Nursing and the childhood obesity epidemic

Obesity has become an epidemic in the developing world. In the past 33 years the rates of overweight and obese have risen 28% in adults and 47% in children across the globe. This is an increase from 857 million people in 1980 to 2.1 billion people in 2013 It’s a public health emergency. Countries have declared obesity a disease and the EU is considering labeling obesity as a disability.

There are numerous theories about why we’re getting so fat. Since girls in lower socieoeconomic families put on more adipose tissue than the boys, there is a theory that estrogen is a factor. One study demonstrated that changes at the cellular level related to oxygen when dieting, trigger inflammation in adipose cells. The immune system is considered to play a role The amount of television a child watches and the amount of sleep both child AND parent get are thought to contribute to the obesity epidemic. as does the amount of light in the bedrooms. Our memory of the most recent sweet treat can add to our cravings for more. One study shows that diet sodas helped with weight loss, while others contradict this news. Medication is known to ‘pack on pounds.’

Of course what we eat and how we exercise plays a role. At a recent conference I learned that our weight is a product of 80% our food intake and only 20% our exercise/activity. Weight loss programs contradict each other and have dubious success rates. Radically changing our diets is very difficult and, depressingly, long term weight loss the ‘old fashioned way’ without surgical intervention is almost impossible.  Every day there is more news about obesity, yet the problem continues to grow and the question is what is nurses’ role, particularly when faced with the issue of childhood obesity?

A dietician from a childhood obesity program presented the rising statistics to us and added that the growth charts for weight in children had been adjusted from the 1970’s to accommodate the growing girth of children in our society. A pediatrician mentor once told me that the first thing that every health care provider must do is to tell the parents and patient that they are overweight/obese. I thought this was a bit strange at the time, however, I soon realized when I started to weigh discuss with parents their children’s weight, that they were often in denial about the extent of the problem. One mother argued with me that her 3-year-old child, who was off the percentile chart for weight, was ‘big boned’. She also insisted that the child should continue to drink two large jugs of ‘juice’, the equivalent of sugar water, each day.

Even with contradictory evidence, possible parental denial and lack of any real control over the dietary intake of children, there are many ways that nurses can help. Our role as advocates may incite us to do such things as enforce or create public policies about the amount of exercise children are given at school and to restrict and prevent companies from selling high sugar products on school properties. Nurses can do such things as lobby municipalities to ensure safe bicycle routes to schools with adequate storage to promote cycling to school. Ultimately, however, focus on the family is key. Even if parents and children continue to be in denial, nurses can inform them about childhood obesity and create accessible programming to assist families to address and cope with it. As difficult as it is to address the issue of childhood obesity in our societies, it is vitally important to do so. Nurses are uniquely qualified to meet the challenge through advocacy for change and by caring for one family at a time.

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