Childhood Obesity and Adult Morbidities, Term Paper Example

Introduction to the Problem

In modern society, there are a number of critical health concerns that require immediate and continuous attention and focus because they contribute to a decline in overall health for many persons, and also contribute to poor health outcomes over the long term. One widespread and prevalent problem is adolescent obesity, which has increased significantly over the past several decades and is now a prominent and disturbing health epidemic. Adolescent obesity is often attributed to a number of factors, such as poor nutrition and the consumption of sugary drinks and processed foods, limited physical activity, and to some extent, the explosion of technology that is now available to this population. Video games, smartphone apps, and other devices keep many children and adolescents indoors instead of outside, where in the past, they might have engaged in one or more forms of physical activity in the outdoor setting, but now, they remain inside on the couch, glued to the television set or enthralled in playing a game on their smartphones. This is a highly relevant yet disturbing trend in many households that has contributed to the dramatic increase in obesity within the adolescent population.

Obesity in adolescents may pose a threat throughout the life span, particularly as these children grow into adults and face numerous health risks and challenges, including chronic diseases such as type 2 diabetes and hypertension. Therefore, this problem must be addressed as early as possible in the life span in order to minimize the risks for these children as they grow into adulthood. There are many complexities involved in the 21^st Century culture that exacerbate this problem even further, such as busy lifestyles, the convenience of processed foods, the advertising of sodas, juices, and other sugary drinks to younger markets, and the continued relevance of fast food throughout society. These factors must be addressed more closely as a means of developing an understanding of the scope of this problem and how it impacts the lives of adolescent youth and their growth and maturity into adults. The following discussion will address adolescent obesity in greater detail and will emphasize the significance of societal norms and expectations as critical components of this epidemic. It is expected that an intervention will take place involving adolescent participants between the ages of 11 and 18 in order to address behavioral risk factors and barriers to change within this population.

Literature Review

A wide body of literature has been established regarding adolescent obesity, including risk factors and behaviors that exacerbate the continued growth of this epidemic and its impact on the life span. Perhaps most significant is the role of the family unit and its contribution to adolescent obesity, as many children are part of families where soft drinks, fast food choices, and video games and television are routine components of daily living (Wen et.al, 2011). From this perspective, therefore, it is evident that there could be emotional and/or psychological limitations in the home environment that limit children’s growth and self-esteem (Wen et.al, 2011). In addition, it is likely that the nature of families with busy lifestyles is not conducive to healthy eating and exercise (Wen et.al, 2011). These factors demonstrate that issues and/or habits within the family unit have a significant impact on weight and overall health in many cases, thereby creating disconnect between the factors associated with family function and weight status (Wen et.al, 2011).

Many adolescent youth exhibit poor health-related behaviors from a very early age, perhaps because positive behaviors are not reinforced in the home environment, or other factors contribute to these weaknesses. Therefore, risk behaviors must be addressed more closely in order to have a lasting impact on children who face these risks (Farhat et.al, 2010). It is known that “Engaging in health-risk behaviors may be considered normative and serve a developmental purpose, such as rebellion against authority and identification with the youth subculture.⁷ Health-risk behaviors may also help to cope with stressful life event” (Farhat et.al, 2010, p. 258). Although these behaviors are well-documented and understood, they are not acceptable alternatives; therefore, other factors must be considered that will demonstrate the importance of new approaches to improve health and wellbeing for adolescents who engage in risk-taking behaviors that could contribute to excess weight and obesity (Farhat et.al, 2010).

It is likely that children who experience greater wellbeing in their adolescent years will participate in fewer risk-taking behaviors during this period and into young adulthood, which may provide further support for the prevention of obesity in many children (Hoyt et.al, 2012). Therefore, wellbeing during this period has a positive impact on reducing risk-taking behaviors in many children and young adults (Hoyt et.al, 2012). On the other hand, when there is a high level of stress in the home environment, this may have a significant psychosocial impact on children and may contribute to obesity because they impact physical and mental health and wellbeing (Gundersen et.al, 2011). From this perspective, “The potential strain on the body because of stressors is particularly important to consider for children, who are still developing biologically, cognitively and socially… additionally, understanding the impact of stressors on children’s development, particularly their weight status, may be especially important for children growing up in low-income households as psychosocial stressors are more common among those living in poverty than for those who are not” (Gundersen et.al, 2011, p. e54). These findings suggest that many children may grow and mature into an obese state as a result of their childhood experiences and how these impact their psychosocial wellbeing on many different levels (Gundersen et.al, 2011).

