I fa chu a thau lutuk deuh niin a lang em? Naupang thau lutuk chungchang i zir dawn teh ang!

I fa tê chu tlem a thau lutuk niin i inhriat châng em? A nih loh leh a hma aia lian zawkin a lang em? I thianpa pakhatin chutiang thu chu a sawi tawh pawh a ni mai thei. Dik tak chuan naupang thau lutuk hi khawvel leh kan ramah hian a hluar hle a ni. Chuvang chuan hei hi kan hriat chian a pawimawh hle a ni.

Naupang thau lutuk hi eng nge ni? A awlsam zawngin...

Naupang thau lutuk chu i fa chu a kum, a san zawng leh a mipa leh hmeichhia (i.e., mipa emaw hmeichhia emaw a nih pawhin) a zirin a thau lutuk emaw, a thau lutuk emaw a ni. Hun rei tak chhunga nghawng nei thei natna rei tak a ni .

Hei hi dik taka tehna atan hian Doctor-te chuan method an hmang a. Body Mass Index (BMI) tih a ni. Kum hnih an tlin hnuah naupang ``BMI'' chu an kum leh mipa leh hmeichhiaah ``95th Percentile'' nen a inang emaw, a aia tam emaw a nih chuan doctor-te chuan chu naupang chu thau lutukah an ngai a ni.

Naupang BMI chhut dan hi puitling BMI chhut dan nen chuan a danglam deuh hlek a. Hei hi a chhan chu naupangte an lo puitlin chuan an taksa pianzia leh thau awm zat chu a pianphungah a inthlak danglam thin a ni. Chuvangin Doctor-te chuan naupang BMI chhut nan special growth chart an hmang thin.

Hetiang dinhmun hi engtiang chiahin nge a awm?

Dik tak chuan naupang thau lutuk hi tunlai naupang zingah natna khirh tak a ni ber . Entirnan, United States-a health organization lian tak, Centers for Disease Control and Prevention (CDC)-in survey an neihah kum 2017 atanga 2020 thleng khan naupang leh tleirawl kum 2 leh 19 inkar mi maktaduai 14.7 vel, a nih loh leh zaa 19.7 velin thau lutuk an vei tih a tarlang.

Kum hrang hrang thlir chuan:

• Naupang kum 2-5 inkar 12.7% an ni
• Naupang kum 6-11 inkar zinga 20.7% an ni
• Kum 12-19 inkar thalai zinga 22.2% an awm

Hetiang dinhmun hi hnam thenkhatah chuan a na zual hle. Tin, naupang rethei, service tlakchhamna hmuna cheng, pem lut chhungkaw atanga lo piang, leh naupang inthliarna leh hnawhchhuah te chu an hlauhawm zawk tih hmuhchhuah a ni bawk. Kan ramah pawh hetiang dinhmun hi a pung zauh zauh tih a chiang hle.

Engvângin nge naupang tê tête chungah hetiang hi a thlen? A chhan engte nge ni?

Naupang thau lutuk hi chhan pakhat vang a ni lo. Thil hrang hrang inzawmkhawm avanga lo awm a ni .

A awlsam zawngin sawi ila, i fa taksa hian an thanlenna leh an thanlenna atan calorie engemaw zat a mamawh a ni. Mahse, an calorie ei zat hian ni khata an calorie an hal zat aia tam a nih chuan chu calorie extra chu taksa thau (adipose tissue) angin a awm ang.

Kan ei zat, kan ei tur chi hrang hrang, leh kan taksain chu chakna a hman dan zawng zawng hi thil engemaw zatin a nghawng vek a ni. Naupang tin taksa leh an chhehvel a inang lo. Naupang thenkhat chu a dang aiin an thau chak zawk. Hei hi rilru hah vang emaw, duhthlanna tlakchham vang emaw a ni lo tih hriatthiam a pawimawh.

Genetics leh Epigenetics te a ni

Genetic factor thenkhat chuan naupang thau lutuk a tipung thei a ni. Naupang nu leh pa emaw, a unaute emaw an thau a nih chuan, chu naupang pawh chu a thau lutuk thei bawk. Zirna hrang hrangah chuan gene hrang hrang hian taksa rihna a tipung tih hmuhchhuah a ni. Mahse, chhungkaw history-a thau lutuk nei naupang zawng zawng chu an thau vek dawn lo.

