Obesity is a nutritional disorder characterized by the accumulation of excess fats in the body. Childhood obesity is a major problem in the USA, with around 16.84% prevalence rates among children between two and nineteen years old. In 2012, 8.4% of two to five-year-olds were overweight (Center For Disease Control, 2012). Evidently, obesity is a condition that affects an enormous cross section of children. Obesity has some far-reaching physical, social, and economic consequences. The physical concerns include high blood pressure and high cholesterol level, which are risk factors for cardiovascular disease (CVD) like to hypercholesterolemia, hyperlipidemia, and hypertension. There is a greater risk of impaired glucose tolerance, insulin resistance and type II diabetes seen in some children due to excessive insulin secretion and organ resistance to insulin. Moreover, they usually develop pulmonary complications like asthma sleep apnea. Furthermore, obese children demonstrate joint problems and musculoskeletal discomfort in a majority of cases, which, coupled with their excess weight, makes it extremely unlikely that they will engage in exercise or lengthy physical activity.
Obese children also suffer from orthopedic issues of bowed legs and hip instability. A common manifestation of this is bow legs and a slipped capital femoral epiphysis. Moreover, obese kids suffer an increased risk of metabolic diseases such as fatty liver disease, gallstones, and gastro-esophageal reflux (heartburn). Girls are likely to develop an irregular menstrual cycle and in some cases, infertility. In general, children with obesity are at a higher risk of carrying the condition into adulthood.
Obesity is also characterized by some psychological and economic effects. Chief among these psychological effects is stress and a negative self-image, depression, behavioral problems, and issues with fitting in school, and society in general. Typically, they display signs of low self-esteem and low self-reported quality of life. Bullying and teasing in schools further reinforce their negative self-image, as does the constant bombardment by the media of perfect images of other people. Economically, the costs of medicine for the condition as well as the associated disorders are very expensive, while indirect costs arising from them include absenteeism and decreased productivity. In general, they suffer an impaired social, physical, and emotional functioning.
John is eight years old and was diagnosed with obesity in 2009 when he was barely three. As a result of his condition, he has had to have many adjustments in his daily day to day functioning. Perhaps the single greatest effect of his obesity is the development of insulin resistance when he was four years old and has only recently been diagnosed with a severe case of type II diabetes as a result of his obesity. Type II diabetes was predominantly common in adults, to such that, at a point, it was referred to as adult onset diabetes. Cases like John’s are becoming exceedingly common. Due to diabetes, John has to have an insulin shot at regular intervals of around three hours to regulate his blood sugar.
Recently, John had to have a medical review after he started complaining of blurry vision and difficulty in seeing. After a visit to the school nurse, his parents were informed his hyperglycemia likely induces it. To further compound his situation, John also has a mild case of asthma, even though the family has no history of the disease. Here, yet again his obesity has been confirmed as the cause. He also suffers some musculoskeletal discomfort and joint pains. This makes it tough for him to engage in physical exercise and, at times, even to walk.
As a direct result of his condition, and the numerous complications, John is continuously teased in the class by his classmates. They take issues with his inability to participate actively in physical education. His performance has gradually dipped, and where he was initially in the top 5% of his class by performance, he has now fallen to the bottom 10%. John also reports trouble sleeping. He was once reprimanded by his teacher for sleeping in the English class, after which, upon further questioning, it was revealed that he suffers from inadequate sleep. As a result, John is constantly fatigued and complains of being frequently tired.
John’s school nurse recommended that he gets a pair of glasses to help him with his studies. Further, the nurse helps him out by administering his dosage of insulin shot as required. Also, she has reprimanded other children severally when they were making fun of John. The nurse has also encouraged that he adopts an exercise routine and tries to get adequate rest whenever he gets home. Furthermore, she is in talks with John’s mom on how his daily diet can be improved so that it is healthier, and the mother seems willing. In all, the nurse is genuinely concerned for John and wants the best for him.
3) Causes
A multitude of factors causes obesity. The most prevalent factor, which is seen in almost all cases of the condition is an unhealthy diet. Obesity is a nutritional disorder which means there is a high correlation between the kind of food one eats and diabetes. Having unhealthy foods and regular consumption of high-calorie foods such as candy, baked goods, soda, and chips contribute to weight gain. New research suggests that snacks account for up to 27% of their daily calorie intake of American children (Piernas & Popkin, 2010). Between 1977 and 2006, children increased their caloric intake from snacks by an average of 168 calories/day, up to a total of 586 calories. The largest increase was found in children aged between two to six, who consumed an extra 181 snack calories per day compared to two decades earlier (Centers for Disease Control, 2012).
Another contributing factor to obesity is the lack of physical activity. Most of the activities which held the interest of children in the previous generations no longer do. With the prevalence of computers, video games, and televisions, a major shift from active to passive recreation, the average weight of American children has gone up. Passive entertainment and recreation conspire to keep kids inside and sedentary, a fact that results in them burning even fewer calories, and this translates to them gaining even more weight. Parents usually cite concerns about the safety of outside play. To compound the lack of exercise, most kids are dropped off at the school premises and picked up later in the day, translating to almost zero exercise on their part, and poor exercise habits later in life.
Another great cause of obesity is the child’s environment. Research has revealed that a good diet is a function of what the environment dictates to the child. If all the food that the parents stock up on is junk food, it follows that the child will be more likely to turn out being obese. Similarly, if a child is used to a healthy diet at home, he or she will have greater chances of maintaining the diet even when the parents are not around, and into adulthood.
One factor that leads up to obesity but is often overlooked is the psychological aspect of it. Like adults, some children turn to food as a psychological coping mechanism for dealing with negative emotions like anxiety, stress, boredom or even depression. In particular, those children trying to cope with issues of separation (or divorce) and family grief have a propensity to ‘stress eat.’
Genetics and medical conditions may also play a role in the susceptibility to Obesity. Genes also play a part as some families have a genetic predisposition to being overweight. However, this is majorly a factor only when junk food is also available; that is, the genetic predisposition is coupled with improper diet. Though not common, some genetic diseases and hormonal disorders predispose a child to obesity. These conditions include hypothyroidism (thyroid is underactive). Two more conditions that result in obesity are the Prader-Willi syndrome, which is a genetic disorder that affects that part of the brain that controls feelings of hunger, and Cushing’s syndrome, a disorder that is characterized by overexposure of the body to too much cortisol hormone. Cushing syndrome is usually a result of hyperactivity of the adrenal glands or use of medications such as those for asthma.
References
Centers for Disease Control. (2012). Prevalence of childhood obesity in the United States, 2011–2012.
Piernas, C., & Popkin, B. M. (2010). Trends in snacking among US children. Health Affairs, 29(3), 398-404.
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