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Childhood Obesity in Australia

In Australia and many other developed countries around the world, childhood obesity is one of the most difficult health issues of our time. The rates of obesity have been rising steadily in Australia over the past few decades, which have significant health impacts on the health of children who are suffering from this disease. In order to combat this issue, there have been a number of prevention and promotion strategies. This article will address and discuss the role of the health care professionals in implementing such strategies, and how to assist families and children to deal with this issue in order to achieve positive health outcomes.

Background

Childhood obesity most commonly occurs over a period of time by the eating of food which is greater than the energy used through metabolism and activity. The greater availability of processed high energy foods, along with fast food combined with the reduction of physical activity and exercise is thought to be the result in most cases 1). Only approximately 1% of childhood obesity is a result of endocrine and genetic diseases 2). The BMI (Body Mass Index) is the most common means of measuring the correct body mass in adults and children. The BMI compares a person’s height to weight ratio, so in a person aged 2-19 is considered obese when their BMI score is at or above the 95th percentile for their sex and age 3). Even though it is possible for every child to become obese, statistics show that adults and children from lower socio-economic groups and also socially disadvantaged groups run a higher risk of suffering from this health issue 4). The keeping and monitoring of statistics is possibly the best indicator to show the development of this key health issue.

Statistics

Statistics from the Australian and New Zealand Obesity Fact Sheet illustrate the importance of this increasing health issue in Australia. Over the past several decades, the prevalence of childhood obesity has been increasing steadily. In the study undertaken in 2007-08, the results indicate that 24.9% of all children aged between the years of 5-17 were overweight or obese. This means that in Australia today, one out of every four children are considered to be overweight or obese. This is a significant jump from what was only five percent during the 1960’s. What makes these statistics more worrying is that not only are these rates climbing; they are increasing at a rate of one percent a year 5). If these statistical trends continue, more than half of all Australian children will be considered overweight or obese by the year 2025. The most negative fact is that those obese children will be twice as likely to become obese in their adult years 6).

Effects

Childhood obesity has an indisputable effect on the biological, psychological and social development of the child. The biological results of obesity during the childhood years include an increase in the risk of developing type two diabetes, hypertension, intolerance of glucose, sleep apnoea and asthma, among many others 7).

The psychological brunt of childhood obesity includes depression, poor self esteem and decreased self-image, which all are accompanied by sadness, loneliness, nervousness and other high risk behaviours 8). In the social arena, children who suffer from childhood obesity are often pigeon holed as unhealthy social outcasts, that they are lazy and also unhygienic. The burden of this can also affect future academic success and personal relationships 9).

Prevention Strategies

As a result of a growing awareness of childhood obesity, there have been many prevention and promotion strategies implemented to assist in tackling this critical health issue. There have been a number of campaigns undertaken by the Australian Government, such as Go for 2 & 5, Get Set 4 Life- Healthy Habits for Healthy Kids Guide and Healthy Active Ambassadors which include professional sports stars such as cricketer Brett Lee and world champion surfer Lane Beachley 10). Television has been used by the government in order to run campaigns to help influence positive health choices for children. In the past television has been used to advertise fast and junk food, but the government has now implemented certain guidelines, such as the restriction of advertising junk and fast food during prime afternoon child viewing time. Promoting healthy food in school canteens is another initiative which has been undertaken, where many canteens have banned sweet drinks and reducing or completely phasing out the availability of processed package food 11). Many schools are now introducing healthy incentives such as being allowed to eat fruit and drink water during class, and also rewards based point’s schemes for healthy lunch boxes 12). A combination of strategies is suggested to be the most likely way to combat and reduce childhood obesity in Australia.

The Role of Health Professionals

Nurses,school nurses and other health professionals are also regularly in contact with parents and the children, so therefore they have a critical role to play in the promotion of healthy lifestyle choices, not only on an individual basis but also at a family level 13). Nurses are able to constantly monitor and provide support and alternatives to families in order to help adjust contributing factors that may lead to unhealthy weight gain. It is now recognised that the early years of a child’s life sets the foundations for long term behaviours and eating patterns, thus making it very important for nurses to encourage and educate children and their families about healthy lifestyle choices. Reviewing recent literature on the management, treatment and prevention of obesity in children proposes that school nurses could implement several management strategies in order to assist children and their families about addressing childhood obesity. Under these circumstances a nurse would assume many roles in order to facilitate these strategies. In the next section of this paper case study four will be used to display what roles the nurse can play and how these strategies could be implemented.

The main role of the school nurses or other health professionals who observe such cases in this situation would be to represent the child. Children are dependant on their families at this age, thus the family would have the main influence on this child’s weight. The nurse’s main objective would be to try and alter family behaviour and awareness, promoting better food choices and more physical activity 14). The nurse would firstly assess the child’s BMI, and determine if that they are overweight or obese. A full history of the child’s dietary aspects and the amount of physical activity undertaken in the past would assist the nurse in discovering where the particular problems may lie 15). After documenting this information, the nurse should then sit down and discuss the situation both with the child and the child’s family, in order to discover the level of awareness or otherwise of both parties, and what they might be willing to do in order to improve the situation 16). If there is a lack of keenness to change, many management strategies will have little or no effect. The use of motivational interviewing could be one such measure taken, which would increase parental involvement and increase the child’s motivation 17).

