Obesity is defined as a BMI greater than or equal to 30 kg/m2, and extreme obesity is defined as a BMI greater or equal to 40 kg/m2, BMI which refers to an individual’s weight in kilograms divided by the square of his or her height in meters.
According to the in utero fetal programming hypothesis (Barker hypothesis), the amount and quality of food that the mother consumes during gestation influences birth weight, size at birth is related to the risk of developing disease later in life and therefore susceptibility of progeny to disease in later life.
Pathophysiology of Obesity is a disorder characterized by excess white adipose tissue and is the result of chronic positive energy imbalance and hypothalamic response as shown below in fetal stage.
Exposure to maternal obesogenic diet through gestation and lactation increases placental inflammation resulting in modified amino acid transport and fetal growth including decreased β-cell mass. Following birth, maternal high fat diet consumption through lactation increases milk volume and lipid concentration, increasing circulating blood lipids, and causing neonatal neuroepithelial cells to undergo mitosis, differentiation and translocation into the hypothalamus where they elevate levels of orexigenic neuropeptides. When combined with accompanying leptin resistance, this increase in orexigenic neuropeptide production stimulates offspring hyperphagia and obesity.
To summarize Obesity in children can be due to gestational exposure in utero fetal programming by nutritional stimuli may serve as the origins of a diverse array of diseases that arise later in life, including heart disease, hypertension, and non-insulin dependent diabetes and hence obesity may become a self-perpetuating problem. Capturing data by Pregnancy Risk Assessment Monitoring System (PRAMS), with every visit ,an ongoing population-based surveillance system that examines trends in prepregnancy obesity by maternal demographic and behavioural counselling are essential.
Reference :Maternal nutrition and risk of obesity in offspring: The Trojan horse of developmental plasticity, Sebastian D.Parlee , https://doi.org/10.1016/j.bbadis.2013.07.007