CHILDREN
AND OBESITY
Introduction
Different authors in clinical research have defined the
term obesity differently. However, the most common definition of the term is
excess body fat. The definition of
obesity defers from adulthood obesity and childhood obesity. The definition of adulthood
obesity has been standardized internationally by the application of body mass
index. This takes into consideration the difference in the height and its
calculation is by the weight, measured in kgs, divided by the height, measured
in m2. This definition does not apply in childhood obesity. Childhood
obesity is defined as a condition where there is excessive body fat that
negatively impacts on the health and normal development of the child. According
to Friedman, Bowden and Jones (2003) a
child is said to be obese when he is above the weight that is normal for his
age. The excess weight is normally an issue for it makes a child vulnerable to
many other health problems. Childhood obesity is very common today, currently being
among the most common medical conditions affecting children in Australia and
other parts of the world. Childhood obesity is one of the greatest health
challenges in the country. Obesity has been suggested to be one of the
lifestyle diseases. As such, using healthful, low-fat foods and vigorous
exercises each day are some of the ways to protect children against obesity (Oyetunji, et al. 2012).
Australia
is one of the economically advanced nations in the world. It is among the many
developed nations that have noted an increase in the problem of childhood
obesity. The numbers of children who are overweight has increased twice in
Australia, with about 25 percent of the children in the country considered
obese or overweight (Australian Institute of Health and Welfare 2005). Friedman,
Bowden and Jones (2003) argue that this number is expected to continue
increasing as more new cases of obesity are being reported each day. Childhood
obesity is quickly becoming one of the major health problems in Australia. Poirier et al. (2006) reveal that in the
last two decades and half, the prevalence of childhood obesity in the country
has increased three times. In some minority group populations most of the
adolescents weigh above normal or are obese.
Proietto (2011) discusses the factors that have led
to the increase in the cases of obesity in the country today. Proietto suggests
that the increase in the rate of obesity can be blamed on the increased use of high
energy diet, coupled with the decrease in the rate of obligatory physical
exercise. Factors leading to obesity in children comprise of unhealthy
food choices, family eating habits and lack of physical activity. This means that the environment plays a major
role in the increase in the prevalence of obesity among children. Human
beings have Stone Age genes developed in a high energy spending environment. Nevertheless,
the present environment is one of food abundance and sedentary society. Most of
the modern western lifestyle disorders like obesity originate from the failure
to have a balance between the genes and the environment. Nonetheless, there is an argument opposing to the environment playing the major role
in childhood obesity. Davin and
Taylor (2009) argue that not
every child will become obese or overweight by being in an obesogenic
environment. Different individuals react differently to the environment.
Proietto (2011) argues that prevention of obesity
can be accomplished through an increase in the levels of fat
accumulated. The author further suggests that this is a characteristic negative
feedback system. This suggests that there has to be genetic predisposition for
the environment to play a role in the onset of obesity. The negative feedback
system is impaired by the genetic predisposition. From this point of view, when
consuming on the same type of food, some children will add weight and others
will not. This has been revealed in twin and adoption studies. A variety of
weight gains have been suggested to emanate from overfeeding monozygotic twins.
In addition, the level of weight gain in every pair of the twins has been shown
to correlate. While genes are may be argued to account for a considerable
amount of obesity, it is evident that monogenetic mutations that cause people
to be severely obese, like deficiency in leptin or mutations of melanocortin-4
receptor, tend to be rare and thus cannot account for majority of the cases of
obesity. Additionally, the present increase in the rates of obesity cannot be
explained from the point of view of changes in genetic levels, due to the fact
that mutations happen over a very long time frame. The developing evidence that
majority of obesity might in nature be epigenetic may bring together the two
clearly opposing perspectives (Oyetunji,
et al. 2012). For example, the impact of the environment on genetically
lean persons is overweight and not becoming obesity. This means that there is
an important role played by the genetic composition of an individual in
obesity. The impact of the genetic composition is that the genes make some people
susceptible to becoming obesity when exposed to the obesogenic environment.
Davin and Taylor (2009) posit that the increase in the rate
of obesity among children is troubling due to the health risks and problems
which are associated with it. It is also posited to cause social issues. Obesity
and overweight are among the main risk factors for the development of short-term
and long-term health problems. According to Potts and Mandleco (2012) the increase in obesity and overweight among
children has been associated with the contemporaneous increase in the risk
profile of chronic disorders. Among those diagnosed with diabetic disorders,
type-2 diabetes accounts for about 45 percent. These are disorders commonly
associated with excess body weight or obesity. Obesity has also been associated
with a number of other chronic health problems among children globally such as
the risk of glucose intolerance, cardiovascular disease, and insulin
resistance.