The creation of an environment for change requires an effective understanding of some of the most prominent causes of obesity, which also include a sedentary lifestyle (Pearson & Biddle, 2011). This approach supports the belief that when children lead a primarily sedentary lifestyle, including excess television and/or video games, their eating habits are generally poorer, thereby increasing the risk of weight gain at a significant level (Pearson & Biddle, 2011). These factors support the development of new interventions to support the growth and change that is required to enable adolescent youth to have a chance to overcome these high-risk behaviors and to eliminate obesity from their lives (Pearson & Biddle, 2011). In addition, children and adolescents who exhibit behaviors involving binge eating and purging must also be considered, as these pose a risk to their lives if these behaviors continue on a long-term basis (Haines et.al, 2010). This problem is particularly evident when children present with low self-esteem and do not receive the psychosocial support that is required to improve their lives and overall wellbeing (Haines et.al, 2010).

It is important to note that many adolescents exhibit behaviors that contribute to obesity that may also have a significant impact on adult morbidity levels (Biro & Wien, 2010). From this perspective, it should be noted that “The consequences of childhood and adolescent obesity include earlier puberty and menarche in girls, type 2 diabetes and increased incidence of the metabolic syndrome in youth and adults, and obesity in adulthood. These changes are associated with cardiovascular disease as well as with several cancers in adults, likely through insulin resistance and production of inflammatory cytokines” (Biro & Wien, 2010). These conditions reflect the need to develop new approaches that will encourage adolescents to understand their own risks and to take action from a behavioral perspective in order to overcome these problems as best as possible to prevent serious complications into the adult years (Biro & Wien, 2010).

Theoretical Framework for the Intervention

The prevention of obesity in young children is a complex challenge that requires many areas of focus. As a result, it is necessary to understand factors such as choice, control, and change (C3) in this process by transitioning from unhealthy foods (sugary drinks, fast food, television) towards a culture of healthier choices (water, fruits and vegetables, and exercise) to improve psychosocial and physical health and wellbeing (Contento et.al, 2010). As a result, the Health Belief Model is appropriate for this intervention because it recognizes some of the reasons why some behaviors exist and how to potentially overcome these behaviors by using specific strategies that attempt to modify these behaviors accordingly. Furthermore, the Theory of Planned Behavior is likely to be effective in predetermining the types of behaviors in which individuals might participate and the reasons why these behaviors occur within a given population group. This theory enables the support of new perspectives to address these reasons and the creative approaches that are required to overcome these behaviors on a gradual basis. This model supports the belief that if individuals feel at all threatened by the condition or disease, action will be taken to prevent the disease from occurring (Crawford et.al, 2013). The model makes a number of assumptions in that individuals recognize their own level of risk and that prevention will be successful in supporting improved outcomes (Crawford et.al, 2013). Unfortunately, this model does not always reflect the reality of human beings, who may appear to be irrational or impractical in their beliefs and perspectives, which could pose a threat to their health if they do not recognize their own risk of developing a condition or disease (Crawford et.al, 2013).

These theoretical approaches reflects the importance of encouraging parents to become “agents of change” in order to address behavioral modifications for children that will promote improved lifestyle choices and weight loss (Faith et.al, 2012). Since the obesity epidemic is so significant, it is necessary to address this problem proactively so that all possible options are explored to gradually reduce the incidence of obesity and provide a framework for change and progress within the context of existing environmental conditions (Gortmaker et.al, 2011).