Epigenetics chu i nungchang leh i chhehvela i genes hnathawh dan a nghawng dan zir chianna a ni. Naupang chi inthliarna leh tharum thawhna ang chi thil tha lo tawk thinte chuan an genes-ah inthlak danglamna an nei thei a ni. Heng inthlak danglamna hian an immune system leh metabolism a nghawng thei a, taksain chakna a hman dan a tidanglam thei a, thau lutuk theihna a tipung thei bawk.

`(Epigenetic)` factor dang thenkhat chu hetiang hi a ni:

• Nausen pian hmaa nu leh pa pakhat emaw, pahnih emaw thau lutuk.
• Naupai laia zunthlum vei.
• Naupai laiin taksa rihna sang lutuk.

Chhungkaw leh in chhung boruak in nghawng a neih dan

Chhungkaw thil tih dun leh in chhunga thil engemaw zat hian naupang thau lutuk a nghawng thei a ni.

• Nu leh pate’n an fate ei tur chi hrang hrang leh engzat nge an pek thin.
• Sugary drinks in fo thin.
• Chaw ei khata ei tur pek zat tihpun.
• Processed foods ei fo thin, artificial ingredients tam tak awmna.
• In lama chaw siam ai chuan pawnah chaw ka ei fo thin.
• Screen hun (TV, phone, tablet) tihpun a ni .
• Taksa exercise pe thei thil tih loh (Sedentary Behavior).
• Mut tam loh vang.
• Mi dangin meikhu an in laiin meikhu hip hi ``Secondhand Smoke Exposure'' an ti a.
• Naupan laia thil tawn \ha lo (ACEs). Ngaihtuah teh, in lama insualna a awm reng a nih chuan, naupang a hlauh chuan chutiang thilte pawhin nghawng a nei thei bawk.

Hriselna chungchanga khawtlang nun tidanglamtu (`SDoHs`) .

Kan pianna, kan chenna, kan zirna, kan hnathawhna leh kan khelhna boruak hian kan hriselna a nghawng a ni. Hei hi Social Determinants of Health (SDoHs) an ti a ni.

I chhungte awmna hmun hian i fa thau lutuk theihna chu direct-in a nghawng thei bawk. Sikul leh daycare-a i fate ei leh in tur pek hian an ei leh in a nghawng thei a ni. I fain ni tin exercise a neih zat pawh an pui thei bawk.

Socio-economic factor dangte nghawngtu:

• Chaw tha, nutritious tak tak hmuh awlsamna leh awlsamna.
• In hnaihah fast food dawr neih.
• Transportation facility hrang hrang a awm bawk.
• I tanpui tura awm mi, social connection te.
• Infiamna leh exercise neihna tur hmun (playground leh park ang chi) awm loh te, a nih loh leh a luh theihna tura himna awm loh te.

Cultural influence te hi a ni

Fast food dawr-a ei leh in hrisel lo advertisement-te hian naupang thau lutuk a tipung a ni. Naupangte chuan heng advertisement te hi TV-ah te, Internet-ah te, dawrah te an hmu thin.

Zirna hrang hrangah chuan naupangte target-a ei tur hrisel lo advertisement-a hun rei vak lo awm pawhin an ei zat a tipung a, chu hun chhung leh a hnuah pawh.

Natna dang leh damdawi dang

A tlem hle nachungin, damdawi lam thil thenkhat chuan naupang thau lutuk a thlen thei a ni.

Hormone inthlauhna, entirnan:

• Thyroid gland hnathawh a tlahniam (Hypothyroidism).
• Hypothalamic tumor a ni.
• Growth Hormone tlakchhamna.
• Cushing-a natna (syndrome) a ni.

Genetic condition awm lo tak takte:

• Prader-Willi Syndrome natna a ni.
• Bardet-Biedl natna vei a ni.
• Alstrom Syndrom natna a ni.
• Congenital Leptin emaw PCSK1 emaw tlakchhamna.

Damdawi thenkhat, second-generation antipsychotics leh corticosteroids te hian naupang thau leh thau lutuk theihna a tipung thei bawk.

Thau lutuk hian hriselna lama harsatna dang eng nge a thlen theih?

Naupang thau lutuk te hian natna chi hrang hrang an nei tam zawk.

Taksa lama harsatna a awm

Harsatna awm tam ber chu:

• Thisen sang a sang.
• Thisen a cholesterol level sang (High Cholesterol - `Dyslipidemia`).
• Insulin do theihna, Prediabetes, leh Type 2 Diabetes te a ni.
• Zu in loh vanga thau natna (NAFLD).

