Obesity and Responsibility - Lab Report Example

Obesity and Responsibility Obesity is one of the most impotent problems today affected millions of children around the world. Like any other human dynamic, childhood is shaped by macro-social forces such as ideology. While individual response to such forces may be unique and self-directed, it is not simply free to operate outside of the boundaries drawn by such social influences. Most researchers parallel obesity problems with poor school management nutrition programs, lack of knowledge about dietary patterns and healthy eating, false advertising and development of fast food industry, sedentary life style and lack of physical activities. Obesity is defined as weight at least 20% in excess of the range suggested in standard height weight tables or a body mass index greater than 27 (Martin 2005).. Every year, child obesity costs 100 million dollars to the government. Poor education and absence of equal opportunities is the main factors limited the equal distribution of economic and social resources. The responsibility of the government can be explained by the fact that it does not introduce strict rules and regulations to control fast food industry and advertising. Most researchers (Anderson et al 2003) parallel child obesity epidemics with economic problems and development and growth of fast food industry which became a distinctive feature of the life style. Fast food life style is dangerous because it results in disbalance of nutrition and causes eating disorders. All fast food contains high cholesterol level which is the primarily cause of obesity. Limited physical activity worsens the problems of obesity. Most fast food restaurants popularize and promote unhealthy eating behavior which leads to obesity problems. Most food proposed in such restaurants is fat saturated with high caloricity level. In spite of advertising efforts to promote health conscious menus or calorie free diet, hamburgers and fried potato are the most "dangerous" products sold by fast food. Social dimensions are manifested in the ability of mass media to control the circulation of ideas about body image and fashion. The researchers state that: Fast food consumption is the other leading suspect in the childhood obesity epidemic. Fast food typically includes all of the things that nutritionists warn against: "saturated and trans fats, high glycemic index, high energy density, and increasingly, large portion size." They further note that a large fast food meal can contain about 2,200 calories, which at a burn rate of 85-100 calories per mile would require something near a full marathon to expend!" (Anderson et al 2003, p. 30). Thus, children's relation to McDonald's and other forms of popular culture is complex: it is not always oppressive; it is not always empowering. All phases of the relationship must be analyzed in their specificity and uniqueness. In the same manner every aspect of McDonald's does not signal a macro-social dynamic at work; on the other hand, however, many do. Researching the impact of McDonald's on children's attention to the testimonies and actions of specific child customers of McDonald's is certainly necessary, but it is not sufficient in the inquiry needed to tell this story. The government can be blamed for false advertising and lack of strict control over fast food industry. The main social institution responsible for ability problem is a family. Staveren and Dale (2004) underline that today many families have a possibility to buy and eat healthier fat free food in contrast to low-income families which are used to buy lower-price fat saturated food. That is why more blue collars suffer form obesity than white collars. In addition, families with high income usually visit more expensive bars and restaurants where they order fat free dishes, but the popular place for low income people is fast food restaurants. The effect of fast food on risk of obesity is tremendous. It was proved that fast-food habits have strong, positive, and independent associations with weight gain and insulin resistance in young people. The main problem is that parents pay no attention to dietary patterns and home cooking which increase obesity problems. Similar position is shared by Lindsay et al (2006) who state that many children have unhealthy eating behavior caused by consuming of fat saturated food with high caloricity level. Limited physical activity and a sedentary lifestyle worsen this problem leading to obesity and obesity related problems. The most important fact is that many parents do not realize health problems until their family doctor becomes conscious of such problems as high body mass index of their children. Following Lindsay et al (2006) "Parents are key to developing a home environment that fosters healthful eating and physical activity among children and adolescents. Parents shape their children's dietary practices, physical activity, sedentary behaviors, and ultimately their weight status in many ways" (p. 169). In the article "Individual Responsibility for Health" Yoder (2002) underlines that traditional dietary management centers on educating children about healthier food choices and persuading them that such changes to lifestyle are important. However, it is now recognized that simply providing nutrition education or 'prescribing' a diet is inadequate and in recent years there has been greater focus on the