Obesity Prevalence in Children/Adolescents
Abstract
Obesity is a long-term complex condition in which having too much body fat increases ones risk for developing other health problems. It has been recognized as a major health problem by the Surgeon General, The World Health Organization (W.H.O.), The National Institute of Health (N.I.H.) and The Centers for Disease Control (CDC). Its over- all prevalence has increased by 33% in the last decade (Merck, 2003, pp. 685-687). Researchers have found that obesity is directly related to an increase in the mortality rate (Journal of American Medical Assoc., 2003, vol. 289, 2, pp.187-193). In many obese people, the root of their condition can be tracked back to their childhood years. Obesity tends to run throughout ones lifetime, meaning that its presence at any age will increase the risk of the condition at subsequent ages. For this reason it is important to address the prevalence of obesity in children and adolescents.
In the past 30 years, obesity in American children has more than doubled resulting in an increase in chronic health problems. For children, these problems are especially profound. More children are being diagnosed with adult conditions such as sleep apnea, type II diabetes, hypertension, and high cholesterol, and most of these children will probably carry the burden of their weight into adulthood (American Obesity Assoc., 2002). Overweight children who mature into obese adults are at greater risk for the early development of these conditions that can include physical disabilities. For some children, the causes of obesity are genetically linked, but for many of them the causes are environmental and behavioral. Something has to be done for our children and for society in general. Interventions which concentrate on health education, weight control, physical activity and a well-balanced diet must be implemented to stem the epidemic of childhood/adolescent obesity. This will require the efforts of various parties in this society. It is important that they be made aware of the consequences of this disease and understands the dangers that long term obesity has on the general health of the child/adolescent. With this knowledge, they can take whatever steps are necessary in order to decrease the prevalence of obesity in this society.
This term paper will investigate the impact that obesity has on children/adolescents in our society.
1. What is the prevalence of childhood/adolescents obesity?
2. What are the contributing factors, which lead to obesity?
3. What are the health complications of obesity?
4. How can we prevent/treat obesity?
The prevalence and impact of obesity in children and adolescents between the ages of 6-19 will focus on these four questions.
What is the prevalence of childhood and adolescent obesity?
Rates of obesity have been climbing for decades. According to the CDC (2002c, Nutrition & Physical activity: obesity trends) in the year 2000, 19.8% of adults in the U.S. were obese, an increase of 61% since 1999 (38.8 million adults). By the year 2001, its prevalence rose to 20.9% and currently there are more than 44 million obese American adults, reflecting a 74% increase since 1991. This dramatic increase in obesity, which has reached an epidemic status, is not limited just to adults; the young are also affected by this condition (CDC, 2002, Physical Activity and Good Nutrition at a glance). Data collected by the American Obesity Association (2002b), shows alarming statistics, 15.5% of adolescents between the ages of 12-19 and 15.3% of children between the ages of 6-11 are obese. At present there are an estimated eight million young obese Americans aged 6 to19 in the U.S. (CDC, 2002 at a glance).
Obesity in children and adolescents is now an epidemic. With the increase in the prevalence of obese children in the last three decades, currently one out of five children is diagnosed as obese (National Institute of Health, 2002, Word on Health). Researchers at the A.O.A (2002c, fact sheet) found that among female youths the highest prevalence was in black non- Hispanic girls, ages 6-11 (22.2%) and black non-Hispanic adolescent girls age 12-19 (26.6%). Looking at the statistics for male youths 27.3% of boys ages 6-11 and 27.5% of the male adolescents age 12-19 is diagnosed as obese. Although the increase is in both children and adolescents, in all ages, races and genders the highest prevalence has been found in African American females.
What are the contributing factors of obesity?
There are many causes of obesity. There is no doubt that genetics plays a role, but genes alone do not account for the dramatic increase in the prevalence of obesity in the past decades. The factors that contribute to childhood and adolescent obesity are the same as those for adults (World Book on line, 2003). The main causes of obesity are behavioral and environmental factors. Obesity occurs when one consumes more calories than he/she burns. In the United States, the changing environment has broadened food options and eating habits. Shelves in the supermarkets are stocked with a greater selection of foods. Soft drinks, fast food restaurants and pre-packaged foods are more accessible today. Although such foods are fast and convenient they tend to be very high in fat and calories contributing to an excess caloric intake, causing weight gain (National Institute of Digestive, Diabetes and Kidney Disease, 2001). Some foods are advertised as healthy, low fat or even fat free but many contain more calories than the fatty foods they are suppose to replace. These misguided notions are leading people to take in more calories from food than they use for energy. Portion sizes have also increased in both restaurants and homes encouraging eating more in one meal because of its larger portion size. (Time, 2003). This also holds true within the school system. School breakfast and lunch programs do not promote healthy eating habits in children and adolescents and do not meet the nutritional standards. The foods provided are high in fat, calories and sugars, leading to an increase in caloric intake. Vending machines are now available in schools, allowing for easy access to junk food (MSNBC, 2003). Our bodies need calories for daily normal functions and activities but weight gain occurs when the amount of calories consumed exceeds over its need (CDC, 2002a , Nutrition and Physical activity, contributing factors).
