Overweight and Obesity in Children

Obesity in Children Obesity is a growing problem in America with more than 64% of the U.S. adult population identified to be clinically obese or overweight. It is estimated that there are more than 300,000 deaths every year which are directly attributed to obesity. [CDC]. It would not be far fetching to say that obesity has in fact assumed epidemic proportions and is one of the fastest growing healthcare problems of our nation. There is a positive association between obesity and cardiovascular diseases, diabetes, cancer and other life threatening conditions.

A disturbing fact is the increasing rate of obesity among children in the age group of 4 to 16. Unhealthy eating habits and the modern sedentary life style have only aggravated the risk factors leading to a health care crisis. Nurses as community healthcare providers have an important role in increasing the awareness and initiating nutritional programs and exercise activities aimed at controlling obesity at an early age.

The Obesity Crisis An obesity crisis is looming large in our nation where more than 15% of all children (6 to 11) and adolescents (12 to 17) are clinically obese. Over the last two decades obesity rates have tripled among adolescents creating a grave health care problem for our young population. Asides the negative psychological effect that obesity has on the affected children they are also at an increasing risk of early affliction from cardiovascular complications, diabetes and orthopedic problems.

The rather disappointing scenario is the complacency exhibited by primary care providers in identifying obese conditions among pediatric subjects. Our biggest problem is that inspite of the awareness generated about the prevalence of obesity and the health consequences, identification and tackling of the problem at the primary care level is still at a slack. One study suggests that only 20% of obese children are identified by health care providers. [Jennifer R.

McCarthy] recent study which analyzed the rates of identification of obesity condition among primary healthcare providers also projects a bleak picture. Children between 3 months and 15 years were observed for their Medicare visits over a period of 3 months. In all a total of 2515 visits were studied and it was found that 244 children fitted the clinical description for obesity. However, only around 120 were identified by their health care providers for their obese condition.

The study also found that obesity in younger children tends to be ignored (goes unidentified) by their primary care providers which, given the fact that they are the group that can be easily corrected presents a worrisome picture. [O'Brien SH] So there is a dearth of preventive and interventional programs at the community level and definitely a clear lack of obesity control programs at the school level.

Another study conducted by the Harvard university found out that calorie restrictive low carbohydrate diets are proving to be detrimental than helpful in the sense that any form of dietary restriction entails the tendency towards binge eating. For the study the researchers analyzed 8203 children in the age group of 9 and 14 and found that low calorie diets only resulted in increase rather than decrease of weights.

One more important point to state when we discuss about the dietary component is that even though 88% of American schools follow the USDA lunch programme (less than 30% calories from fat) these schools also simultaneously sell junk foods in their canteens which defeats the whole purpose of the USDA dieting prescription. For example the soft drinks sold in the school premises have 150 calories per can and it is estimated that on an average 85% of all school children consume at least one soft drink per day at school.

[Holcomb] Obesity Management (Role of Nurses) The key to managing obesity epidemic is identifying the problem early and hence addressing the problem at the pediatric level would definitely produce positive results. Nurses have an important role in promoting the health and well-being of the community and by nature of their profession they have better reach-out and interaction with the public. Both environmental factors as well as genetic susceptibility are responsible for obese condition in a person.

However the prevailing viewpoint is that of obesity as a purely genetic inheritance and hence people do not initiate any action to control it. The role of eating disorders and the lack of physical activities are neglected. One of the main drawbacks of the present weight management programs is that they only offer dietary advice but do not involve professional support in the form of monitoring the progress.

Weight management must be a part of the health care system and nurses can monitor the progress of the patients on a regular basis. Targeting the Schools Since children constitute the most amenable age group it is much easier to mend their ways and change their dietary habits and activities towards a more active and healthier lifestyle. The supportive role of the nurse is paramount in the battle against obesity and schools are the best place to start such activities.

It would be great if our schools employ the services of obesity clinic nurses. Nutritional imbalance, inactive lifestyles as reflected in too much time spent before television and computers are the main reasons for obesity among the children. Nurses can offer excellent dietary advice and also provide psychological support for these students which is more important if the results are to be successful in the long-term.

Such an effective working partnership offered by the nurses at the schools would definitely help control and eradicate obesity problems in children and prevent potential health hazards. [Steven Jeffrey] Community-based screening programs Community-based programs can be also organized by nurses to increase the awareness of the physical risks of obesity and the positive benefits of obesity control. Distribution of material relating to health effects of obesity and the dangers of junk food would certainly create a positive change in the lifestyles.

Providing family-based counseling sessions are important and nurses can interact more closely with the parents and discus treatment modalities with them. Pediatric obesity control clinics can be setup in communities and free screening sessions can be held to identify obese children and regular counseling support can be organized for them. Conclusion.