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personal and medical factors. The respec- tive three- to ten-fold increased obesity risk if one or both pa rents a re obese demonstrates this genetic connection. Affected children have a genetic predis- position to increased hunger, but they do not eat uncontrollably, as some imagine. Even with this genetic caloric craving, on average, Dr. Atwa states that obese children consume only 100 calories more each day than their non-obese counter- parts. And the latest findings reveal that the genetic predisposition to childhood obesity is not solely caused by the parents. Instead, such a predisposition takes root two generations prior. "People say that genes don't just change in four generations, and that's not true," Dr. Atwa says. "Actua l genetics cha nge over t hou s a nd s of ye a r s , but we 'r e ta lking epigenetics, and these [changes occur] within a generation or two." The source of these cha nges resides within the obese child's g ra ndmother. W h i le i n ut ero, t he g ra nd mot her i s ex posed to a toxin. This impacts t he g ra ndmother's genetics in such a way t h at t he g r a ndch i ld i s at i ncrea sed r isk of ex per iencing obesit y or mor- bid obesit y. Though there is some question about what introduced toxin could cause this dilemma , Dr. Atwa suspects responsi- bilit y lies with the va riet y of cha nges t hat occurred w it hin food a nd drin k over t he la st si x t y yea rs. Diet soda , low-fat foods, chemica ls, preser vatives and improved agricultura l genetics that a llow for the production of more food quicker may a ll contribute. A departure from ancient grains may a lso play a role. W hen seeking a hea lthy choice, ma ny opt for whole-g ra in bread. Thoug h a better option than white bread, Dr. Atwa states that whole-wheat bread causes a higher glucose spike tha n a ca ndy ba r. RISKS OF UNCHECKED OBESITY Children, adolescents a nd teens face ma ny of the sa me risks from obesity as adults. For example, their lifetime risk increases for dangerous and deadly conditions such as hear t disease and diabetes, high blood pressure and cho- lesterol, kidney problems, fatty liver, and sleep apnea. Many of these risks do not have immediate effect. Rather, they are complications that arise from years of obesity. Obesity in childhood jumpstarts the process toward such disease. Regardless of how long the issues take to manifest in physical symptoms, they result in lower quality and quantity of life. "[For the] first time in our lifetime, children are going to live shorter [lives] than their parents because they 're so overweight," Dr. Atwa says. "A ll these medical problems are accelerated in kids. The earlier you catch the problem, the more likely you can resolve it." MANAGING RISKS THROUGH SURGERY The resolution offered through adoles- cent bariatric surgery is significant. On average, adolescent bariatric surgery patients lose one-third of their excess weight within the f irst 9–12 months. This comes with the benefit of resolving comorbidities brought on by obesity. Following bariatric surgery, resolution rates among adolescents and teens are: + Hypertension — 100% resolution + Diabetes — 94% resolution + Sleep apnea — 91% resolution This bodes well for the long-term health of patients, as adolescent bariatric surgery Childhood obesity complications M D N E W S . C O M /// M D N E W S L O N G I S L A N D ■ 2 0 2 2 1 3