Physical activity is good for overall health. Despite this, most Americans; both adults and children are sedentary. Technology has created labor and timesaving products such as elevators, cars, and computers, TVs with remote controls devices. Instead of walking or riding a bike for short distance errands, people use their cars, decreasing the overall amount of energy used in their daily lives. (NIDDK, 2001). At the work place, employers do not provide opportunities for physical activities and most Americans hold jobs that involve minimal physical labor. Children and adolescents spend two to three hours daily watching TV or playing video games (sedentary activities) instead of engaging in physical activities, which burn up calories. Schools do not encourage physical activities nor do they provide an environment that promotes it either. (Surgeon General, 2001). This lack of physical activity and the consumption of too many calories leads to obesity and comes with consequences that have major impact in the health of the individual as well as on society.
What are the consequences of obesity?
Along with the increase in the prevalence of childhood obesity, there has also been an increase in other major medical problems among children and adolescents. Childhood obesity is associated with increased factors for heart disease, such as hypertension, elevated cholesterol levels and elevated blood sugar (diabetes). It is also associated with an increase in sleep apnea (interrupted breathing during sleep) asthma, some cancers and orthopedic problems especially of the lower limbs due to excess weight bearing to the joints. (AOA, 2002d, Health Risks).
The most alarming finding and of great concern is the appearance of diabetes type II (adult onset) in adolescents. A condition which was rare among the young is now found in increasing numbers (NSW, 2002,). Recent research shows in 1990 fewer than 4% of children were diagnosed with diabetes. At present there is more than 20% and this number varies from 8-45% depending on the age group. Type II diabetes is the most frequent type found among the ages of 10-19 yrs. Of all the children diagnosed with diabetes, 85% are obese (American Academy of Pediatrics, 2003).
Aside from the increased risk of major health problems that are associated with obesity, investigators have presented information on the impact of obesity on the health care cost and the mortality rate in the U.S. Health care cost in 1999 was estimated to be $102.2 billion; currently is estimated at $117 billion. In reference to the mortality rate in the U. S. alone, there are approximately 300,000 deaths a year have been attributed to obesity (AOA, 2002a, Advocacy Update).
How can obesity be treated / prevented?
According to the CDC, (2003, FAQ), AOA, (2002, Childhood Obesity), AAP, (2002), The Surgeon General’s call to action and the NIDDK, (2001), the treatment is the same. The emphasis is placed on prevention: the reduction of dietary fat, caloric intake and increase in physical activity. This includes minimizing sedentary behaviors such as watching television too much, reading nutrition labels supplied on the food containers/ packages and following the food guides recommended in the food pyramids to include fruits and vegetables. The changing of eating habits must also be implemented. The selection of proper portion sizes, eating slower, taking smaller bites and chewing the food thoroughly (longer). In reference to physical activity, it should be part of an individual’s daily activity, whether it be walking, biking, jogging, garden work or moderate house work, it must be included in ones routine.
Once obesity has already been identified, the primary concern is weight loss, and the weight loss must be gradual. The treatment is dependent on the severity of the condition, the overall health of the individual and the motivation to lose the weight. The treatment differs from person to person. It can be a combination of diet and exercise with the inclusion of environmental and behavioral modifications. With extreme cases and when the individual health is in jeopardy, medications and/or surgery are strongly recommended. The treatment of medication and/or surgery must be under the continuous supervision of a physician and the involvement of a nutrition specialist (NIDDK, 2001).
The evidence is over whelming that childhood and adolescent obesity has been on the rise for several decades, having major effects on health and longevity. There are approximately eight million young obese Americans in the United States between the ages of 6 and 9. Obesity is clearly associated with the increased prevalence of diabetes type II and sleep apnea along with the increase in other risk factors that lead to heart disease in children and adolescents. The contributing factors that lead to obesity are clearly evident and recognized by government agencies and health professionals alike, yet there are an estimated 300,000 deaths a year attributed to obesity.
It is obvious that prevention is the long term answer. Prevention is the best hope for decreasing the prevalence of this condition, but an obesity prevention program does not exist. Emphasis must be placed on the development of such a program, a comprehensive preventive program that incorporates educational, behavioral and environmental components. Implementation of such a program will require the efforts from public health agencies, education professionals, media (food advertisements), industries (providing some means of physical activity) and health care providers.
Health education should be widely available in all schools for the teaching and reinforcement of health behaviors which should begin at home. Healthy eating and physical activity are the cornerstones in the prevention of obesity especially in children and adolescents. Families and schools are major critical links in providing the foundation for these behaviors. They are role models in creating an active and healthy eating environment that promotes healthy nutrition and good physical activity habits.
As a nation we need and must take action to assist in the reduction of obesity and the major health conditions associated with obesity. We must lobby and let our voices be heard demanding for the involvement of government agencies and politicians in allocating funds for continual research in the prevention of obesity. We should create programs that educate the public on nutrition and encourages physical activity. Controlling the cost of food, making nutritional foods more affordable for easier accessibility, and encouraging the media to promote healthier foods.
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