Harsatna dangte chu:

• Asthma natna a ni.
• Obstructive Sleep Apnea (Mut laiin thawk mumal lo) .
• A rilru a buai em em a, a rilru a hah em em bawk a. Polycystic Ovarian Syndrome (PCOS).
• Lungngaihna.
• Joint natna.
• Blount’s Disease (ke hrual) a ni.
• Lung natna.

Rilru leh khawtlang harsatna

Tin, naupang thau lutuk te hian:

• Naupang dangte hnen atanga tihduhdahna .
• Khawtlang nunah inthiarfihlim.
• Mahni inngaihhlutna hniam.

A pawimawh ber chu, naupan laia naupang thau lutuk te hi puitling an nih chuan an thau chhunzawm zel a rinawm.

I fa naupang enkawltu doctor chuan heng harsatna te hi enfiah turin test neih a rawt ang a, a tul chuan enkawl dan tur ruahmanna siam bawk ang che.

Engtin nge doctor chuan hetiang hi a nih leh nih loh a hriat theih ang ?

Naupang enkawltu doctor-te chuan well-child checkup tih dan pangngaiah an thau lutuk leh thau lutuk tih an hmuchhuak tlangpui. Naupang BMI hi an kum nena inmil em tih en nan special growth chart (BMI-for-age growth charts) an hmang thin.

BMI sang hi taksa thau tam lutuk chhinchhiahna a ni thei. BMI hian taksa thau hi direct-in a teh lo. Mahse, i fain taksa thau tam lutuk a neih leh neih loh hriat nan test belh a ngai em tih chu i doctor hnenah clue a pe thei a ni.

I fa doctor chuan taksa a enfiah ang a, i fa hriselna chanchin, nungchang leh in chhung boruak chungchang zawhna a zawt ang che. Tin, thisen test leh scan-te chu an ti thei bawk a, chu chu an thau lutuk chhan bulpui berte an zawng thei a, a nih loh leh an thau lutuk chhan ni thei damdawi lam thil dang an enfiah thei bawk.

Naupang thau lutuk enkawl dan tur engte nge ni?

I fa rihna hian hriselna atana hlauhawm a nih leh nih loh i doctor chuan a hre ang. Chutiang a nih chuan, enkawlna program mumal tak i ngaihtuah a ngai mai thei.

Medical team te chanvo

Obesity treatment program tha takah chuan health professional hrang hrang an tel tur a ni. Programme tha ber berte chu:

• Naupang enkawltu doctor te.
• Dietitian registered te an ni.
• Exercise Physiologist emaw Physical Therapist emaw a ni thei.
• Chhungkaw doctor te.
• Nursing lama mithiamte an ni.
• Naupang rilru lam thiamte.
• Psychiatrist te an ni.

Enkawl laia ngaihven tur thil

Comprehensive obesity treatment-ah hian a tlangpuiin:

• Hun rei tak chhunga enkawlna nasa tak pek .
• Naupang chu thau lutuk avanga damdawi leh rilru lama harsatna lo awm thei te chu endik leh enfiah fo thin ang che.
• Hriselna tichhe thei khawtlang thil (e.g., ei tur thianghlim, hrisel tak tak hmuh theihna) te hriatchhuah leh ngaihtuah.
• Naupang leh chhungte tana tihmualpho loh enkawlna hmanraw hman, an dinhmun danglam bik ngaihtuah .
• Ei leh in, taksa tihchakna, leh hriselna lama nungchang inthlak danglamna chungchanga Motivational Interviewing hman dan.
• Hriselna lama harsatna awmte tihchangtlun emaw, chinfel emaw, nunphung tihchangtlun, leh mahni inngaihhlutna tihchangtlun ang chi thiltum pum pui neih.
• A tul chuan intensive health behavior leh lifestyle treatment (IHBLT) leh taksa rihna tihtlem damdawi leh/ emaw metabolic leh bariatric surgery te inzawmkhawm
• Naupang leh chhungkaw mamawh danglam zel ang zela enkawlna siam.

Enkawl dan bik `(IHBLT)` tih a ni

Naupang thau lutuk chungchanga mithiamte chuan Intensive Health Behavioral and Lifestyle Therapy (IHBLT) hman hi an rawt hle a ni. He therapy hian chhungkawte chu hun rei tak chhunga hriselna tichaktu ei leh in leh taksa tihchakna lama inthlak danglamna siam turin zirtirna leh puihna a pe a ni.

`(IHBLT)` enkawlna hi hetianga tih a nih chuan a hlawk ber:

• Hmaichhana kan inhmuh hunah.
• Chhungkaw pum pui an inrawlh lai hian.
• Thla thum atanga thla sawm leh pahnih chhunga ei leh in, taksa tihchakna, leh nungchang tihdanglam chungchang zirna darkar 26 aia tlem lo a huam a ni.