Besides
the physical problems associated with obesity, there are psychological problems
that occur as a result. Research has revealed that there is a relationship
between childhood obesity and psychological variables. Some of the researches a
reported in Poobalan et al. (2008) have revealed that childhood obesity has a
negative impact on the children’s feelings on self-worth and social competence.
They have also revealed that there is a relationship between self-esteem and
obesity. Children who are obese are more likely to be mocked by other children
and as such are more likely to develop self-esteem and other body image issues.
Childhood
obesity has been suggested in a number of studies to be a precursor for obesity
in adulthood. According to Potts and
Mandleco (2012) the excess body fat cause a number of conditions during
adulthood such as cancer, behavioral problems and sleep dysfunctions, arthritis
hyperinsulinemia, hyperlipidemia, and the risk of cardiovascular disease. Obesity
beginning in childhood has been suggested by Green and Maiorana (2012) to account for about 25 percent of
obesity cases in adulthood. Obesity starting prior to the age of eight and
persisting into adulthood has been associated with an average body mass of 41
later in life, as opposed to a body mass index of 35 among those who become
obese in adulthood. Official reports suggest that about 300,000 individuals
succumb to obesity-related disorders or conditions that are worsened by excess
weight every year. Additionally, poor eating habits that are developed during
childhood are likely to be carried on to later in life. This can also lead to
lifetime health effects.
The
issue of obesity among children in Australia has a huge implication in nursing.
The health care providers have had to deal with the problem and the associated
health issues. This is because they have the responsibility of preventing
obesity to be able to prevent those other related disorders and problems. From
the perspective of unhealthy diet and lack of physical exercise as the main
factors behind the increase in the prevalence of obesity, current treatment
strategies are focused on the two factors (Poirier, Giles and Bray et al. 2006). Encouraging consumption of
health diet and regular physical exercise are important in addressing the
problem of obesity among children. Healthy
diet and exercise for weight loss have been used for a long time in the
treatment of obesity, and have been suggested to have a significant level of
effectiveness. This is achieved by encouraging weight loss. Loss of weight, changes
in energy expenditure as well as in the hormones that control hunger. Following
loss of weight, there is an increase in the levels of ghrelin, and a subsequent
decrease in the levels of holecystokinin, leptin, and insulin. Additionally,
there is conversion of the thyroid hormone T4 to the inactive reverse-T3 rather
than T3, leading to the decrease in energy expenditure. More important, in case
the regulatory mechanism is working in the individuals who are already obese,
the treatment strategies which encourage use of health diet and physical exercise
are likely to have long term effects on weight loss (Burke and Wang, 2011).
While Green and Maiorana (2012) offers some of the
arguments suggested by some authors for the lack of effectiveness in the use of
exercise as an intervention strategy in
obesity, the authors have also developed a case for the effectiveness of
exercise. They have posited that there is a decrease in cardiovascular risk
because of exercise via mechanisms that depend on changes in body mass index. A
number of studies have been carried out to show that exercise
is related to a considerable decrease in weight loss and thus in cardiovascular
risk of about 30%. Meta-analyses also reveal the same kind of effectiveness
achieved from cardiac rehabilitation programs based on exercise. Collectively,
modification of common risk factors to cardiovascular problems was about 35.5% of
exercise-mediated decrease in coronary risk. There is also a considerable
effect of exercise on body mass index
which accounted for approximately 6.8% of the total effectiveness of
exercise-based intervention on coronary artery disorder (Burke and Wang, 2011).
Majority of the obese individuals manage to achieve
weight loss in the short-term through the use of exercise-based intervention.
It is important to note that loss of weight is one of the goals of treatment
for people who are obese. Individuals who are obese, through physical exercise
are able to loose weight and prevent further weight gain. Prevention of further
weigh gain is an important short term effect of exercise-based intervention in
obesity. However, maintaining physical exercise is one the key factors in the
achievement of this goal. The long term implication for exercise-based
intervention strategies is the decrease in the risk of other disorders related
to obesity. The primary goal of this intervention strategy is the reduction of
the incidence of myocardial infarction, diabetes and
stroke, as well as improving health and longevity. Obese individuals who are
able to maintain physical exercise can maintain loss for more than one year. It
is important for the health care providers to emphasize on the need for
physical exercise for children and also the importance of feeding them with
health diet (Burke and Wang, 2011).
Conclusion
This
paper has reviewed literature on obesity among children, the risk factors for
obesity, the effects of obesity and the most effective intervention strategies.
Childhood obesity is becoming a challenging health issue in Australia. The
major concern is the increase in cases of obesity among the children,
adolescents and young adults. Most of the people suffering the effects of
obesity are in these groups. More children are being affected every day. The
current estimates are alarming and it is revealed in research that they are
likely to continue increasing. The negative effect on the health of children is
a rationale behind the development of effective intervention strategies,
basically based on physical exercise and health diet.
References
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