Demi
Mon, Apr-14-08, 00:29
The Times
London, UK
13 April, 2008
The children too obese to sleep safely
DOZENS of children as young as six and seven have become so obese that doctors are being forced to put them on ventilators at night to keep them breathing while they sleep.
The children, whose breathing difficulties are blamed on overeating rather than any medical conditions, have been judged by the National Health Service to be morbidly obese - weighing as much as four times the normal weight for their age.
The excessive weight bearing down on the chest, together with deposits of fat around the throat and neck, mean the children need ventilators to help them to breathe while they sleep.
Doctors have revealed that the problem, previously witnessed only in obese adults or children with medical problems, is spreading to children of primary school age as the latest consequence of the childhood obesity epidemic.
Many of the children will need to sleep attached to a breathing machine every night for the rest of their lives and doctors warn that they are at “huge risk” of dying because they cannot get enough oxygen.
Those affected include Regan Taylor, 7, from Conisbrough near Doncaster, who weighs 11 stone and is so obese that he has to wear adults’ clothes. He has had to sleep attached to a breathing machine ever since he was admitted to hospital for resuscitation four years ago.
One consultant warned that some children aged just six or seven may need to be considered for stomach-stapling surgery, usually restricted to adults, to reduce their weight and allow them to breathe properly.
Dr Jerry Wales, a consultant paediatric endocrinologist at Sheffield children’s hospital, said: “We have some children who are on nocturnal ventilation while prepubertal, and their life span is going to be limited because of that. This is happening in mid-childhood.
“You could make the argument that the only treatment that has any possibility of saving their lives is [stomach] surgery.
“Noninvasive nocturnal ventilation is a common treatment in adults and is getting more common in children. There is some fat round the airway narrowing it. The chest is also heavy and more difficult to move [when breathing].”
The children are suffering from a form of sleep apnoea caused by their obesity. Paediatric respiratory physicians previously diagnosed sleep apnoea in children with conditions such as enlarged tonsils but say that an increasing percentage of their patients now have the condition because they are morbidly obese.
Dr Rob Primhak, a paediatric respiratory physician at Sheffield children’s hospital, said colleagues in America had told him that obesity was the cause of the sleep apnoea in up to 50 per cent of their patients. Primhak said he was seeing an emergence of the same trend.
Respiratory physicians in London also say that an increasing percentage of their patients have obesity-related breathing difficulties.
“I saw the first case five years ago but we are much more aware of it now,” Primhak said.
“We have had three or four children whom we have had to treat for obesity-induced sleep apnoea.
“So far none of the obese patients I have treated for this have got better.”
Regan, who is one of Primhak’s patients, uses a device called a continuous positive airways pressure (CPAP) machine, which holds the airways open. Some children need more powerful noninvasive ventilators.
Regan’s mother, Paula Taylor, is considering putting locks on her cupboards to prevent her son eating all the time. She also has to shop for groceries on a daily basis to reduce the quantity of food available at any one time.
Taylor, a support worker for the elderly, says she has tried hard to curtail her son’s overeating but believes he has a genetic condition that stops him being able to control his appetite. Tests carried out on Regan have, as yet, failed to identify a known genetic condition, but doctors say that he could suffer from an as yet unknown defect.
“I worry about Regan’s weight. I cut down my hours at work so that I could be at home more to keep an eye on him,” Taylor said.
“The doctors have said Regan will always need the ventilator until they control his weight. If his weight comes down he will no longer need it. They tried him on slimming tablets but they didn’t seem to do anything.
“They are now going to put him on tablets to suppress his appetite. As a last resort they will consider surgery.”
Patient groups say the increase in children needing ventilators is evidence that the obesity epidemic has got out of control.
Tam Fry, chairman of the Child Growth Foundation, said: “We are seeing this now because we have failed to monitor the growth of our children and these children are being allowed to become morbidly obese. This kind of case confirms we have a horrendous obesity problem that we have not yet faced up to.”
