Childhood Obesity: Nursing, Ethical, and Legal Considerations

Introduction

Childhood obesity is quickly manifesting itself as one of the predominant health concerns of the decade. If childhood obesity remains on the exponential growth trajectory it currently holds, it will almost inevitably become an epidemic within the United States. The issue has received such public attention that former First Lady Michelle Obama embarked upon a national campaign to increase the healthy choices available to children at school lunch counters and implored children to engage in increased levels of physical activity.

According to the Centers for Disease Control and Prevention (CDC), a child is considered obese if they are above the 95th percentile of the Body Mass Index (Berkowitz, 2009). Children are considered at risk of becoming overweight if they fall above the 85th percentile but below the 95th percentile for BMI (Berkowitz, 2009). The statistical trends paint a troubling picture. Teenagers who are overweight face an 80% probability of becoming obese as they enter early adulthood (Berkowitz, 2009). Even among younger children, those who are four years old face a 20% probability of progressing into adulthood with obesity.

Childhood obesity has become a prominent topic among politicians and lawmakers. There have been persistent calls to regulate the foods offered in vending machines near schools and to limit sugar content in certain products. Some states, such as New York, have instituted taxes on certain foods to discourage consumption of items high in sugar and fat — two components that contribute directly to the persistent problem of childhood obesity.

The premise of this analysis is to examine the main issues surrounding childhood obesity. Nursing considerations are plentiful when analyzing this condition, and this paper discusses those considerations as they relate to nursing practice. Furthermore, there are ethical, moral, and legal issues surrounding childhood obesity, each of which is analyzed within the overall context of the condition.

Cultural Influences and Nursing Considerations

Several researchers have described differing cultural views as a central factor in shaping perceptions of childhood obesity (Crawford, 2004). According to some cultures — specifically within the Hispanic/Latino community — there is a general attitude that weight and health are not significantly correlated. Consequently, Hispanic/Latino children have a statistically significant probability of being overweight. This cultural attitude is confirmed by a study conducted at the outset of the decade: a study of over 200 Hispanic children revealed that 35% of parents did not view their child as obese (Myers & Vargas, 2000).

Minority children show higher rates of increase compared to white children. According to a recent study, African American and Hispanic children experienced an increase in obesity prevalence of 10%, compared with an increase of less than 1% among white children — lending strong evidence to the premise that certain demographic groups carry higher rates of obesity (Thorpe, 2004).

Nurses are at the front lines of the struggle against childhood obesity. However, nurses cannot fight this battle alone. They must take critical steps in addressing childhood obesity, including engaging in community awareness and outreach programs tailored to the appropriate social and cultural groups (Garcia, 2006). Nurses working in community health care are best positioned to introduce parents and children to these outreach programs. To do so effectively, nurses must possess strong advocacy and leadership skills.

Nurses must find ways to expand their abilities to enhance advocacy skills at the national, state, and local levels. Although many nurses have readily accepted this provider-advocate role, some question the viability and appropriateness of nurses engaging in such advocacy practices. A study conducted by Gebbin et al. (2000) found that the majority of nurses view effective community outreach as a natural extension of their professional role.

Concomitant with a nurse-practitioner's capacity for effective outreach is the leadership skill necessary to ensure that those who need information actually receive it (Berkowitz, 2009). Collaborative leadership, as described by Chrislip (1996), involves a shared leadership model. In order to effectively address childhood obesity, the nurse must establish a rapport with the community — one that involves developing a deep sense of trust, insight, and a meaningful understanding of human behavior and power dynamics (Berkowitz & Nicola, 2003).

Each of these nursing considerations assists nurses in working with parents and community organizers to address childhood obesity. In addition to these considerations, various ethical, moral, and legal implications factor into the issue. These nursing considerations should not be examined in isolation, but rather in conjunction with the broader issues surrounding childhood obesity.