need to combine nutrition information with behavioral techniques As weight management strategies have moved away from achieving ideal body weight towards moderate weight loss, and maintenance of this loss, so emphasis in dietary management has changed from very severe energy restrictions towards modest, staged changes which are more feasible to maintain long term. The practice of advising a fixed energy allowance to all obese individuals has been subject to some criticism. The more obese the person, the higher their energy requirements and the greater the energy deficit imposed, so the more likely the person is to struggle with such drastic food changes (Yoder 2002). It has been demonstrated that compliance to dietary advice and sustained weight loss are improved with a modest deficit of 500kcal per day (from energy requirements) compared to very severe energy restriction. The two articles by Story et al (2006) and Story and Kaphingst (2006) explain that ss well as reinforcing physical activity behaviors, there is evidence that reducing access to sedentary behaviors can increase activity levels in obese children. To date, a stronger relationship has been detected between patterns of sedentary living (such as the amount of time spent watching television) and obesity, than physically active pursuits and obesity. The odds of being overweight were 4.6 (2.2-9.6) times greater when viewing exceeded 5 hours compared with 0-2 hours per day. Additionally, the odds of developing obesity and remission from obesity were linked to time spent watching TV, with estimates of attributable risk for obesity as high as 60% linked to degree of TV watching. The conclusion of the authors is that reductions in TV time may be effective in preventing some incidence of obesity. These author blame parents and schools for inadequate curriculum developed for children both at home and at school. The authors underline that "federal nutrition regulations are inadequate, they permit state and local authorities to impose additional restrictions. Some states limit sales of nonnutritious foods, and many large school districts restrict competitive foods" (p. 109). School, as the main social institution, is also responsible for childhood obesity. From earlier years, children eat unhealthy fat saturated food at kindergarten and school (Story et al 2006). Obese and overweight children present with very different management problems and unraveling the specific factors which are contributing to the individual's difficulty controlling weight, and which of these factors it is feasible for the child to modify, is an important aspect of the assessment process. The aim of assessment is to help the school gain an understanding of the children's current circumstances, the possible problems they face, together with present and previous approaches to weight management. This provides insight into whether they acknowledge, and are ready to implement long-term changes to lifestyle, or whether they seek the elusive quick-fix solution to obesity. Story et al (2006) find that: "Poor diets and physical inactivity are pushing rates of overweight and obesity among the nation's children to record levels. (1) Indeed, since 1960, U.S. childhood and adolescent overweight prevalence rates have more than tripled. (2) The health risks associated with childhood obesity pose a critical public health challenge for the twenty-first century" (p. 143). Anderson & Butcher (2003) and Cawley (2006) in a recent study tested the idea of economic implications of childhood obesity using a randomized controlled trial featuring a school-based educational intervention. This was accompanied by small but significant relative decreases in body mass index, triceps skinfold thicknesses, waist circumference and waist to hip ratio over the 6 month intervention period. However, there were no significant changes in high-fat food intake, moderate to vigorous activity or cardiorespiratory fitness. The researcher found that: "Given the fact that many children have either a single working parent or two working parents, the school environment may be particularly important. For example, schools may need to focus more on exercise if children have few opportunities for physical activity once they leave the school grounds. Similarly, children may be consuming a large fraction of their calories for the day at school. Changing the school nutritional environment has become a hot-button issue for policymakers at many levels of government" (Anderson & Butcher 2003, p. 30). Support for using sedentary pursuits as a mechanism for reducing overweight in those children who are already obese is also evident in the work of Epstein et al. They demonstrated more success for weight loss through reinforcing a reduction in sedentary pursuits rather than increasing physical activity. Daniels (20060 finds that family and parents are the main responsible parties for obesity problems. The author describes outcomes and causes of obesity and analyzes possible health-related diseases. Garbe & Hoot (2004) blame schools and teachers for unhealthy life style and unhealthy eating hobbits of children. They state that reducing TV watching and video game usage may therefore be a useful strategy for both a population-based approach to help prevent childhood obesity and also reduce overweight in those children who are already obese. Much more needs to be learned about how to