CHILDHOOD OBESITY

 Obesity is a major contributor to morbidity and mortality.

 The prevalence of obesity in children has tripled since 1981.

 Obese children tend to become obese adults, treatment of childhood obesity may be  the most promising and cost-effective way to ameliorate adult obesity and its associated health risks.

Obesity increases the risk of adverse health conditions, including cardiovascular disease, diabetes, certain cancers, and musculoskeletal disorders.

Obesity Epidemic

Governments are recognised as the most important in reversing the obesity epidemic.

Safeguarding public health is a fundamental responsibility of governments and they need to provide leadership and formulate, monitor and evaluate comprehensive policies.

Stigma, Obesity and Adolescent risk behaviors: Current research and future directions.

Adolescents are particularly vulnerable to risk behaviors.

They are experiencing intense physical, psychological and social changes. Overweight/obese, but particularly those who perceive themselves as such, are more likely to engage in risk behaviors than those who are, or perceive, themselves of normal-weight.

Weight stigma and discrimination may contribute to this association as they reinforce poor body image and create intense stress.

Stress is associated with poor emotion regulation, more impulsive, contextually-determined, and less rational decision-making, leading to greater engagement in risk behaviors.

Prevention is better than cure

Prevention remains of paramount importance, with mounting pressure to avoid triggering eating disorders while fostering increasing athletic participation and decreasing national and international rates of obesity.

Preventive strategies

 Perinatal life: is there a need for preventive strategies in infancy or even   prenatally?

 Birth weight, postnatal weight gain, and subsequent obesity.

A U-shaped relationship exists between birth weight and obesity in young adult life.

 Low birth weight owing to maternal undernutrition, smoking, or placental insufficiency, or alternatively large size at birth attributable most often to GDM, may both be associated with obesity.

Responsibilities of Physicians/Nurses

They have a responsibility in all settings to identify children who are at risk for becoming overweight or obese and ensuring that families are well educated regarding health promotion strategies to prevent further progression of obesity into the adult years.

Engaging Caregivers in School-Based Obesity Prevention Initiative

Caregiver involvement in obesity prevention may be fostered by transmitting information through children, addressing cultural barriers, and avoiding potentially stigmatizing approaches to delivering health messages.

  Schools are hubs of prevention

School-based obesity prevention programs, which include a combination of changes to school-provided meals, nutrition and healthy lifestyle education, and physical activity, show promise in improving health and academic achievement of young children.

Public health strategies to prevent obesity should begin with schools and extend to the entire community.

Schools must review their policies and procedures to promote healthy eating.

Proposed suggestions for the prevention of obesity

Public health strategies to prevent obesity should begin with schools and extend to the entire community.

Schools must review their policies and procedures to promote healthy eating

Mandate minimum standards for physical education, including 30–45 min of strenuous exercise two to three times weekly. 

  Encourage “the walking school bus.” 

Ban advertising of fast foods directed at preschool children, and restrict advertising to school-age children.

Support groups & websites

?My Obesity Team is a social network and online support group for people who are living with obesity.

? Childhood Obesity Foundation is to lead a societal shift toward healthy eating and active lifestyles to promote childhood healthy weights and the resulting physical and emotional benefits.

?Healthy Outcomes Paediatric Program for Scarborough (HOPPS).

?Healthy Eating & Active Living Resources/Sick kids.

?Clinical Social Work/Therapist Obesity Counselling Toronto.