Data from the Chinese Center for Disease Control and Prevention shows that the current rate of overweight and obesity among children aged 6 to 17 in my country is about 19%. If it is not effectively curbed, the overweight and obesity rate of children in my country will reach 31.8% in 2030. At the same time, physiological and psychological problems caused by obesity are also being paid more and more attention.

  A reporter from Beijing Youth Daily visited many schools and hospitals and found that there were many fat people with severe weight exceeding the standard. To this end, many schools provide assistance to students in losing weight by offering "small stools" in diet and holding "fat-reducing classes" after class. At the same time, children's specialty hospitals such as Beijing Children's Hospital and Capital Pediatrics Research Institute have also concentrated their professional efforts to open multi-disciplinary joint weight management clinics to provide young fat men with scientific weight management plans. However, weight management is not a day's work.

  Individual case

The main reason for   the weight gain of 140 pounds in three years

  At the end of March, Xiaolin (pseudonym), who lives in Xicheng, came to the Shouken School with her mother and asked for help from Cao Bingyan, director of the Endocrinology Department. Kobayashi is 14 years old this year, 1.7 meters tall, but weighs 280 kilograms. It turns out that because of eating more and moving less, Kobayashi's weight has soared by 140 kilograms in the past three or four years, and now it has become a problem for walking.

  After a comprehensive examination, Cao Bingyan found that Xiaolin's blood pressure was relatively high and losing weight was urgent. "Considering that Kobayashi has a large weight base and her previous lifestyle interventions such as exercise and diet regulation were limited, combined with his physical condition, we decided to use drug treatment, supplemented by diet and lifestyle adjustments, hoping to help him lose weight successfully," said Cao Bingyan.

  Similar to Kobayashi, his weight of more than 140 pounds made Xiao Wang, a first-year junior high school student, very worried. He told the Beijing Youth Daily reporter that he likes to eat fried foods and also likes to eat sweets, especially fried chicken and fries. Previously, my parents felt that it would not affect their normal life, so they did not interfere too much in their diet.

  Bad eating habits make Xiao Wang fatter and he becomes less active, and he is more despised in his exercise. "If you can't eat, the more you don't move, the fatter you get, the more you get, the more you get..." In Xiao Wang's own words, he usually "can lie down and not sit, and sit down and not stand." Such a vicious cycle continues to take place. Xiao Wang began to fail to keep up with the rhythm of the students' collective movements, and finally gave up directly, "I am always slower than others, and the students dislike them, and I am unwilling to participate in the activities anymore."

  status quo

  A bunch of certificates to avoid taking the exam and give birth to school aversion

  "I can't even do pull-ups at the moment, so I'm very anxious." Faced with the physical education high school entrance examination, Xiaopeng Xiao Liu was very upset. Xiao Gao, a first-year junior high school girl who was in the same school as Xiao Liu, felt that physical examinations were "like a nightmare". Because she was fat, Xiao Gao always disliked sports. "He often had a 400-meter run, and no one of them was good at other events."

  Cao Bingyan told the Beijing Youth Daily reporter that she found a rule in her daily outpatient clinic: more primary school students come to the hospital than junior high school students, but once the physical education high school entrance examination is approaching, junior high school students will come to the hospital in groups. "They are basically obviously obese children, and some weigh more than 200 kilograms." Because it is difficult to achieve immediate results with weight loss, many parents will take their children to the hospital to get obesity certificates first, hoping to pass a certificate to avoid the trouble of exams.

  A reporter from Beijing Youth Daily learned that some children are allowed to apply for the Beijing Sports High School Entrance Examination. For candidates who are abnormal physical development (such as dwarfism, gigantia, etc.), severe malnutrition, obesity, deformities (such as severe spinal bending, O-type and X-type legs reaching II degrees), but still take physical practice classes, they apply by themselves. After the school review, they can choose one of the sports field exam items to take the exam. The final score is converted according to the proportion of the actual test score to the score of the item. "When the child's obesity has made him unable to take the physical education high school entrance examination normally, it means that the problem is already serious," said Cao Bingyan.

  Relevant studies show that obesity can reduce the self-esteem and confidence level of adolescents, and emotional problems such as inferiority, anxiety, and depression have put many fat people in trouble. Among the many students with overweight weight interviewed by Beijing Youth Daily reporters, more than 70% expressed their unwillingness to participate in group exercises. The reasons given are mostly "I have poor exercise ability and cannot keep up with other students, I am afraid of being disliked by my classmates, and even afraid of seeing some students' strange eyes."

