occurred in 61% of children with obesity.
Initiation of eating disorders often happened in families with such features as overprotectiveness (an attempt to control everything) and rigidity (inability to change stereotypes, fixation on them; the inability to solve conflicts with direct or indirect involvement of children) (45.5% and 23.5%, respectively).
It is shown that first of all taciturnity, criticism and severity of parents often correlates with the formation and the presence of obesity in adolescence (r = 0.67, p < 0.05). It’s worth a note that the general level of obese children’ trust to their parents was particularly higher than the level of their anticipation of parents’ love. In our opinion, it demonstrates parents’ inability to show affection more than their indifference.
In certain families of obese children the phenomenon of mutually exclusive behavior (33,8%) was fixed. The microclimate in the parental family of obese patients was mentioned from the standpoint of conflict and indifference as "conflict" (33,8%), "on one’s own" (45,9%), and "none" (20,3%).
Due to the results of our research the injuring factors for obese patients are excessive parental claims (57.9%) and indifference (45.8%). The feeling of lack of rest and relaxation in obese children was recorded in 33.5% individuals, the dissatisfaction with social role - in 24.6%, inadequate family support or its absence - in 45.8%, stress - at 52.4%, exhaustion (lack of vital energy) - in 25.5% altered pattern of family relationships in childhood – in 28.8%, malnutrition – in 55.2%, the feeling of isolation (the current time) - in 24.2%, emotional problems - in 37.8%.
Conclusion. The impaired eating behavior in obese adolescents is statistically significant as compared with healthy coeval children. The external type of eating behavior is the most often to be diagnosed. In most cases there is a combination of several types (external, limitative, emotional) of eating behavior. The occurrence of eating disorders is inherent in overprotective and rigid families (45.5% and 37.8% respectively).
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