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client on Ben Blackall and his specific needs regarding his obesity. Ben Blackall is an 8-year-old boy who is unable to join in any sports at school because of his obesity. He weighs 70 kilos and is 140 cms in height. His family including his 2 brothers are all overweight or obese. This paper will explore the short-term and long-term implications of such an illness. This study will look at interventions that can be implemented into the child's life in hopes of prevention of continued obesity.
The impact of adolescent overweight extends into adulthood. Adolescents who are overweight have an increased risk of morbidity from coronary artery disease and arthritis in adulthood, independent of their weight as adults, and are more likely to be overweight as adults. Obesity in adulthood is perhaps the most serious of all consequences because it is associated with increased mortality and morbidity from a variety of conditions. Overweight in adolescence also is associated with adverse social and economic consequences in adulthood.
The most recent National Health and Nutrition Examination Survey (NHANES) estimates that 20.6% of children two to five years of age, 30.3% of children six to 13 years of age, and 30.4% of adolescents and young adults 12 to 19 years of age are overweight or at risk for becoming overweight (Hodges, p. 5). Black and Hispanic children are much more likely to be overweight than white children. Multiple nonbehavioral risk factors for overweight in children have been identified; they include sex, race/ethnicity, socioeconomic status, and having parents who are obese. The adverse health outcomes resulting from overweight include short-term consequences during childhood and long-term consequences that manifest in adulthood. The most common short-term consequences are psychosocial problems. Eating disorders have a higher prevalence among children and adolescents who are overweight, especially binge-eating, which has an estimated prevalence in overweight female adolescents of 30%. Nonpsychologic health consequences of overweight are less common in childhood and adolescence than in adulthood.
When obesity begins in early childhood and it often persists, it is guaranteed to be an issue in adulthood. It is reported that 80% of obese children become obese adults. Also it appears the earlier the onset of obesity, the more severe the adult obesity will be. The odds for being overweight in adulthood has been reported to be significantly greater for children with BMIs in the 75th percentile. Still as much as factors like race, gender and age of onset play roles in determining different implications, it is clear the obese child or teen suffers from a gammet of specific health issues later in life. The issues the research pinpointed to be the most severe and traumatic are as follows: cancer, mainly breast and prostate; Diabetes and Hypertension; and psychological disorders such as Depression and low sense of self. The following paragraphs will look at these health issues as they relate to the obesity epidemic in general.
There is devastating evidence of a link between childhood obesity and an increased risk of cancer in adulthood. The Bristol University team report, "most overweight children had a much greater chance -- 38% of developing pancreatic, bladder, lung and mouth cancers later in life" (McDougall, 2004, p.1). If this statistic remains strong this will burden today's children and teens with high cost healthcare and illness within the next twenty to thirty years. This is substantial information as it predicts how the next generation will age and respond to environmental factors. In other words, the impact of this knowledge is enormous as it creates a foundation for understanding how obesity causes long-term problems. After analyzing data from 2347 subjects across the United Kingdom that studied closely nutrition changes after World War II, it was discovered that there are vital clues about the links between childhood diet and susceptibility to cancer in adulthood. The Bristol study discovered that children with higher BMI scores were more likely to develop cancer than their thinner counterparts. It was also found that in obese children who were diagnosed as obese before the age of eight, have a higher chance of cancer as adults. This study shows "overweight adults have a higher risk of developing cancer but this study provides evidence that children who are overweight are more at risk" (McDougall, 2004, p. 1). Statistics show that "25% of kids had about a 43% greater risk of developing cancer than lean kids" (McDougall, 2004, p. 2). Also there are specific cancers linked to obesity such as: ovarian, breast, colon and prostate. It is unclear why these cancers are higher in obese patients but this correlation may have something to do with fat cells produce a build-up of cancer-causing hormones in the body. This points out that getting cancer is not something that happens overnight, that one can take steps to prevent such a condition and this case, understanding the impact of this study will promote intervention at an earlier age. Weight maintenance has been cited at the single biggest preventable cause of caner after smoking. Dr. Campbell of the National Obesity Forum also comments, "Given that childhood obesity has doubled over the past 15 years, it really does impress again how important it is to tackle the problem and not wait until overweight kids are fat adults" (McDougall, 2004, p. 2). Intervention can be carried out in the schools and through active advertising but how children eat at home set the standard of how they will eat in the future.
Diabetes and Hypertension
The Bandolier Obesity and Health Web site calls attention to how obesity not only impairs health but also affects other aspects of people's every day lives. Obesity predisposes people to higher risks of associated diseases. There is a high human cost in diabetes, hypertension and other disorders. There is a big cost to the NHS and a big cost to society through lost work time and economic output (estimated by the NAO to be around £2,000,000,000 a year). A trend that contributes to this problem is not only fat ladden diet but also suger-sweetened soft drinks as they are "consumed by 70% of American adolescents. Excessive weight is now the most common peditatric medical problem in the United States. Is there a relationship between soda drinking and childhood obesity?" (Bandolier, 2001). It is assumed that introduction of low fat diets will produce reductions in percentages of energy from fat and mean a weight loss of up to 10 kiligrams. This in turn, would aid in reducing the risk if diabetes and hypertension in teens later on in life.
Depression and Low Self-Esteem
How one views oneself establishs morale and a healthy self-esteem throughout life. Unfortunately, the world is an image conscious place where beauty is valued and any flaw is seen as ugly. Society has not figured out that beauty is more than skin deep. The unfortnate fact is that children and adolescents can be cruel to peers that do not meet the social standard of beauty. This equates to many being ridiculed or put down because of their weight. The ironic part of this notion is that even as our society grows fatter, we still hold the skinny ideal above all else. Why is this? To fuel the fire for the weight loss industry? Why is it that we are not taught that we are beautiful for other attributes and not just the ability to be thin?
As part of this research it was discovered that there is not only a direct relationship between obesity and physical health issues but also there is a direct relationship between obesity, being labeled as obese and one's self-image and mental health. A study out of Australia, did find that overweight children are teased more than their thin counterparts but that this behavior is likely to reduce self-esteem. Kathleen Doheny (2004) found, "that overweight children tended to have lower self-esteem than non-overweight children and that any self-esteem found in overweight children was lower than non-overweight children" (p. 1). It has been found that there is a direct correlation between one's weight and the amount of self-esteem. This reflects a complex causal relationship between weight and emotion. Studies have shown that over a three-year period depending on weight loss success, self-esteem either decreased or improved. More than likely the self-esteem went up at weight became more successful. Still as the study dove deeper, it was found that teens who did not lose weight, thought poorly of themselves and displayed patterns of depression or "blue" periods. They also felt unaccepted by their peers especially peers of the opposite sex. They felt motivated to lose weight in hopes of attracting the opposite sex but their self-esteem did not improve until their weight decreased. This goes to show that not only will interventions help decrease serious health issues but also emotional ones that determine mental well-being as growth into adulthood.
Recommendations for the Future
Today our present knowledge gives us the possibility to take the following positions regarding key issues in pediatric obesity.
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