  Kobayashi was once looked at by classmates because of obesity, and she became disgusted with school and was reluctant to go to school again. She even stayed at home for more than half a year. Xiao Ke, who came to the First Children's Hospital for treatment in Inner Mongolia, also developed a disgust for school. At the age of 14, he weighed 186 kilograms. Because obesity caused high blood pressure, there were problems with sugar and lipid metabolism. He was prone to dizziness, unable to persist in studying for a long time, and his grades plummeted, which led to Xiao Ke's idea of ​​not wanting to go to school, and his parents were also worried about this.

  investigation

  Parents have misunderstandings about experience and use the wrong method to backfire

  Weight is related to genes, family life habits, and health management awareness. Parents’ cognition is particularly critical. Huang Hongmei, chief physician of the Clinical Nutrition Department of Beijing Children's Hospital, found in the outpatient clinic that many parents have misunderstandings about their children's weight loss.

  "Some parents think obesity is not a disease. They think that although their children are fatter, they can eat and sleep well, but they ignore the potential harms behind obesity. For example, obesity may cause metabolic problems, including insulin resistance, high uric acid, increased blood lipids, etc.." Huang Hongmei said that because the child is young, the problem is not very obvious at first, so parents disagree. "Some parents also believe that when their children grow up, they will naturally lose weight. However, relevant research shows that among the obese people in childhood, one-third of them will continue to be obese until adulthood; when teenagers are obese, about two-thirds of them will remain obese after adulthood. Because they are worried about the heart and lung burden of their children, some parents will also restrict the exercise of a fat boy, which is not conducive to fat loss and muscle gain."

  Shi Lin, director of the Department of Cardiovascular Internal Medicine of the Shou Academy, also noticed that some parents have the awareness to help their children lose weight, but are losing weight wrongly according to their own experience, such as using the so-called ketogenic diet, not eating supper, or exercising wildly, etc. "In fact, children are in the growth and development stage. A balanced diet and sufficient nutrition are necessary. Unscientific weight loss methods can easily affect children's health." Shi Lin said that in the outpatient clinic, doctors will calculate the daily calories required by the child based on the child's age, height, weight, development status and other data, and evenly distribute them to essential foods for the body such as protein, fat, sugar, etc., and then distribute them to three meals a day to allow children to eat full and healthy.

  "By adhering to a scientific diet, you can basically control your weight in 3 to 6 months. And as long as one or two months of adjustment, many children are not very interested in a high-oil and high-salt diet. Among the little fat guys I manage, 70% of them are effective, and except for the other 30% are not strictly implemented." Shi Lin said.

  In Shi Lin's view, although some parents realize that they need to lose weight for their children and bring their children to the outpatient clinic, compliance is a major challenge for their children's weight loss. Many families have difficulty in implementing diet and exercise plans given by the hospital.

  "Especially for dual-working families, parents do not have enough time and energy to cook for their children or urge them to eat well. Some parents want to lose weight for their children, but grandparents and grandparents secretly add meals to their children, making their weight loss fail. The children do not have enough supervision at school." Some parents tend to follow the tastes of adults, such as giving their children boiled vegetables and cold salads, but these foods are not delicious for children, which can easily cause resistance. Shi Lin said that it is best for children's food to be warm, scented and softer, so that it is easier to stick to it, but it does test parents' patience.

  Cao Bingyan found in the outpatient clinic that 80% of the "little fat guys" could achieve effective weight management in about three months as long as they insisted on following the doctor's advice, but many people had a rebound in weight for less than a year. "Most parents can realize the seriousness of the problem at first and attach great importance to it, but they tend to relax over time. In the sequence of importance of children's affairs, learning and social priorities may be higher, and weight management is easily gradually ignored."

  ·Expert medical advice·

  Hospitals should conduct joint interventions for children with obesity and clinical risk factors

  Medical and school-home linkage to detect problems as soon as possible

  Obesity is not a simple personal problem, but also social factors. To reduce the small fat guys, we need to give full play to the strength of all parties. In Huang Hongmei's view, a joint management model of "medical school and family" can be established to build a healthy ecology for children through multi-party collaboration.

  Huang Hongmei suggested that hospitals should focus on leveraging their professional advantages, developing and providing support technologies and guarantee technologies. For children with severe obesity and obesity with clinical risk factors, joint interventions such as medical, dietary, exercise, psychological and behavioral corrections will be carried out according to relevant guidelines and regulations, or treatment and management of metabolic syndrome and various diseases.