Changes to alleviate obesity must be gradual, thought-provoking, and timely, as these efforts are essential to the growth of practice settings and the creation of an environment that is likely to embrace these changes over time (Gortmaker et.al, 2011). As a result, it is important to identify the resources that are necessary so that a decline in obesity is a probable occurrence in the coming years (Gortmaker et.al, 2011). This may be achieved through large-scale system changes, such as food preparation by using healthier and non-processed ingredients, reducing food prices for consumers, and providing support to those persons who are obese through various psychosocial interventions and other methods (Gortmaker et.al, 2011). These processes are likely to have an impact on children over the long term, particularly when their parents, teachers, and family members also promote similar behaviors in their own actions (Gortmaker et.al, 2011). This requires an ongoing effort in order to ensure that patient care is not compromised and that there are sufficient opportunities for growth through interventions in order to alleviate obesity as best as possible.

Purpose of Intervention

The primary purpose of the chosen intervention is to establish a program that involves three components: education, nutrition, and exercise. Each of these components will be designed to enable adolescents between the ages of 11-18 to improve their understanding of their own behaviors and how they contribute to excess weight and obesity. This process is instrumental in providing comprehensive support for this group of adolescents so that they are able to make better lifestyle decisions in their own lives that do not involve high-risk behaviors. This intervention will also address the importance of improving nutritional habits, which includes the reduction of sugary drinks, fast foods, and processed foods from the diet. It is also important to identify different methods that will enable participants to become involved in the intervention by volunteering in different capacities.

This group of adolescents must be interested and invested in the intervention in order for it to be at all successful. This process will also require an effective understanding of the behaviors that commonly exist in many adolescents in order to determine how to best overcome these challenges and to achieve greater outcomes for the intervention group and beyond. It is important to remember the target audience at all stages of the intervention program in order to support the best possible strategy for the intervention that will have a lasting impact on the participant population, with the potential for lessons learned that they will carry into their adult years. It is believed that with a positive intervention in place, there will be lasting benefits for the target population in the form of modified lifestyle behaviors that will include healthier food choices and increased physical activity in order to promote weight loss in overweight and obese adolescents.

Proposed Participants/Criteria for Choosing Participants

The proposed target population for the intervention will include adolescent youth between the ages of 11-18 who are overweight or obese. These youth will be preselected by teachers and parents within a local school district for possible participation. These youth are likely to exhibit many of the negative lifestyle behaviors that the program is designed to target; therefore, these youth are critical to the potential success of the intervention and its impact on their lives. Recruitment of participants will be conducted at the school with proper permission, and parents will be notified regarding the program, including its benefits and risks to participants. The target number of participants for the proposed intervention is 25, with the anticipation that there will be a larger number of girls than boys, as girls often care more about weight and nutrition than boys within this age group.

It is believed that this target population of an initial 25 students is small enough to allow participants to feel comfortable within the program, but also large enough to stimulate conversation and enable children to actively participate without feeling crowded or intimidated by the group and its leaders. This initial target population also aims to obtain a mix of adolescents from the different age groups in order to ensure that different levels of experience are participating in the group in order to obtain a well-rounded sample of individuals. This is likely to stimulate conversation and promote different types of discussion within the group on the topics that are chosen, while also enabling the older participants to serve as mentors and to set an example for the younger adolescent members of the group. This will reinforce the probable success of the intervention by enabling participants to become fully immersed in its content and areas of focus.

How Intervention will be conducted

The proposed intervention will be conducted by using a variety of methods to maintain participants’ interest and attention over a period of time. This process requires a knowledgeable and experienced group of individuals leading the intervention in order to accomplish the desired objectives, while also considering other factors that play a role in shaping the intervention as it evolves in order to make any required changes as necessary throughout the process. It is expected that some of the different methods to be used will include skits and role-playing to gauge participant interest in the intervention, as well as videos and speakers who are relevant to the participants. The use of examples from pop culture will also make the topics relevant to the adolescent population and will motivate them to perhaps consider making changes in their own lives. These changes could develop into habits that could have lasting and permanent benefits for this participant population throughout the life span. Furthermore, the use of relevant examples from pop culture sill stimulate the conversation regarding obesity, including its causes and what can be done to overcome this problem in the adolescent population. These methods will be conducted in a manner that is appropriate, understandable, and relatable for an adolescent audience of participants.

