CHILDREN AND OBESITY
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).
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.
Australian Institute of Health and Welfare. (2005). A picture of Australia’s children. Canberra,
A.C.T: Australian Institute of Health and Welfare.
Burke, L, & Wang, J (2011). 'Treatment Strategies for Overweight and Obesity', Journal Of
Nursing Scholarship, 43, 4, pp. 368-375
Davin, S, & Taylor, N (2009). 'Comprehensive review of obesity and psychological
considerations for treatment', Psychology, Health & Medicine, 14, 6, pp. 716-725,
Green, D.J. & Maiorana, A.J. (2012). Why exercise is an important component of risk reduction
In obesity management, Med J Aust 196, 3, pp. 165-166.
Friedman, M., Bowden, V. and Jones, E. (2003) Family nursing: Research, theory and
practice. Upper Saddle River, N.J: Prentice Hall.
Oyetunji, T, Franklin, A, Ortega, G, Akolkar, N, Qureshi, F, Abdullah, F, Cornwell, E, Nwomeh,
B, & Fullum, T 2012, 'Revisiting Childhood Obesity: Persistent Underutilization of Surgical Intervention?', American Surgeon, 78, 7, pp. 788-793
Poirier P., Giles T.D., & Bray G.A. et al. May (2006). "Obesity and cardiovascular disease:
pathophysiology, evaluation, and effect of weight loss". Arterioscler. Thromb. Vasc. Biol. 26 (5): 968–76
Poobalan, A. et al. (2008). Prevention of Childhood Obesity: A Review of Systematic Reviews,
Retrieved on September 25, 2012 from http://www.healthscotland.com/uploads/documents/7918-RE049FinalReport0405.pdf
Potts, N. and Mandleco, B. (2012) Paediatric nursing: Caring for children and their
families. Clifton Park, N.Y: Delmar Cengage Learning.
Proietto, J. 2011, Why is treating obesity so difficult? Justification for the role of bariatric
surgery, MJA, 195, 3, pp. 144-146