Doctor Tran Quyen An, Nutrition Specialist at Tam Anh General Hospital Hanoi, stated that Ngoc has a BMI of 26,4 kg/m², classifying her as obese according to age and gender growth charts. The patient's waist circumference is 84 cm, with a waist-to-height ratio of 0,6, exceeding the recommended threshold of below 0,5. These indicators point to abdominal fat accumulation, increasing the risk of metabolic disorders and related diseases.

The child's nape showed acanthosis nigricans – a common sign in individuals with insulin resistance. Tests revealed she had a metabolic disorder and elevated blood uric acid.

The family reported that before Ngoc turned 5, she was thin and malnourished. Concerned about slow growth, her parents gave her high-energy foods, leading to rapid weight gain. Doctor An attributes the patient's health abnormalities to being overweight and obese. Weight management and lifestyle changes are the appropriate intervention at this stage.

Doctor An advises Ngoc on nutrition and develops a personalized treatment plan. *Photo: Tam Anh General Hospital*

The nutrition specialist developed a personalized plan and advised Ngoc to limit sugary drinks, high-energy formula milk, processed foods, and high-fat meals. The plan increased her intake of green vegetables, fiber, and appropriate protein sources. Ngoc was also instructed to engage in physical activity for at least 60 minutes daily, reduce screen time, and maintain adequate, timely sleep.

After more than two months, the patient lost 5,5 kg, and her waist circumference decreased by 10 cm. Inbody machine analysis results showed her body fat percentage dropped from 45,6% to 35,1%, and skeletal muscle mass increased. Her blood uric acid level returned to a safe range.

Doctor An explained that nutritional intervention for obese children differs from adults. Parents should not put children on extreme diets; instead, the focus should be on reducing excess fat, maintaining muscle mass, and improving metabolism while ensuring the child's height and physical development are appropriate for their age.

Many parents, concerned about their children being thin or growing slowly, frequently feed them high-energy foods such as weight-gain milk, sugary drinks, or supplements. Some families also increase meal portions beyond age-recommended needs. Prolonged energy surplus and lack of physical activity lead to rapid accumulation of excess fat.

Childhood obesity not only affects appearance but also leads to early health disorders such as insulin resistance, fatty liver, dyslipidemia, elevated blood uric acid, or pre-diabetes. When a child experiences abnormal rapid weight gain, has a large waist circumference, or develops acanthosis nigricans in skin folds like the nape or armpits, parents should seek nutritional consultation early.

Thuy Hanh

*Patient's name has been changed