● Hypertension: Elevated blood pressure contributes to the risk of heart disease and stroke. Obesity and diets high in saturated fats and sodium significantly increase the risk of hypertension. ● Liver and gallbladder disease: Obesity has been linked to the development of liver and gallbladder disease. Foods high in fat and calories have been shown to exacerbate these disorders. ● Malignancies: Overweight and obesity can increase the risk for the development of a number of cancers. To date, obesity has been linked to an increased risk for breast, colon, and endometrial malignancies. ● Osteoarthritis: Excess weight places more stress and pressure on affected joints. ● Sleep apnea and respiratory problems: Excessive weight, especially around the diaphragm and abdomen, contributes to respiratory difficulties as well as sleep apnea. ● Type 2 diabetes: Obesity is linked to the development of type 2 diabetes. Even an increased percentage of body fat (without being obese) in the abdominal region increases this risk. at or above the 85th percentile and less than the 95th percentile for young people of the same age and gender (Centers for Disease Control and Prevention, 2018f). Childhood and young adult obesity can have serious consequences (Centers for Disease Control and Prevention, 2018f; Mayo Clinic, 2018g): ● Children who are obese have a higher risk of having chronic health conditions and diseases that impact physical health, including asthma, sleep apnea, bone and joint problems, type 2 diabetes, elevated cholesterol, hypertension, and nonalcoholic fatty liver disease (NAFLD). ● Children who are obese are bullied and teased more than their normal weight peers. ● Children who are obese are more likely to suffer from low self-esteem, depression, and social isolation. They are also more likely to have behavior and learning problems and poor social skills. ● Children who are obese are more likely to be obese as adults. Adults with obesity have a higher risk of developing heart disease, type 2 diabetes, metabolic syndrome, and many types of cancer. The dietary and physical activity behaviors of children and adolescents are influenced by their families, friends, schools, and childcare settings. They are also influenced by how their healthcare providers talk to them about their eating habits. If children and adolescents feel that they are being scolded, they may rebel against healthy eating and lifestyle suggestions (Mayo Clinic, 2018g; Pandita et al., 2016). Recommendations must be practical. If the family has a limited income, the adults who purchase food are more likely to purchase what is inexpensive, regardless of its health benefits, than what is healthy, especially if the costs exceed what they are able to spend. Think about the causes and risk factors for obesity. If family members are overweight or obese, it is likely that their dietary and lifestyle habits contribute to the child’s unhealthy weight. It is also likely that the entire family would benefit from adopting a healthier diet and increasing the amount of exercise they get (Mayo Clinic, 2018g; Pandita et al., 2016). Schools play an important role in facilitating the development of a healthy environment. What kinds of food are being served in the school cafeteria? What kinds of foods and beverages are available in vending machines on school property?
problems (Centers for Disease Control and Prevention, 2018c; Gersch et al., 2017): ● Cardiovascular disease: Excess fat contributes to the development of atherosclerosis, the buildup of fat and plaque within the arteries. This narrows the lumen of blood vessels, which decreases the volume of blood that can move through these vessels. Diminished blood flow means that the heart does not receive adequate amounts of oxygen and other nutrients, which can lead to heart attack. ● Cerebrovascular disease: Persons who are obese generally have higher deposits of fat and plaque in their blood vessels, including the cerebrovascular vessels. This leads to narrowed or blocked blood vessels, which impairs blood flow. This decreases the amount of oxygen and other nutrients that the brain receives, which can lead to stroke. ● Dyslipidemia (elevated cholesterol): High total cholesterol or high levels of triglycerides are linked to overweight and obesity. ● Gynecological issues: Obesity can negatively impact fertility and cause menstruation problems. Consequences of Obesity in Children Jason is 10 years old. He enjoys playing games on his iPad and computer and gets very little exercise. His parents are slightly overweight, and Jason is significantly overweight. Despite concerns expressed by Jason’s pediatrician and nurse practitioner, Jason’s parents do not believe that Jason’s weight is a matter of serious concern. “He’s just a little plump. He’ll outgrow it. It’s just “baby fat.” On a recent wellness visit to the pediatrician, Jason’s parents are horrified to learn that he has high blood pressure. In the United States, the percentage of children and adolescents affected by obesity has more than tripled since the 1970s. Recent data show that almost one in five school-age children is obese (Centers for Disease Control and Prevention, 2018f). CDC recommends that healthcare professionals use body mass index (BMI) percentile when measuring the bodies of children and young people aged 2 to 20 years. BMI percentile takes into consideration that young people are still growing and growing at different rates, depending on their age and gender. Growth charts are used to determine whether a young person’s weight falls into a healthy range for his or her height, age, and sex. The CDC defines overweight in children and young people as a BMI Prevention and Reduction of Obesity in Children The best treatment of obesity in children is to prevent it. Because research has shown that childhood obesity occurs at an alarming rate in the United States and that obesity exists even in toddlers, it is imperative that healthcare professionals work with parents and families to encourage healthy lifestyle habits, including healthy eating and physical activity (Gersch et al., 2017; Pandita et al., 2016). Obesity in children and adolescents is a global health issue with increasing prevalence in low-income and middle-income countries (LMICs) as well as a high prevalence in many high- income countries. Obesity during childhood is likely to continue into adulthood and is associated with cardiometabolic and psychosocial comorbidity as well as premature mortality (Jebeile et al., 2022). The rising obesity epidemic and its associated complications led to the World Health Organization Commission on Ending Childhood Obesity recommending three strategic areas for action. These include prevention through health education, treatment for childhood obesity, and advocacy regarding healthier environments (Salam et al., 2020). Most parents and families and even most adolescents and even most children can respond appropriately when asked about weight loss strategies: Eat less, eat healthy (increase amounts of fruits and vegetables and decrease amounts of high-fat, high- calorie foods), and increase physical activity. If almost everybody knows this, why is not everybody doing it?
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