At 12 years old, Hung weighed 70 kg; two years later, his weight increased to 125 kg. He developed a double chin and neck fat, making it difficult to lie on his back or side while sleeping due to breathing difficulties. Hung was examined at Tam Anh General Hospital, TP HCM, where his body mass index (BMI) was nearly 40, indicating severe obesity, with visceral fat 2,5 times the safe limit.

Doctor Lam Van Hoang, Head of Endocrinology and Diabetes, noted that despite being 14, Hung presented with nearly all common obesity-related complications typically seen in adults. These included: dyslipidemia, grade three fatty liver, elevated liver enzymes, prediabetes, and increased uric acid. Excessive visceral fat in his throat and substantial neck fat compressed his airway, leading to obstructive sleep apnea. Fat accumulation in his chest and abdomen also reduced lung capacity, causing shortness of breath and rapid fatigue.

Doctor Hoang analyzing test results for Hung and his father. Photo: Tam Anh General Hospital

Obstructive sleep apnea negatively affects many bodily systems, especially the cardiovascular system. It causes high blood pressure and exacerbates conditions like congestive heart failure, type 2 diabetes, and pulmonary hypertension. Frequent sleep apnea can also lead to personality changes, irritability, increased risk of depression, and memory impairment.

Doctor Hoang recommended Hung lose at least 12-15 kg to alleviate sleep apnea symptoms and other obesity-related conditions, with an ideal target of 40 kg. Hung was prescribed appetite suppressants to reduce hunger and promote satiety. Concurrently, he adopted a diet rich in vegetables, fruits, and lean protein, replacing sugary drinks and milk tea with coconut water, fresh milk, and unsweetened yogurt. He also needed to maintain physical activity, such as jogging or cycling for one hour daily, to preserve muscle mass.

Acanthosis nigricans around Hung's neck, a characteristic sign of obesity. Photo: Tam Anh General Hospital

Initially, Hung still craved food and ate at night. He later switched from rice and noodles to low-calorie, high-fiber options that promote satiety, such as boiled corn, oatmeal, and fruit cereals. After two months, Hung lost 9 kg, aiming to lose at least 20-25 kg.

"Treating obesity in children is much more challenging than in adults," Doctor Hoang explained, "because children have not fully developed the cognitive ability to change behavior, making them prone to boredom and loss of motivation." Children under 18 represent a specific group in overweight and obesity treatment. Patients need to maintain an appropriate weight through lifestyle changes. When considering early medication for children, doctors must carefully assess potential impacts on their overall health.

Duc Hanh

* Patient's name has been changed