Dr. Sonita Alexander
In Barbados, the rising rate of adolescent obesity is becoming a significant concern, with one in three children now classified as overweight or obese. According to Dr. Sonita Alexander, a local physician, this trend has been increasing steadily in recent years, demanding urgent attention.
Dr. Alexander explains that obesity in adolescents is not just about excess weight; it comes with a host of serious health risks. Young patients with obesity face a significantly higher likelihood of developing conditions like type 2 diabetes, hypertension and early-onset heart disease. “We’re also seeing joint issues and even certain types of cancer becoming more prevalent at younger ages,” she notes. Yet, the effects are not only physical. Dr. Alexander emphasizes that obesity can have a devastating impact on mental health, leading to low self- esteem, anxiety, and depression, particularly as these adolescents often experience bullying or social isolation.
While genetics can play a role in some cases, Dr. Alexander believes the root of the issue lies primarily in environmental and behavioural factors. Poor dietary habits and sedentary lifestyles are now more common among Barbadian youth. “Most of our students are drinking at least one sugar-sweetened beverage every day, and about 18.5% are consuming fast food three to four times a week,” she reveals. These poor eating patterns are exacerbated by limited physical activity. “We’re seeing more kids spending time on screens instead of playing outside,” Dr. Alexander adds. Family eating habits and economic factors also contribute significantly to this issue, making it harder for many families to adopt healthier lifestyles.
Diagnosing obesity in adolescents involves careful assessment beyond just measuring weight.
Dr. Alexander and her colleagues use BMI-for-age percentiles, waist circumference, and check for signs of metabolic syndrome, such as high blood pressure and insulin resistance. “We also consider family history, diet, physical activity, and even sleep patterns to get a full picture of a child’s health,” she explains.
Addressing adolescent obesity, according to Dr. Alexander, requires a focus on gradual lifestyle changes rather than quick fixes. “We emphasize small, sustainable adjustments, like cutting down on sugary drinks and increasing daily physical activity,” she advises.
Behavioural counselling plays a vital role in helping adolescents develop healthier habits, with family support being a crucial component. “When families are involved, it’s easier to create an environment where healthier choices become the norm,” she notes. For severe cases, medications or structured weight-management programs may be considered, though Dr. Alexander approaches these cautiously. “We only explore pharmacotherapy in adolescents when absolutely necessary and under close supervision.”
The psychological impact of obesity is an aspect Dr. Alexander does not overlook. “We have to recognize that many of these kids are battling body-image issues and, in some cases, depression. Addressing these mental health concerns is essential, so we often include psychological support in our treatment plans. Sometimes, referrals to therapists are needed,” she explains.
Recent technological advances provide some hope in tackling this issue. “We’re seeing promising results from apps that encourage physical activity and track dietary habits. These can be particularly effective with teenagers who are comfortable using technology,” she shares. For older adolescents with severe obesity, new medications like GLP-1 agonists are cautiously being introduced, though lifestyle changes remain the foundation of treatment. “The key is early intervention and family-based programs,” Dr. Alexander emphasizes.
On a broader scale, community efforts like the initiatives led by the Heart and StrokeFoundation’s Childhood Obesity Prevention Programme are essential. Dr. Alexander praisestheir efforts, particularly the “Out of Our Schools” campaign, which aims to eliminate unhealthy foods from school cafeterias and advocate for clearer food labelling. “These are critical steps in making it easier for children to make healthier choices,” she says.
Dr. Alexander also highlights the importance of empowering parents to support their children in making healthier choices. “Prepare balanced meals, limit sugary snacks, and try to incorporate physical activities into your family routine, like going for walks or even dancing together,” she suggests. “The key is to create an encouraging, supportive atmosphere at home rather than one of pressure.”
Looking forward, Dr. Alexander believes that policy changes are necessary to address adolescent obesity effectively. The School and Nutrition Policy, which provides guidelines for healthier food options in schools, is a positive step, but it needs broader support. “We need everyone on board—parents, schools, healthcare providers, and policymakers—to create a healthier environment for our children,” she urges. With a collective effort, Dr. Alexander remains hopeful that Barbados can turn the tide on adolescent obesity and support a healthier future for its youth.