More than half of the children with obesity seen at the Hospital have insulin resistance

52% of the children seen by the paediatric Endocrinology team, aged between five and fourteen years old, present insulin resistance, according to data from SJD Sant Boi Hospital. It is one of the metabolic alterations that occur due to obesity. Having this problem means having elevated insulin levels compared to the normal blood glucose levels of children, a fact that if it occurs in the long term can lead to type 2 diabetes.

Childhood obesity is one of the main public health challenges of the 21st century, according to the World Health Organization, and also a growing concern at the Catalan and Spanish level. In Spain, the most recent data indicate that four out of ten children have excess weight, and around 8% have obesity, with a particularly high incidence in the most socioeconomically vulnerable environments.

In 2025, 30% of the children referred to the paediatric Endocrinology consultation at SJD Sant Boi Hospital were seen for an obesity problem and among the most serious metabolic complications, insulin resistance stood out especially.

“These figures indicate that some of the paediatric patients we treat already present alterations in cholesterol levels, a fact that is not common in childhood and which is related, in most cases, to childhood obesity,” explains Dr. Patricia Gallardo, head of the Paediatrics Service at SJD Sant Boi Hospital. Dyslipidemia is another consequence of obesity that affects 27% of paediatric patients, and which translates into a metabolic alteration that produces high levels of LDL cholesterol (bad), and low levels of HDL cholesterol (good).

Regarding the other metabolic alterations, according to the Hospital’s figures, almost 23% of the patients seen in the paediatric Endocrinology consultation present warning signs in blood pressure, in the high-normal range that can lead to an increased probability of developing hypertension if measures are not taken. Finally, 16% of children with obesity have ultrasound-detected hepatic steatosis, popularly known as fatty liver. This means that the liver is infiltrated with fat. “If it is not caught in time, the structure of the liver is modified and what is known as hepatic fibrosis originates, a disease that can be irreversible and lifelong,” explains Dr. Daniel Sánchez, paediatric endocrinologist at SJD Sant Boi Hospital.

From weight-centrism to healthy habits

In the case of the paediatric patient, the risk of metabolic alterations will be linked to the consequences they suffer due to their obesity and its progression over the years. The approach to obesity involves various spheres. Firstly, it is necessary to review the difficulties in their social environment to acquire healthy lifestyle habits (diet, physical activity, sleep), and to check whether families are already receiving social support or are in contact with professionals who can guide them. “Obviously it is necessary to control weight, but now the approach has changed, it is less weight-centric and broader so as not to contribute to creating a weight-related stigma that prevents them from moving forward,” explains Dr. Gallardo. Previously they were more focused on checking weight and diet, and now they focus on reviewing healthy lifestyle habits, such as having good sleep habits (sometimes even as important as dietary ones), exercising and following a healthy diet.

All this without losing sight of the psychological aspect, which involves the relationship children have with food and which, if negative, links their mood (if they feel sad or anxious) with eating more. A poor relationship with food can end up leading to an eating disorder.

Screen use also plays a significant role in the rise of obesity. “The higher the use of screens, the more the quality of sleep deteriorates; eating is altered and, due to a more sedentary lifestyle, the amount of physical activity also decreases,” explains Dr. Daniel Sánchez. She adds that, to treat obesity in children, they first focus on improving it through changing habits and, only if that does not yield results, they consider introducing medication.

HR4ALL, a Gasol Foundation project to fight obesity

Public administrations and health institutions agree in highlighting that childhood obesity is a complex phenomenon, conditioned by social, economic and environmental factors, and that combating it requires a comprehensive response involving families, schools, communities and healthcare systems.

Along these lines, the Parc Sanitari SJD participates in the European HR4ALL project (Healthy Regions for All), born from the Gasol Foundation and co-financed by the European Union, with the involvement of four European countries (Spain, Denmark, the Netherlands and Slovenia). The aim of the project is to improve regional and local policies for the comprehensive approach to obesity, a multifactorial disease with physical, psychological, social and occupational implications.

After an initial phase of detecting difficulties in all areas of the Sant Boi territory (school, healthcare, commercial, etc.), the project is currently in the second phase, where work will be carried out in depth on the strategies to be applied so that the first changes take place. In this second phase, the Parc Sanitari Sant SJD contributes with the participation of Dr. Daniel Sánchez and Cristina Herranz, dietitian-nutritionist, as members of the group of experts, where they act as reference consultants in the healthcare field.