  Schools should highlight educational and demonstration functions. This includes strengthening children's health literacy education and allowing every student to be the first person responsible for their own health. Nutritional signs or health tips can be set up on campus to provide students with healthy food and drinking water, and help students establish a healthy dietary nutrition concept. Help children develop exercise habits, create opportunities for children to discover that they like and persist in exercise for their lifetime.

  In terms of family, parents or other family members are encouraged to participate in children's overweight and obesity intervention, and behavioral changes such as improving cognition, goal setting, and self-monitoring are adopted to guide children to develop good lifestyles and behavioral habits.

  Shi Lin also suggested that in the future, AI can be used to help parents and children continue to carry out weight management. For example, the AI ​​platform can intuitively form body data reports, helping doctors monitor changes in children's various indicators as soon as possible, and adjust their diet and exercise plans in a timely manner. "We hope that with the development of AI platforms in the future, school teachers will also join in, pay attention to and record the exercise and consumption of the fat guys during school, and better urge children to manage their weight through multi-party linkage."

  The physical and mental health of children involves two major areas: education and health. Shi Lin found that there are still some difficulties that need to be overcome in the cooperation between the two parties. For example, although Shunyi, Haidian and other districts have piloted the "school doctor-hospital" linkage, many places have been restricted during the promotion process.

  "For example, although children are found to be obese or hypertensive in schools, the data sharing between the education system and the medical system is insufficient and cannot be directly related to the medical system, and children's health problems cannot be detected and intervened early; some schools and school doctors lack professional training, resulting in limited effectiveness of obesity screening and management. I hope that these links can be opened in the future to promote medical and school linkage, and better promote the healthy growth of children and adolescents." Shi Lin said.

  ·Campus Prescription·

  Beijing No. 10 Middle School Xiaoyueyuan Branch

  Nutrition package standard calorie AI prescription exercise prescription

  A reporter from Beijing Youth Daily noticed that in order to help the little fat people lose weight scientifically, many primary and secondary schools in the city have given them "small stomps" in terms of diet, exercise, etc.

  In terms of diet, taking the Xiaoyueyuan Branch of Beijing No. 10 Middle School as an example, it helps the "little fat men" lose weight from the source of diet. The school canteen optimizes the stall settings and specially sets up nutritional meal stalls with different needs. Among them, low-calorie and high-fiber meals are provided at the "low-fat weight loss package" stall, such as chicken breast sets, mixed grain rice, etc. The calorie volume of the "Nutrition Balanced Package" stall is controlled at 500-600 calories. Each package contains 1 staple food (combined with coarseness and fineness), 1 high-quality protein, and 2 vegetables.

  In addition, the school marks calories and nutrients (such as protein, fat, and carbohydrate content) next to each dish to help students understand their intake intuitively. For example: steamed fish (150g), about 180 calories, 25g of protein, 6g of fat. Fried shrimp with broccoli (200g) about 150 calories, 15g of protein, 3g of dietary fiber. "In this way, students can choose healthier combinations independently to avoid excessive intake of high-calorie foods." said Xi Jing, manager of the school's system department and public nutritionist.

  Xi Jing introduced that in order to cultivate students' health concepts, the school regularly holds nutrition knowledge lectures and healthy diet theme activities. Among them are the "My Healthy Meal Plate" activities that teach students how to match the nutritional ratio of a meal, and also invites nutritionists to explain how to scientifically control weight and diet safety through diet and exercise.

  In addition to scientific diet, the Xiaoyueyuan Branch of Beijing No. 10 Middle School also provides a scientific training system for the "Little Fatty" group. Based on traditional sports courses, an innovative sports course project developed by Peking University's Sports Science and Health Big Data Laboratory - "Full Score Intelligent Physical Fitness Course" was introduced to conduct real-time data monitoring of students' exercise processes, accurately analyze the weak links of the "Little Fatty" in terms of five qualities: speed, strength, endurance, sensitivity and flexibility. With the help of AI diagnosis and training models, a professional evaluation report and personalized "sports prescription" are generated for each student.

  In order to stimulate the sports interest of "Little Fatty Dun", the school makes physical education classes interesting and lovable through diversified incentives such as smart device interaction, online physical fitness games, event competition PK, and personalized ID data. In terms of weight monitoring, the "Full Score Intelligent Physical Fitness Class" intelligent management system continues to track the changes in the exercise data of "Little Pangdun", and combines regular BMI indicator detection to comprehensively evaluate the effect of exercise intervention. (Text/Reporter Wu Wenjuan and Jiang Ruojing)

[Editor in charge: Wang Qi]