Effective Strategies

The formation of a successful strategy for implementation requires the group to address the target outcomes and to determine what issues are most important for inclusion in the intervention itself. This process is essential to the discovery of new challenges and techniques that will have a positive impact on participants over the long term. A forward-thinking strategy must also consider current trends in food and exercise that could be integrated into the intervention as possible discussion topics, such as the Paleo diet, juice fasts, Zumba, Crossfit, and the dangers of diet supplements. Each of these sub-topics is important in order to shed light on potentially beneficial and/or controversial issues that could impact this population in one way or another. These factors play an important role in determining the appropriate course of action for the intervention as it hopefully evolves and grows into a larger program. This process is essential to the discovery of new techniques and strategies that will be effective in providing the necessary resources for adolescents that will motivate them to give up sugary drinks and snacks and drink water and eat an apple instead. Although this is a difficult task to accomplish, it is likely the activities that are performed and conversations that take place will provide further evidence and support of the need for improved lifestyle choices for this target population.

Expected Results

Based upon the small initial number of participants (n=25), it is expected that the intervention will provide a framework for achieving success within this population, and will also stimulate new ideas and approaches to improve lifestyle behaviors for the adolescent population. It is also anticipated that if the program is successful, a larger rollout of the program will occur with an expanded number of participants in a larger geographic area. This intervention program will capitalize on the resources that are available in literature, in the local community, and in the news that are relevant symbols of popular culture in order to achieve the desired results for the program. It is expected that the lifestyle behaviors of participants will improve on a gradual basis and may stimulate weight loss and improved health, self-esteem, and general wellbeing within this population group.

References

Biro, F. M., & Wien, M. (2010). Childhood obesity and adult morbidities. The American journal of clinical nutrition, 91(5), 1499S-1505S.

Contento, I. R., Koch, P. A., Lee, H., & Calabrese-Barton, A. (2010). Adolescents Demonstrate Improvement in Obesity Risk Behaviors after Completion of Choice, Control & Change, a Curriculum Addressing Personal Agency and Autonomous Motivation. Journal of the American Dietetic Association, 110(12), 1830-1839.

Crawford, L., Howard, J., Karmali, R., Pjecha, M., & Santoro, H. (2013). Childhood obesity and possible policy interventions. Georgia Institute of Technology, retrieved from http://policychallenge-usa.org/uploads/3/1/5/9/3159875/2013_challenge_-_memo_-_georgia_tech.pdf

Faith, M. S., Van Horn, L., Appel, L. J., Burke, L. E., Carson, J. A. S., Franch, H. A., … &

Wylie-Rosett, J. (2012). Evaluating Parents and Adult Caregivers as “Agents of Change” for Treating Obese Children: Evidence for Parent Behavior Change Strategies and Research Gaps A Scientific Statement From the American Heart Association. Circulation, 125(9), 1186-1207.

Farhat, T., Iannotti, R. J., & Simons-Morton, B. G. (2010). Overweight, obesity, youth, and health-risk behaviors. American journal of preventive medicine, 38(3), 258-267.

Gortmaker, S. L., Swinburn, B. A., Levy, D., Carter, R., Mabry, P. L., Finegood, D. T., … & Moodie, M. L. (2011). Changing the future of obesity: science, policy, and action. The Lancet, 378(9793), 838-847.

Gundersen, C., Mahatmya, D., Garasky, S., & Lohman, B. (2011). Linking psychosocial stressors and childhood obesity. Obesity Reviews, 12(5), e54-e63.

Haines, J., Kleinman, K. P., Rifas-Shiman, S. L., Field, A. E., & Austin, S. B. (2010). Examination of shared risk and protective factors for overweight and disordered eating among adolescents. Archives of pediatrics & adolescent medicine, 164(4), 336-343.

Hoyt, L. T., Chase-Lansdale, P. L., McDade, T. W., & Adam, E. K. (2012). Positive youth, healthy adults: does positive well-being in adolescence predict better perceived health and fewer risky health behaviors in young adulthood?. Journal of Adolescent Health, 50(1), 66-73.

Pearson, N., & Biddle, S. J. (2011). Sedentary behavior and dietary intake in children, adolescents, and adults: a systematic review. American journal of preventive medicine, 41(2), 178-188.

Wen, M., Simpson, J. M., Baur, L. A., Rissel, C., & Flood, V. M. (2011). Family functioning and obesity risk behaviors: implications for early obesity intervention. Obesity, 19(6), 1252-1258.