¶ … nutritional and nutrition-related health problems of adolescent obesity and being overweight. The writer explores the issues of obesity as it relates to adolescence and discusses strategies that have the potential to impact the issue. The writer also reports the effectiveness of some of the strategies. The final section identifies the most effect strategy to combat obesity in adolescents. "Rates of childhood and adolescent obesity have increased dramatically in the past decade. According to a recent article in the Journal of the American Medical Association based on results from the 1999-2000 National Health and Nutrition Examination Survey (NHANES), more than 15% of youths ages 6 through 19 were obese, and more than 10% of children ages 2 through 5 were obese (Ogden et al., 2002). The percentages of obese children and adolescents were relatively stable over NHANES I (1971-1974) and II (1976-1980) but doubled to 11% during NHANES III (1988-1994) and then increased again by 4% during NHANES IV (1999-2000) (National Center for Health Statistics

"It is currently not known why children and adolescents become obese, or what environmental, genetic, and psychiatric pathways lead to obesity

The problem of obesity is one that has gained considerable attention in recent years. Medical science has proven that obesity causes health issues that can lead to an early death. The incidence of obesity in adolescence is also a growing problem. Adolescent obesity is a leading cause of health issues according to industry experts and the race to develop effective preventative and curative strategies is on. It is important to develop effective coping and preventative strategies to combat adolescent obesity so that the adolescents have the hope of growing into healthy adults.

The Problem Defined

Adolescent obesity is a concern nationwide as it continues to grow as a problem. Adolescents who are overweight or obese have a much higher chance of being obese or overweight adults. The FDA recently approved a new drug for adolescents called Xenical. It is designed for teens ages 12 to 16 years old and will be the first drug available for overweight teenagers.

Whether it will be effective or not remains to be seen over time, and until then it is important to keep trying strategies that are already developed for the obese adolescent.

Before one can fully analyze effective strategies for adolescents who are overweight or obese it is essential to understand what the standard definition of adolescent obesity or overweight is.

"The development of a standard definition of child and adolescent overweight and obesity for inclusion in the Australian National Health Data Dictionary is part of a strategy to address the growing prevalence of obesity among young people in Australia. A standard definition will allow more consistent data to be collected for monitoring the prevalence of overweight and obesity, for research into the causes and consequences of overweight, for public health program evaluation and for evaluating and improving clinical practice

Overweight and obesity is a major health problem in Australia, with obesity contributing over 4% of the total burden of disease in 1996. Recent reports have found that 19 to 23% of young Australians are either overweight or obese and that the prevalence of overweight and obesity doubled between 1985 and 1997 (2-4). Among children and adolescents, it is unclear at what level of adiposity health risks begin to rise. There is ample evidence however, that overweight and obese children suffer from a range of health problems. These include immediate problems of psychological dysfunction and social isolation, as well as the development of risk factors for intermediate and long-term physical problems such as cardiovascular disease and diabetes. In addition, children and adolescents who are overweight and/or obese are more likely to be overweight or obese as adults, with all of the subsequent health implications

The standard definition of obese is a body mass index greater than 25.

Several strategies are being examined and tried to reduce the incidence of adolescent obesity. One of the measures being tried is a school program aimed at cafeterias. Nationwide schools are working to provide more nutritional meals and snacks for the teens that they serve each day. Many schools are eliminating the sale of soft drinks, candy and other nutritionally vacant foods and beverages.

Another strategy being tried is to encourage more exercise at the schools the teens attend.

"Schools should expand opportunities for all students to engage in at least 30 minutes of moderate to vigorous physical activity each day. Schools should provide physical education classes that last 30 to 60 minutes each day. Because children have a variety of abilities and interests, schools also should expand opportunities beyond traditional physical education classes to create or enhance intramural sports,...

These messages, through advertisements on television, pamphlets, office counseling and other means are aimed at the whole family as adolescent obesity is usually a family related issue. Whether the family is not eating nutritionally, or the teen has emotional issues or physical issues causing the gain in weight the entire family needs to be involved in the prevention or cure of the problem.
Entire families being targeted is being tried in many communities. The families are asked to fill out surveys, attend nutrition and exercise classes and become educated about obesity and its potential future impact on their teen's health.

Many health problems can be traced to adolescent obesity including cardiovascular disease, and breathing problems. In addition to the problems that can present themselves to the adolescent there are a host of future health problems waiting in adulthood for the obese adolescent.

"Obesity is immensely costly at a national level, as well as mentally and physically costly to those who suffer from it. A safe and successful treatment of obesity remains elusive, particularly during maintenance

"Although many of the effects of adolescent obesity do not manifest themselves until adulthood, the obese child may suffer immediate consequences from his or her condition. The medical sequel that threaten the young obese child include cardiovascular disease, endocrine and pulmonary problems, and orthopedic, gastroenterological, and neurological difficulties. A 40-year follow-up study revealed a twofold increase in the rate of cardiovascular disease and hypertension and a threefold increase of diabetes in obese children compared with normal-weight children (Mossberg, 1989). A 50-year follow-up to the Harvard Growth Study of 1922 to 1935 showed that obese adolescent boys ages 13 to 18 experienced twice the mortality rate from cardiovascular disease in adulthood. Being obese as an adolescent was a better predictor of overall mortality than being obese as an adult

Several studies were conducted to measure the effectiveness of various strategies and treatments for obesity.

"Study #1. Conducted by Flodmark and colleagues (1993), this Swedish study evaluated the effects of family therapy on preventing progression to severe obesity during adolescence in 44 obese, school-aged children, ages 10-11 years with a BMI greater than 23 kg/[m.sup.2], a cutoff level representing the mean plus 2.4 times the standard deviation of the population of 1,906 children who were screened for obesity at school. These 44 children also exceeded the 85% in skinfold thickness for 10- to 11-year-olds. All of the children had blood pressures of less than 140/90 and were free of endocrine disorders, including thyroid disease. Forty-five percent of the children had one obese parent, and 30% of the children had two obese parents

"Study #2. Robinson (1999) speculated that watching television or videotapes and playing video games are easily modifiable contributions to the causes of obesity in children. According to the author, there are two mechanisms by which television viewing contributes to obesity: (a) reduced energy expenditure from displacement of physical activity and (b) increased dietary high-calorie intake during viewing or as a result of food advertising. Robinson hypothesized that, when compared to control subjects, children exposed to a television reduction intervention would significantly decrease their levels of adiposity. This randomized, controlled, school-based trial of decreasing television, videotape, and video game viewing was conducted with 198 third- and fourth-graders from two public elementary schools in San Jose, California, that were matched on demographics and scholastics

This study found that it was effective in a little less than half of those studied.

"Results indicated that children in the intervention group had a significant relative average decrease in BMI (-0.45 kg/[m.sup.2]) and triceps skinfold thickness (-1.47 mm). Children in the intervention group also demonstrated statistically significant reductions in reported television viewing and meals eaten in front of the television. There were no significant differences between the groups on vigorous physical activity, cardiorespiratory fitness, or changes in high-fat food intake

The studies as well as the literature reviews indicate the most effective treatment for adolescent obesity is a combination of school and family effort. Using nutritional facts to put together meals both in the school system and at the family table is effective but also needs to be coupled with…