Taylor Anhouse November 28, 2010 Final Paper Childhood Obesity “Obesity is defined as a body mass index (BMI) of 30 or greater. BMI is calculated from a person's weight and height and provides a reasonable indicator of body fatness and weight categories that may lead to health problems,� (www.cdc.gov). In 2009, Colorado was considered the fittest state in the nation, but even still 18.6 percent of the population in Colorado alone suffered from obesity. Obesity has become such a large epidemic in our country, leading to multiple health problems and causing many deaths in our nation. Although obesity can occur in both adults and children, the definition for children and teens differs from that of adults due to the varying fat ranges among boys and girls going through puberty. It is an issue that we will continue to face and one that we need to improve in order to increase the value of our lives. Often time people wonder what contributes to overweight and obesity. While there are a variety of factors that play a role, the ultimate variables are: genes, metabolism, behavior, environment, culture, and socioeconomic status. Overweight begins with an energy imbalance where a person consumes more calories than they burn in a days time. This enables extra calories to simply sit in your body, allowing for fat build up. Environment also plays a huge role in obesity due to the way you choose to live your life. For example, if you live in a busy city where walking is a large part of your everyday life it is more likely that you will maintain a healthy body weight by
exercising every day. According to cdc.gov, in 2001 The Surgeon General implemented a call to action in order to reduce obesity and overweight. The chart consists of four categories: home, school, work, and community and demonstrates ways in which you can increase physical activity to reduce health issues. In the home category, the activity calls for reducing the amount of time spent watching television, as well as building physical activity into regular routines. When you have a consistent routine it is easier to stick to the schedule rather than choosing not to partake in your physical activity certain days of the week. The next section, school, calls for healthy and nutritional breakfasts and lunches that meet the standards, and provide food options that are low in fat, calories, and sugar. Also, kindergarten through sixth grade should be provided with a period of physical activity that is included in their everyday schedules at school. For work sites, it is merely just adding more physical activity that is accessible when you are working a long day. Last, the community section calls for the most action to reduce obesity. Promoting healthier choices that include all food groups and the correct amount of servings for each category is essential. They also call for healthier portion sizes. In the United States, we are recognized for over eating. We enjoy a cheeseburger the size of softball, but in reality your portion sizes should be similar to the size of your fist. The Surgeon General also states that food outlets should provide healthier choices for people on the go. Allowing selection of multiple healthy options enables people to make an easier, more nourishing choice. Another question often asked pertaining to obesity is whether genetics play a role. “Science shows that genetics do play a role in obesity,� (www.cdc.gov). When people suffer from disorders such as Bardet-Biedl syndrome and Prader-Willi
syndrome genetics directly affect the weight of the person suffering from these diseases. In other cases, behavior and genes must both be involved for genetics to really cause a direct affect on a person. If you have a parent who is overweight you may choose to learn from their mistakes and be a healthier person, choosing nutritious foods and partaking in physical activity, but on the other hand you may take these roles on and follow in the footsteps of your parent(s). There are also instances of disease or drugs that can cause an increase in weight such as steroids, Cushing’s disease, and anti-depressants. (www.cdc.gov) Choosing to live an unhealthy lifestyle leads to many consequences that can be life altering or even lead to death. The most common disease we hear about that is linked to obesity is type two diabetes, but other problems such as: strokes, hypertension, sleep apnea, and many others can arise in just a short matter of time. There are also economic consequences that arise with obesity, causing more stress on a human. There are both direct and indirect costs. Direct costs consist of preventative care, diagnostic, and treatment services, while indirect costs consist of morbidity and mortality costs. “Morbidity costs are defined as the value of income lost from decreased productivity, restricted activity, absenteeism, and bed days. Mortality costs are the value of future income lost by premature death,” (www.cdc.gov). “According to a study of national costs attributed to both overweight (BMI 25–29.9) and obesity (BMI greater than 30), medical expenses accounted for 9.1 percent of total U.S. medical expenditures in 1998 and may have reached as high as $78.5 billion ($92.6 billion in 2002 dollars),” (www.cdc.gov).