There are about 1m obese children in Britain, according to the British Medical Association. Estimates indicate that, if current trends continue, at least one fifth of boys and one third of girls will be obese by 2020.
http://www.timesonline.co.uk/tol/news/uk/health/article3736388.ece
London, UK
13 April, 2008
The children too obese to sleep safely
DOZENS of children as young as six and seven have become so obese that doctors are being forced to put them on ventilators at night to keep them breathing while they sleep.
The children, whose breathing difficulties are blamed on overeating rather than any medical conditions, have been judged by the National Health Service to be morbidly obese - weighing as much as four times the normal weight for their age.
The excessive weight bearing down on the chest, together with deposits of fat around the throat and neck, mean the children need ventilators to help them to breathe while they sleep.
Doctors have revealed that the problem, previously witnessed only in obese adults or children with medical problems, is spreading to children of primary school age as the latest consequence of the childhood obesity epidemic.
Many of the children will need to sleep attached to a breathing machine every night for the rest of their lives and doctors warn that they are at “huge risk” of dying because they cannot get enough oxygen.
Those affected include Regan Taylor, 7, from Conisbrough near Doncaster, who weighs 11 stone and is so obese that he has to wear adults’ clothes. He has had to sleep attached to a breathing machine ever since he was admitted to hospital for resuscitation four years ago.
One consultant warned that some children aged just six or seven may need to be considered for stomach-stapling surgery, usually restricted to adults, to reduce their weight and allow them to breathe properly.
Dr Jerry Wales, a consultant paediatric endocrinologist at Sheffield children’s hospital, said: “We have some children who are on nocturnal ventilation while prepubertal, and their life span is going to be limited because of that. This is happening in mid-childhood.
“You could make the argument that the only treatment that has any possibility of saving their lives is [stomach] surgery.
“Noninvasive nocturnal ventilation is a common treatment in adults and is getting more common in children. There is some fat round the airway narrowing it. The chest is also heavy and more difficult to move [when breathing].”
The children are suffering from a form of sleep apnoea caused by their obesity. Paediatric respiratory physicians previously diagnosed sleep apnoea in children with conditions such as enlarged tonsils but say that an increasing percentage of their patients now have the condition because they are morbidly obese.
Dr Rob Primhak, a paediatric respiratory physician at Sheffield children’s hospital, said colleagues in America had told him that obesity was the cause of the sleep apnoea in up to 50 per cent of their patients. Primhak said he was seeing an emergence of the same trend.
Respiratory physicians in London also say that an increasing percentage of their patients have obesity-related breathing difficulties.
“I saw the first case five years ago but we are much more aware of it now,” Primhak said.
“We have had three or four children whom we have had to treat for obesity-induced sleep apnoea.
“So far none of the obese patients I have treated for this have got better.”
Regan, who is one of Primhak’s patients, uses a device called a continuous positive airways pressure (CPAP) machine, which holds the airways open. Some children need more powerful noninvasive ventilators.
Regan’s mother, Paula Taylor, is considering putting locks on her cupboards to prevent her son eating all the time. She also has to shop for groceries on a daily basis to reduce the quantity of food available at any one time.
Taylor, a support worker for the elderly, says she has tried hard to curtail her son’s overeating but believes he has a genetic condition that stops him being able to control his appetite. Tests carried out on Regan have, as yet, failed to identify a known genetic condition, but doctors say that he could suffer from an as yet unknown defect.
“I worry about Regan’s weight. I cut down my hours at work so that I could be at home more to keep an eye on him,” Taylor said.
“The doctors have said Regan will always need the ventilator until they control his weight. If his weight comes down he will no longer need it. They tried him on slimming tablets but they didn’t seem to do anything.
“They are now going to put him on tablets to suppress his appetite. As a last resort they will consider surgery.”
Patient groups say the increase in children needing ventilators is evidence that the obesity epidemic has got out of control.
Tam Fry, chairman of the Child Growth Foundation, said: “We are seeing this now because we have failed to monitor the growth of our children and these children are being allowed to become morbidly obese. This kind of case confirms we have a horrendous obesity problem that we have not yet faced up to.”
There are about 1m obese children in Britain, according to the British Medical Association. Estimates indicate that, if current trends continue, at least one fifth of boys and one third of girls will be obese by 2020.
http://www.timesonline.co.uk/tol/news/uk/health/article3736388.ece