The second role the nurse or health professional should undertake is that of education. Educating the family and also the child about obesity, their awareness on the subject should naturally rise. The impact of obesity on general health, the BMI scale and how it is used, and the importance of healthy eating and physical exercise should also be discussed and explained. It is also important that the family and child are made aware that food restriction and the reduction of weight is inappropriate for children that are growing rapidly 18). Maintaining weight will ultimately prevent the development of obesity. The child should then grow in height which will eventually lead to a more suitable BMI 19). The ideal goal is to develop awareness of good and bad eating habits, and physical activity habits. By altering behaviour to limit or eliminate bad habits and replacing them with good habits, positive steps can be taken to reducing this problem 20).

The third role which should be undertaken by the nurse or health professional is counselling. The nurse would then be able to play the role of someone whom the child and family can ask questions to in relation to healthy lifestyle habits. Regular meetings between the family and the nurse may also lead to the family attaining their goals. The nurse can also discuss any difficulties that are encountered which then can be adjusted, and positive feedback on achievements can be given 21). Maintaining records and charts, the nurse can physically show the child and family their progress, thus giving them the encouragement that what they are doing is actually showing positive results.

Conclusion

This article has identified and highlighted the serious issue of childhood obesity, the prevalence of it in society today, and how it affects the physical and psychological well being of many children who unfortunately suffer from this issue. It has also shown that this health issue can be controlled and reduced by using a multitude of approaches. Also discussed was the vital role that the nurse or health professional can play in order to help educate and support children and their families in tackling this issue, and how a strength based approach can be used to help combat this issue and to stop it from getting to what could potentially be alarming numbers, which would have a disastrous impact on individuals and the health system overall.

Health | Australia

1) Larsen, L., Mandleco, B., Williams, M., Tiedeman, M., (2006) 'Childhood Obesity: Prevention Practices of Nurse Practitioners', Journal of American Academy of Nurse Practitioners, vol.18, pp. 70-79
2) , 5) Australian Government, 2012, 'The Australian and New Zealand Obesity Fact Sheet', Available: www.healthyactive.gov.au Accessed 5th of February, 2014
3) , 17) Larsen, L., Mandleco, B., Williams, M., Tiedeman, M., (2006) 'Childhood Obesity: Prevention Practices of Nurse Practitioners', Journal of American Academy of Nurse Practitioners, vol.18, pp. 70-79
4) , 9) Hedley, A.A, Ogden, C.L., Johnson, C.L., Carroll, M.D., Curtin, L.R., Flegal K.M., 2004, 'Prevalence of Overweight and Obesity Among US Children, Adolescents and Adults', 1999-2002, JAMA, vol. 291, no.23, pp. 2847-2850
6) Dietz, W. H., 2004, 'Overweight in Childhood and Adolescence, New England Journal Of Medicine, vol. 350, no. 9, pp. 855-857
7) Johnson, J., G., Cohen, P., Kasen, S., Brook, J.,S., 2002, 'Childhood Adversities Associated With Risk for Eating Disorders or Weight Problems During Adolescence or Early Adulthood', American Journal of Psychiatry, vol. 159, no. 3, pp. 394-400
8) Swinburn, B., Gill, T., Kumanyika S., 2005, 'Obesity Prevention: A Proposed Framework for Translating Evidence Into Action'. Obes Review, vol. 6, pp. 23-33
10) , 11) Australian Government, 2012, 'A Healthy and Active Australia', Avaliable: www.healthyactive.gov.au Accessed 5th of February, 2014
12) The Australian Nutrition Foundation Inc, 2013, Available: www.nutritionaustralia.org Accessed 5th of February, 2014
13) , 19) Lyznicki, J. M., Young, D. C., Riggs, J. A., & Davis, R. M., 2001, 'Obesity: Assessment and Management in Primary Care', American Family Physician, vol. 63, pp. 2185-2196
14) , 15) , 20) Epstein, L.H., Roemmich, J.N., & Raynor, H.A., 2001, 'Behavioral Therapy in the Treatment of Paediatric Obesity', Paediatric Clinics of North America, vol. 48, no.4, pp. 981-993
16) Edmunds, L., Waters, E., Elliot E.J., 2001, 'Evidence Based Management of Childhood Obesity', British Medical Journal, vol. 323, pp. 916-920
18) Dietz, W. H., 2004, 'Overweight in Childhood and Adolescence', New England Journal Of Medicine, vol. 350, no. 9, pp. 855-857
21) Society of Pediatric Nursing, 2006, 'Position Statement on Physical Activity and Exercise'. Journal of Paediatric Nursing, vol. 21, pp. 80– 83

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