As you can see overweight and obesity not only affects your own well being, but those around you as well. There are out-of-pocket expenses, as well as medical and private that greatly impair life for that particular person suffering. Obesity in childhood is a growing concern for health care persons all over. “An estimated 17 percent of children ages 2-19 suffer from obesity, and numbers are on the rise,” (www.cdc.gov). Children who suffer from obesity increase their risk of cardiovascular disease and put themselves at greater risk for an overall unhealthy lifestyle in the future. It is much easier to maintain a healthy weight than to work towards losing weight from becoming overweight. In other words, children who suffer from obesity are much more likely to suffer as adults as well so it is important to learn healthy habits young. Children who are considered to be overweight are considered to have a BMI at or above the 85th percentile, and obesity is considered a BMI at or above the 95 th percentile. For children, low-income households also contribute to overweight due to the inability to possess healthy nutritional meals for the family. (www.cdc.gov) Like adult obesity, childhood obesity stems from an imbalance of energy. If a child consumes more calories than he or she burns in a day then they may begin to gain weight. Genetic factors, behavioral factors, and environmental factors all play a role in how a child develops physically. As we learned above, genetics do play a role in a child’s weight; however, the behavioral and environmental factors must also exist in the child’s life. When discussing behavioral factors activity level, and energy level are important aspects, but with newer generations technology is becoming a large topic of interest. Are
children engaging in too much sedentary behavior? Although technology is of great importance to our society today, research has shown that it has been correlated with overweight problems around the nation. There are many problems that too much down time can cause, for example, “children displace physical activity time, they tend to snack extensively, make unhealthy food choices due to the increased exposure to advertisements, and the metabolic rate decreases noticeably,� (www.cdc.gov). Environmental factors include home, childcare services, as well as school, and the community. Parents are role models to their children, and in order to provide a positive example it is important to show them healthy eating habits and the importance of physical activity. Schools must teach children about health and the ways in which they can partake in building a wholesome lifestyle for themselves. Communities allow access to physical activity opportunities, but also impair the ability to access affordable nutritional foods. While childhood obesity has sadly tripled in the past three decades states are beginning to realize we must make a change in our programs to enhance the lifestyles of the young generations. The first steps to making a change include interventions and preventative care, so states have begun to spring into action by imposing laws that increase the learning tools in communities as well as creating facilities for neighborhood residents. By implementing school programs, children receive education about nutrition and physical activity starting in grade school. They are required these courses in order to develop their knowledge on the important rules of living a long and
healthy life. Acts may impose schools to change their breakfast and lunch supply, as well as create more education classes, and allow for more time for periods such as health, physical education, and recess. Act 1220 of Arkansas worked towards these exact guidelines, asking legislators to revise the requirements for children. “Legislators often face a multitude of issues, have little time to consider all the data they need to address them, and may have to choose from among a number of policy alternatives to address any given issue,” (Craig, Felix, Walker, & Phillips, 2010, p.2047). However, the most important note is that we are beginning to see changes in societies around the nation. While the primary efforts to prevent obesity in children pertains to interventions and preventative care, a secondary level of effort to reduce the number of obese children would address the physician-based interventions. While we may discuss these topics within our families, schools, and communities, ultimately it is important for our doctors to discuss the ways in which we can prevent our children from obtaining weight issues.
“Although there are no data surrounding the effectiveness of physician-based interventions in preventing obesity or increasing physical activity and healthy food choices, studies have shown that physician interventions about lifestyle behaviors are effective in reducing cardiovascular risk for patients with diabetes and other diet-related chronic diseases,” (Lawrence, Hazlett, Hightower,
2010, p.150). Due to time constraints, physicians have been found to skip over these important conversations. It is evident that finding the time to discuss these topics with children can greatly increase the awareness, active participation, and overall understanding of a beneficial and healthy lifestyle. The next level of awareness would stem from social workers. Although we are working towards preventative care rather than assisting those already suffering from obesity, we must still support those whom are already overweight. Social workers are available to teach about the different lifestyle changes that can be made in order to improve the quality of life, but they are also there to assess situations. Social workers often find other underlying factors contributing to a person’s weight gain, such as psychological disorders, or stressful situations that may be occurring in one’s life. As children we undergo much stress…we face distorted body images, weight control behaviors, and self-esteem issues. Low self-esteem is presented as the most common consequence of obesity, so how do we inform children that no one is perfect? While we can talk to our own children about self-image, and we can teach them through school programs, ultimately children learn from one another. It is crucial to include personal experience, and peer-to-peer conversations within interventions. The more we are able to relate to one another, and discuss our issues openly, the more comfortable we will feel working together towards a new and improved lifestyle. With the support of others, it is possible to achieve great goals. Allowing children to relate to one another is of great importance due to the increased risk of harmful behavior when a child suffers from obesity. “Strauss (2000) found that obese children with decreasing levels of self-esteem
were more likely to engage in high-risk behaviors, such as smoking or consuming alcohol,” (Broomfield, 2009, p.196) so as you can see it is extremely important to openly discuss these topics with your children, as well as encourage them to talk with other children whom they can relate to. Not only does obesity in children cause a greater risk for health problems later in life, but it also disturbs the individual’s childhood experience. As you may know, obesity and overweight can cause children to experience tremendous amounts of bullying and social seclusion in school, daycare, and even out in the community. “Having lower self-esteem and altered self-perception may result in a situation where children lack the available psychological resources that are integral to engaging in health-promoting behaviors aimed at reducing obesity and improving well-being (Phillips & Hill 1998). Given that obesity and self-perception are both amenable to intervention, an examination of the nature of the relationship between obesity and selfperception in children has important implications for physical and psychosocial health and well being,” (McCullough, Muldoon, & Dempster, 2009, p.357).