Naupang thau lutuk hi ven theih a ni em?

Naupang thau lutuk venna kawng khat, awlsam tak a awm lo. A ven hi nangmah leh i chhungte mawhphurhna chauh a ni lo tih hriat reng a pawimawh bawk. Sorkar, tualchhung thuneitute, sikul, khawtlang leh company lian te pawhin mawhphurhna inzawmkhawm an nei bawk. Chu bakah, genetic leh damdawi nena inzawm thil engemaw zatin thau lutuk a thlen bawk. Hengte hi i thunun theih loh thil a ni.

I tih theih pakhat chu i naupan lai atanga ei leh in hrisel leh taksa tihchakna siam hi a ni. Naupangin a naupan lai atanga a ei leh in dan chuan a lo puitlin hunah nun hrisel tak a neih theih nan a pui ang. Chhungkaw tana ei tur chi hrang hrang thlan leh buatsaih dan tur i hriat chian loh chuan i fa doctor zawt rawh. Nutrition counseling atan registered dietitian hnenah a refer thei che a ni . I khawtlang hmun hrang hranga ei tur hrisel duhthlan tur awmte pawh a hrilh thei bawk che.

Naupang thau lutuk venna atana rawtna dang thenkhat:

• I naute chu thla 6 vel an tlin thlengin hnute chauh pe rawh.
• Nitin taksa tihchakna nuam takah tel ve rawh.
• Screen hun hi ni khatah darkar khat atanga darkar hnih aia tam lo turin tihtlem rawh.
• Sugary drinks ei loh tur a ni a, 100% fruit juice ei kha tihtlem tur a ni.

Heng ang hriselna tihhmasawn dan tur dangte chungchang hi i pediatrician hnenah zawt la.

Engtin nge ka fa thau lutuk chu ka tanpui theih ang?

I fate tanpuina atana i tih theih pawimawh ber chu an taksa rihna lam ngaihtuah lovin an hriselna lam ngaihtuah hi a ni. I fate hriselna tha zawk an neih theihna tura an zinkawngah i thlawp a pawimawh. I fate rilru put hmang chu i rilru put hmang a innghat fo thin. I fa chu eng rit pawha i pawm chuan anmahni an inhriatthiamna a sang zawk. I fa emaw, nangmah emaw, mi dang emaw mawhpuh loh tur.

Tin, i fate nen an rihna chungchang hi rorelna tel lovin sawipui a pawimawh bawk. I fa chu an rilru put hmang chu i hnenah i hrilh turin i phal tur a ni. I fate chu zawi zawiin i chhungte taksa tihchak dan leh ei leh in dan thlak danglamin i pui thei a ni. Tichuan, i chhûngkaw pum pui chuan nungchang hrisêl tharte chu an hlâwkpui thei ang.

A pawimawh ber chu: hriselna aia thau lutuk!

Kan tum ber chu naupang cher siam hi a ni tur a ni lo va, naupang hrisel, hlim taka siam hi a ni tur a ni tih hre reng ang che.

Chhungkaw angin i thawkrim ang u!

Chhungkaw in tih theih tam tak a awm a, taksa chakna tihpun hi a pawimawh zual hle. I fa chu ni khatah darkar khat tal taksa tihchakna mumal neih theihna tur thiltum siam rawh. Chutianga tih theih dan thenkhat chu hetiang hi a ni:

• Nangmah ngei pawh entawn tlak ni rawh: I fate chu active leh hlim taka awm i hmuh chuan i fa chu a active a, a dam chhung zawng a active reng thei a ni.
• Chhungkaw thiltih tur ruahman: Chhungkaw zinga mi zawng zawng exercise neih tir thei tur thil tih tur ruahman rawh. Kea kal te, bike khalh te, tui chawi te ang chi thil.
• I fa mamawh chu fimkhur rawh: I fate chu an taksa tihchakna nuam tak leh an tana harsa lutuk lo zawng chhuak turin tanpui a pawimawh.
• Screen atang hian rei lo te chhung inthiarfihlim rawh: I chhungte hmun khata hun hman zat (TV en, video game khelh ang chi) tihtlem tum ang che. I fa chu ni khatah darkar hnih aia tam screen-ah awm tir suh.
• Mut dan tha siam: Hun ruat saa mut leh electronic hmanrua te chu i fa mutna pindan chhunga dah loh chuan an mut that theih nan a pui ang.

