" (Dietz, 1998). Obese children are often taller than their non-overweight peers, and are apt to be viewed as more mature. This is an inappropriate expectation that may result in adverse effects on their socialization. (Dietz, 1998). Overweight children and adolescents report negative assumptions made about them by others, including being inactive or lazy, being strong or tougher than others, not having feelings and being unclean. (American Obesity Association, 2000).
This epidemic did not occur overnight. Obesity and overweight are chronic conditions.
This study was concerned with genetics, family dynamics and parenting, and nutrition and dietary intake, all three of which contribute to childhood obesity. Specifically the researcher will attempt to determine what factors are contributing to the nations epidemic rises in obesity among children and what the effects are of the growing girth that is plaguing the nations children. The objective of the research study will be development of a concrete theory that clearly defines the effects of all contributing factors. The intent is to provide healthcare providers and researchers with new avenues for exploring the epidemic affecting this nation's children.
The purpose of this study was to sample 50 K-12 physical educators to determine their perceptions of the unintended physiological and psychological consequences of childhood obesity in their classrooms over their tenures from 3-30+ years. In doing so the researcher hopes to provide clear information that may help guide research in the future related to the subject of childhood obesity.
Obesity - a state or condition present in the body that results in abnormal levels of fat in the body. Typically the term obesity is used for people that are more than 20 to 30% overweight for their combined sex, age and height (Crofton, 2005). Obesity may also be defined as being over 100 pounds the normal body weight. Obesity may be considered a level above overweight, and is typically associated with symptoms including fatigue, depression, problems with compulsive eating (Crofton, 2005).
Physiological - the biological effects of a given phenomena or substance.
Psychological - the emotional and mental effects of a given phenomena or substance.
Psychosocial -the combined social and emotional effects of a given phenomena. Relates to how individuals perceive themselves and their place in the world. Psychosocial factors can influence one's self-esteem. May include society's perceptions that overweight or obese people are lazy, inefficient and poor learners (Tweedie, 2004).
REVIEW of the LITERATURE
There are a variety of factors and many theories that play a role in childhood obesity making it a complex issue to address. It is vital that researchers examine obesity and its impact on children from a variety of different perspectives in order to gain a clear and accurate picture of how and why the problem is occurring.
For the purpose of this paper, a concentrated focus of literature was researched focusing specifically on the following factors: the role of genetics, family dynamics and parenting and nutritional choices. The researcher assumes that all three of these inherently contribute to childhood obesity based on the preliminary data presented in this review.
Preliminary Causes of Obesity: Energy Imbalances
Studies from a variety of disciplines including pediatric nutrition and epidemiology demonstrate that childhood obesity is not caused by one thing; rather, "obesity has a multifactorial origin." (Gable & Lutz, 2000). Some of these factors include: genetic disposition, family demographics, parenting beliefs and practices, child television viewing and computer use, physical activity, "food as reward," increasing hectic family lifestyles and large portion, high fat foods in abundant supply.
One particular theory holds that obesity is a result of an imbalance of energy. "This epidemic is a result of energy imbalance over a long period of time" (Strauss, 2005). Energy balance is like a scale. When calories consumed are greater than the number of calories used weight gain results. Overweight conditions and obesity result from an energy imbalance thus, according to this theory. According to Richard S. Strauss, MD this scale is an example of energy balance and imbalance:
Calories consumed > Calories used
Calories Consumed < Calories Used
No Weight Change:
Calories Consumed = Calories used
Weight gain involves eating too many calories and not getting enough physical activity (Strauss, 2005). The cause of energy imbalance for each individual may be due to a combination of several factors. "A persons body weight," according to Strauss (2005) "is the result of genes, metabolism, behavior, environment, culture, and socioeconomic status."
BMI and Other Body Weight Assessments
The most common method for determining whether adults or children are either overweight or obese is based on a measure called the body mass index (BMI). (Grantmakers in Health, 2001).
Body Mass index=
Weight in pounds x 703
Height in inches x Height in inches
Because the BMI for children is supposed to increase as they grow, an overweight classification cannot be based on a single number, rather the determination of whether a child is overweight is a function of age and sex specific percentiles based on the Growth Charts for the United States as issued by the Centers for Disease Control and Prevention (CDC) in May 2000 (Grantmakers in Health, 2001). Children with a BMI above the 95th percentile for their age and sex are considered overweight. Those between the 85th and 95th percentile for their age and sex are considered at risk of being overweight. Obese and overweight are often used interchangeably, but both refer to children who are above the 95th percentile (Grantmakers in Health, 2001).
The Office of Genetic and Disease Prevention (2005), has found fat stores are regulated over a long period of time by complex systems that involve input and feedback from fatty tissues, the brain, and the endocrine glands like the pancreas and the thyroid. Overweight and obesity can result from only a very small positive energy input imbalance over a long period of time (Office of Genetic and Disease Prevention, 2005).
Behavior and Environment as Causes for Obesity
Strauss writes that behavior and environment play a large role causing people to be overweight and obese. These are according to many researchers, the greatest areas for prevention and treatment actions (Strauss, 2005). "Genetics and the environment may increase the risk of personal weight gain. However, the choices a person makes in eating and physical activity also contributes to overweight and obesity" (Strauss, 2005). "Personal choices concerning calorie consumption and physical activity can increase a person's risk for gaining weight" (Strauss 2005).
There are many factors causing childhood obesity. "A person's bodyweight is regulated by numerous physiological mechanisms that maintain balance between energy intake and energy expenditure" (Strauss, 2005). Under normal conditions these systems are extraordinarily precise, for example, a positive energy balance of only 120 kcal per day (about one serving of a sugar sweetened soft-drink.) would produce a 50-kg. Increase in body mass over the next ten years. Therefore, any factor that raises energy intake or decreases energy expenditure by even a small amount will cause obesity in the long-term.
Bourbeau, Crawford, Freeman et. al, (2005) suggest that rapidly declining rates of sports participation among youths has contributed to the obesity epidemic that is affecting the young. The researchers examine several underlying trends which have contributed to the decline in sports participation, which they define as: (1) personnel issues, including how many teachers and coaches support intramural programs, (2) facility issues, including problems securing space to meet the demands of students interested in engaging in intramural sports and lastly (3) cultural issues, which either suggest that children play numerous competitive sports at once or do nothing (Bourbeau, Crawford & Freeman, 2005:11).
There are also many behaviors and amusements that children currently engage in that have contributed to youth obesity rates, including amusements for children that require no activity, such as video games, computer media, television use, MP3 players and even cell phones which all promote sedentary behaviors and obesity at a young age (Bourbeau, Crawford & Freeman, 2005).
Psychosocial and Physical Effects of Obesity
The physical effects of obesity have been well documented. Children who are obese are more at risk for suffering lifelong health problems which include but are not limited to heart disease, stroke, high blood pressure, Type II diabetes and even orthopedic problems resulting from increased stress on the joints and bones in the body (Hoot, 2004; Blasi, 2003; Tweedie, 2004; Crute, 2000). More so than the physical complications or more devastating are the "psychosocial" effects of being overweight. Children who are overweight are more likely to suffer emotional consequences that are negative and damaging. Generally children tend to "develop negative attitudes about overweight peers" early on in life; such negative attitudes often result in stigmatization of overweight children (Hoot, 2004). Overweight children are more often thought of as "lazy, stupid, slow and self indulgent" (Hoot, 2004:70). In addition overweight children are more likely to be perceived by other children as less likeable, which typically results in them being excluded from "social development opportunities" including play (Hoot, 2004:70).