These risks cause a vicious cycle that is very difficult to overcome as a child. As we grow and our minds are developing we want to feel socially accepted. We want people to like us, and most of all we want to be kids. If there are multiple other psychological problems running through a child’s mind, it is almost impossible for an individual to develop confidence within their self. As obesity grows as an epidemic in the United States, it is essential to find ways in which we can reduce the risk of this severe illness. We are a country fulfilled with
unhealthy habits and learning to incorporate wholesome living into our every day lives is extremely important. Though we have begun to incorporate health classes, physical activity, and counseling throughout school, and daycare systems, we must take our education to the next level. “In 2007—2008, approximately 72.5 million adults in the United States were obese, 19.6% among 6-11 year olds, and 18.1% among 12-19 year olds,” (www.cdc.gov) As we have discussed throughout this paper, interventions have become the next resource in teaching the younger generations preventative and beneficial care for themselves in order to live a long and satisfied life. As a nation that promotes unhealthy foods, inactivity, and oversized portions, policies should begin to be implemented before statistics reach an even greater amount. “Television advertisements routinely promote unhealthy food products, and the popularity of television and related media in the US has contributed to sedentary lifestyles for many Americans.” With an increase in technology such as computers, video game systems, and DVDs children are becoming less active leading to greater health risks. It is an issue that we will continue to face, and one that deserves much attention as it is killing and impairing the lives of many. While there are multiple factors that contribute to overweight and obesity, learning how we can improve our personal lives as well as the lives of those we love can help our country to turn around from this horrific malady. Learning about obesity, and the preventative care we can pass down from generation to generation is the ultimate solution to escape this complication.
Works Cited Birch, L.L., & Ventura, A.K. (2009). Preventing Childhood Obesity: What Works?. International Journal of Obesity, 33. Retrieved from http://0-
web.ebscohost.com.skyline.ucdenver.edu/ehost/detail? vid=36&hid=105&sid=a2f81b95-8b58-428f-90bdc3d36a548e37%40sessionmgr114&bdata=JnNpdGU9ZWhvc3Qtb Gl2ZQ%3d%3d#db=aph&AN=37580472 Broomfield, P.V. (2009). Childhood Obesity: Psychosocial Outcomes and the Role of Weight Bias and Stigma. Educational Psychology in Practice, 25(3), Retrieved from http://0web.ebscohost.com.skyline.ucdenver.edu/ehost/detail? vid=32&hid=105&sid=a2f81b95-8b58-428f-90bdc3d36a548e37%40sessionmgr114&bdata=JnNpdGU9ZWhvc3Qtb Gl2ZQ%3d%3d#db=aph&AN=44080699 Center for Disease Control and Prevention, (2010, March 31). Childhood Overweight and Obesity. Retrieved from http://www.cdc.gov/obesity/childhood/index.html Center for Disease Control and Prevention. (2010, September 30). Obesity and Overweight. Retrieved from http://www.cdc.gov/obesity/index.html Craig, R.L., Felix, H.C., Walker, J.F., & Phillips, M.M. (2010). Public Health Professionals as Policy Entrepreneurs: Arkansas's Childhood Obesity Policy Experience. American Journal of Public Health, 100(11), Retrieved from http://0web.ebscohost.com.skyline.ucdenver.edu/ehost/detail? vid=31&hid=105&sid=a2f81b95-8b58-428f-90bdc3d36a548e37%40sessionmgr114&bdata=JnNpdGU9ZWhvc3Qtb Gl2ZQ%3d%3d#db=f5h&AN=55088857 Lawrence, S., Hazlett, R., & Hightower, P. (2010). Understanding and Acting on the Growing Childhood and Adolescent Weight Crisis: A Role for Social Work. Health and Social Work, 35(2), Retrieved from http://0web.ebscohost.com.skyline.ucdenver.edu/ehost/detail? vid=31&hid=105&sid=a2f81b95-8b58-428f-90bdc3d36a548e37%40sessionmgr114&bdata=JnNpdGU9ZWhvc3Qtb Gl2ZQ%3d%3d#db=f5h&AN=51455542 McCullough, N., Muldoon, O., & Dempster, M. (2009). SelfPerception in Overweight and Obese Children: A CrossSectional Study. Child: Care, Health and Development , 35(3), Retrieved from http://0web.ebscohost.com.skyline.ucdenver.edu/ehost/detail? vid=34&hid=105&sid=a2f81b95-8b58-428f-90bdc3d36a548e37%40sessionmgr114&bdata=JnNpdGU9ZWhvc3Qtb Gl2ZQ%3d%3d#db=aph&AN=37320711 Wang, F., & Veugelers, P.J. (2008). Self-Esteem and Cognitive Development in the Era of the Childhood Obesity Epidemic. Obesity Reviews, 9(6), Retrieved from http://0web.ebscohost.com.skyline.ucdenver.edu/ehost/detail? vid=34&hid=105&sid=a2f81b95-8b58-428f-90bd-
c3d36a548e37%40sessionmgr114&bdata=JnNpdGU9ZWhvc3Qtb Gl2ZQ%3d%3d#db=aph&AN=34767045