Childhood obesity in Taiwan.
As other developed countries of the world, obesity has become a major health problem of children and adolescents in Taiwan. According to an island-wide survey, the prevalence of obesity varied from 4.3% to 17.4% in children aged three to nineteen years. Obesity is defined as an excess of body fat. Since the standard references of weight-for-height and body mass index for Taiwanese are not available, a weight-for-length index has been introduced. We have found that its easy computation and interpretation with high reliability make it a desirable measure of relative weight either in clinical practice or in research. The family background of the obese children has been investigated by many workers. In our own series, the obese children were about five times as likely to have an obese parent as control. There was also a significant difference in the chance of having an obese sibling between the obese and control groups. Several health sequelae of childhood obesity have been studied in Taiwan. Obese children appear to have high prevalence of hypertension, hyperlipidemia, and abnormal glucose metabolism. Of several cutaneous manifestations of obesity, colored striae were sometimes overlooked. In our experience, 40% of the moderate to severe obese cases have such striking marks prominently located on the thighs, arms and abdomen. A few pediatric weight-losing programs have been carried out in Taiwan. In our Pediatric Anti-Obesity Club, four fundamental components: diet, exercise, behavior modification and parent involvement were included in the treatment program. In family-based parent-directed program, 11% of the participants showed decreases in degree of obesity after one year follow-up, compared to 3% of a control group. In another individualized outpatient counseling clinic, the success rate was 59% after one year. Although the long-term effectiveness cannot determined, it seems rational that a realistic and culturally sensitive weight reduction program should be developed for countries, such as Taiwan, with increasing prevalence of childhood obesity.