Ei leh in tur pawh i buaipui ang u!

I fa i ṭanpui theih dân kawng dangte:

• Chaw ei tur chungchanga thutlukna siam ai chuan chhungkaw duhthlanna kaihhruai: I in chhungah ei tur hrisel chi hrang hrang dah tum ang che. Hetiang tih dan hian i fa chu mahni chauha ei tur hrisel thlan dan zir turin a pui ang.
• I fa chu thil lei leh ei tur buatsaihnaah tel tir rawh: Heng thiltih hian i fate chu ei leh in chungchang a zirtir thei a, thil tihhlawhtlinna a pe thei bawk. Chu bâkah, i fa chuan an buatsaih ṭanpui chaw ei emaw, ei tûr thar enchhin emaw a duh zâwk thei bawk.
• I fa chu chaw ei \hin turin zirtir rawh: Naupangin chaw a ei \hin chuan a ril\am leh chawhmeh chu a hlim zawk a ni.
• A theih phawt chuan chhungkuain chaw ei dun rawh u: Chaw ei hun hi inhnialna emaw, inhnialna hun emaw ni lovin, inbiakna leh inpawlhona hun atan siam tum ang che. Chaw ei hun a nuam lo a nih chuan i fa chuan chaw ei a tum ang a, a rang thei ang bera dawhkan a chhuahsan ang. Tichuan, ei leh in chu lungkhamna nên a inzawm thei a ni.
• In chhunga hmun ruat bik (dining room emaw kitchen ang chi) chauh ei tum ang che.
• I fate chaw chu thilpek atan pe suh: I fa hnenah thil thlum tak i pek hian i fa chuan ei tur dang aiin a tha zawkah a ngai mai thei. Entirnan, "Thlai zawng zawng i ei vek chuan dessert ka pe ang che" tih hian thlai chungchangah thu dik lo a thawn a ni.
• I fain i in pawna a ei tur chu ngaihtuah rawh: I fate sikul chaw ei program-ah chuan ei leh in inthlau tak a awm em tih zawng rawh. A theih chuan i fate lunchbox-ah ei tur chi hrang hrang pack la. Pawn lama chaw ei hunah ei tur hrisel thlang la, portion size ngaihtuah bawk ang che.

Engtikah nge Doctor ka hmuh ang?

I fate well-child appointment neih reng reng a pawimawh a, thau lutuk enkawlna nena inzawm appointment zawng zawngah tel vek a pawimawh. I fa doctor chuan nang leh i fate hmalam hun hrisel tak an panna kawngah a pui thei che a ni.

He dinhmun khirh tak chhehvela ngaihdan dik lo leh khawtlang nun sawichhiatna zawng zawng nen hian i fa thau lutuk chungchangah hian inthiam lohna emaw, mawhphurtuah emaw inhriat hi a awlsam hle. Mahse, naupang thau lutuk hi thil chhiar sen lohin a nghawng tih hre reng ang che – chung zinga tam tak chu i thunun theih loh a ni thei. Thu lawmawm tak chu, i fate hriselna chhawmdawl nan nang leh i chhungte tih theih tur thil a awm. I fa chu a thau lutuk tih i ngaihtuah a nih chuan an doctor nen inbia ang che. Anni chuan thau lutuk hian a thlen theih harsatnate tihtlem emaw, tihdanglam emaw tumna siam turin an pui thei che a ni.

I sawi tur pawimawh ber chu

Naupang thau lutuk hi thil pawi tak a ni a, mahse i hlawhchham tihna emaw, i fain hmalam hun a nei lo tihna erawh a ni lo. A pawimawh ber chu a hmaa hmachhawn a, thurawn dik tak anga hmalak hi a ni.

• I fa chu hmangaihna leh hriatthiamna nei takin thu sawi rawh. Naupang rihna hi mawhpuh emaw, nuihzat emaw loh tur.
• Chhungkaw angin nun hrisel tak hmang rawh u. Hrilhfiahna tenau tak tak hmangin tan la rawh.
• I doctor thupek ang chiah kha zawm rawh. A tul chuan dietitian emaw psychologist emaw hnenah tanpuina zawng rawh.
• Beiseina chu bansan ngai suh. I thawhrimna leh i hmangaihna chu i fa tan chakna nasa tak a ni ang.

He thu hi in tan a tangkai ngei ka beisei. Zawhna dang i neih chuan doctor nen inbia ngei ang che.

` Naupang thau lutuk, naupang thau lutuk, naupang hriselna, BMI, ei leh in hrisel, exercise, naupang rihna