Cyndi's final paper

Childhood obesity is on the rise, some would say to epidemic proportions. Something must be done today, and the best defense to this problem is prevention. Preventing children from becoming overweight will assist to reduce the potential problems these kids will experience now and later in life. Because childhood obesity leads to long-term health and social problems, nurses can take a lead role in the prevention of childhood obesity through recognizing and becoming educated on risk factors and using developmentally appropriate strategies for prevention, educating the patient and family on risk factors, problems of obesity, and strategies to make healthy lifestyle choices, and through working with other health professionals to address this multi-faceted issue.

Childhood obesity has been increasing alongside adult obesity. The rate of childhood obesity almost tripled since 1970 (Koplan, 2007). There are many reasons for the increase in obesity, but most can be attributed to lack of activity, amount of television watched, diet, and family attitudes towards eating (MacKenzie, 2000). The health professional failing to recognize the risk factors, inadequate counseling skills, and lack of time with the patients also accounts for unsuccessful prevention (Story, 2002). It is much easier and successful to prevent obesity than to try to treat this disease. Not only is prevention more successful, but the problems associated with obesity can be life-long. Heart issues, diabetes, social stigma, and self-esteem issues are just a few of the problems that can develop with childhood obesity (Ruxton, 2004). Obesity is a national health crisis, and the time to act is now.

For any strategy to work, the nurse needs to be educated on identifying the risk factors for obesity. Some of the risk factors are high birth-weight, overweight parents, socioeconomic status, and more than 1.5 hours TV per day (Ruxton, 2004, p.52). There are standardized criteria for accessing obesity in children. Understanding the criteria used to determine if an adolescent is overweight. For example, on growth charts, a weight at the 85th percentile indicates overweight, and obesity at the 95th percentile, the nurse, with other factors, can determine actual risk (Ruxton, 2004, p.48). If the child is identified at risk for being overweight or already is according to criteria, the nurse can then suggest ways to decrease this risk or at least maintain the risk and the child’s weight. The nurse must know what teaching strategies are appropriate given the patient’s age and gender to be effective. Many parents fail to see their child having a problem with weight or have concern with their lack of activity, which makes the nurse’s job very important in identifying these children at risk.

Nurses need to play a key role in educating the patient and family. Often the nurse spends more time with the patients and family than the doctor or other professional. When the nurse recognizes risk factors in the child, they can teach strategies on preventing obesity. These strategies need to be tailored to where each child is developmentally. For example, parents may be concerned with their toddler being a picky eater and bribe their child to eat more. This can result in the child not being able to regulate their caloric intake. The nurse needs to understand this and educate the parents on other ways to encourage healthy eating by their toddler (MacKenzie, 2000). Another example is educating a pregnant woman or new mother on the importance of breast-feeding and the link between overweight children and being formula-fed. The nurse should provide suggestions for physical exercise. For a teenage boy, this may include encouraging enrollment in a team sport. The nurse is the first line of defense for preventing obesity in children. Because of one obstacle identified as lack of time (Story, 2002), the nurse needs to recognize the need for collaboration to put the education into practice. The nurse needs to address the specific needs of the child, but it is just as important to look at the family unit (Vaughn, 2005).

Collaboration between health care professionals is a must in preventing obesity. The nurse needs to refer patients to a nutritionist if appropriate to help develop healthy eating habits. In addition, the nurse or family can contact the child’s school nurse to address lifestyle choices at school. The school nurse can advocate for the patient by being involved in any behavioral issues that may be developing, or in cafeteria choices. The school nurse needs to ‘act as catalyst for change’ (Harrison, 2004, p.1). The nurse can be an educational resource and teach strategies for making healthy lifestyle choices. The parents’ involvement, as well as siblings, is crucial to successful prevention. Parents need to be educated on risk factors identified in their child and possibly learn themselves what healthy choices to make in regards to diet and exercise. For prevention to work, every aspect of the child’s life needs to work together.

Childhood obesity is a public health issue that can have long-term effects on the child. Waiting until the child is overweight or obese, instead of preventing this problem, is similar to waiting for the car to run out of gas before getting more. Prevention can be effective when the nurse takes the primary role in identifying risks factors and knowing appropriate strategies, educates the patient and family on strategies for a healthy lifestyle, and works with other health professionals in addressing this issue. These three strategies must be established for prevention to work. Successful prevention of childhood obesity starts with the nurse.

Intervention 1: Nurses need to become educated on identifying risk factors and problems of obesity, and able to offer developmentally appropriate strategies for prevention of obesity.

Disadvantage 1: Nurses need to be aware that just looking at BMI will not give an adequate picture of whether the child is at risk for being overweight or obese. You must also look at the child’s ethnicity, gender, age, and physical activity (Henry & Royer, 2004). Standard growth charts should be looked at to see a trend in a child’s pattern, again along with heredity and other factors (Ruxton, 2004, p.48). This requires the nurse to be educated on all types of measures of obesity, and keep up with new and more accurate tools. This can be difficult for the busy nurse, and would require additional and continuing education.

Disadvantage 2: For the nurse to be able to make appropriate suggestions for health lifestyle and activity choices, the nurse must assess where the patient is at developmentally. The nurse would want to suggest and offer strategies that the patient will want to follow and stick to. Also, since lack of time was cited as a main barrier to successful prevention(Story, 2002), you may not get another chance for a year at the patient’s next annual exam to know how they are doing. This is a huge disadvantage, and makes this intervention hard to evaluate.

Intervention 2: Nurses provide education to the patient and family on risk factors, problems associated with obesity, and strategies to make healthy lifestyle choices.

Disadvantage 1: Parents don’t recognize that their child is overweight. According to Dorhan (2002), differing perceptions, especially in low-income mothers, between the primary care provider and the mother on what it means to be overweight. Mothers did not see their children as overweight by the measures of growth charts. To them, having a larger child meant they were well-fed and healthy. In fact 79% of 99 mothers failed to see their children as overweight (Childhood Education, 2003). If parents do not see their children as overweight, no amount of interventions will work, it is crucial to successful prevention of obesity in children. Changing parents attitude is a difficult task, and makes this intervention very difficult to follow through on and be successful.

Disadvantage 2: Need to look at whole family unit, socioeconomic status, and lifestyle not just the patient’s attitude towards eating. One very big disadvantage, especially in today’s economy, and for families in lower socioeconomic status, is the cost of healthy foods. It is a lot cheaper to buy pasta, or that fast food meal, than to spend money of fresh fruits, vegetables, and chicken or fish. Not to mention the cost of milk these days compared to a 2-Liter of soda. The problem is complex, with many causes, from food costs, to convenience fast food, decreased activity time in school, and soft drinks (Feeg, 2004). While the patient may be willing to change their eating, there needs to be a full multi-faceted approach to enabling this child to succeed. For this disadvantage to be overcome, some type of government program needs to exist to reward families for healthier choices.


References
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