promote more physical activity and reduce time spent in front of a TV screen for overweight and obese children. However, on current knowledge, it is clear that approaches need to be comprehensive and emphasize the development of skills necessary for behavior change and maintain those changes. Youngsters spend almost all of their time under the influence of the home and school, so both environments need to be considered by health professionals who are working with obese children. Following Garbe & Hoot (2004): "Teachers can refrain from using unhealthful foods as rewards, as materials for curricular activities, or as the focus of celebrations. Instead, teachers can provide nonfood rewards, such as privileges or activities, to reinforce desired behaviors. Providing a child with special time to do a favorite classroom activity is one way to motivate a child without using food" (p. 70). Thus, schools can help through physical educators being sensitive to the special needs of overweight and obese children. For any particular physical task, the heavier child works harder for the same result as a lean child and it would help if this was acknowledged. Classes need to be accepting, nonthreatening and fun, and to emphasize social interaction and focus on personal improvement of skills and fitness, rather than comparison with others. It is ironic that alongside increasing obesity, we have more and more youngsters who are becoming hypersensitive about fatness. Many girls (and increasing numbers of boys), several of whom are within the optimal fat range, are using unhealthy and ineffective weight management strategies such as semi-starvation, diuretics and appetite suppressants. Teachers need to be extremely careful how they deal with issues such as overweight and place the emphasis on healthy eating and enjoyable exercise. Children who are already overweight or fat need a sensitive, individualized approach. The literature review suggests that there is a gap in obesity research which has a great impact on current state of the problem. The researchers pay much attention to physical activities and active life style, but omit the role and structure of dietary patterns. Many parents do not aware of healthy eating habits and healthy nutrition. Many children are unaware of how much, what or where they eat. Much of the food we eat can be considered forgotten food, this is particularly so with snacks, food eaten whilst watching TV or food tasted during cooking. Helping children increase their awareness of current eating habits is an essential first step in the management process. Only when they begin to recognize the eating practices which are contributing to their excess energy intake can they move towards considering where and how to make appropriate changes (Story et al 2006; Garbe & Hoot (2004). Much of the condemnation of current dietary treatment strategies is based on the results of clinical trials and hospital-based programs. Children who participate in these represent a very small percentage of the total obese population and tend to be the more challenging children, often presenting with significant psychological problems and a higher incidence of 'binge eating' disorder, factors known to affect treatment outcome detrimentally It is therefore inappropriate to consider the findings from clinical trials and hospital-based programmes as being representative of the likely outcome of intervention in the general overweight and obese population. Evaluating the long-term effect of dietary intervention is essential if we are to achieve improved practice and treatment outcomes. It has been suggested that this should be a research priority in the primary care setting. Nevertheless, careful and appropriate interpretation of findings is paramount. Interpretation of the 'diets don't work' message is also influenced by the definition of the term 'diet'; it is important to make the distinction between medically approved healthy diets with a scientific rationale and the plethora of popular weight loss diets, which often make unrealistic and scientifically unsupported claims. It is well known that the body's fat and energy stores are determined by the balance between energy intake and energy expenditure. Weight loss occurs when the body is in negative energy balance, as fat stores must be mobilized in order to meet the body's energy demands. Negative energy balance can be induced by a reduction in energy consumed, an increase in energy expended, or a combination of both. In spite of the fact that child obesity affects all populations, it has become a major problem around the world caused by social and economic problems. At the turn of the millennium, about 9 million children over 6 years are obese. Obesity is a direct result of unhealthy eating and eating disorders. As western pop culture is shipped abroad to sell western commodities, the problem went as well like unwanted freebies that are stuck and taped around a product. Some children are plagued by unhealthy eating habits because they simply wish to achieve the same physical attributes of celebrities they idolized (Story et al 2006). Many researchers underline the impact of school nutrition programs on child obesity epidemics. Most of them are heavy eating who pay no attention to quantity of food (Martin 2005). Most of them eat three times more than an average person which results in obesity problems. Most of obese people suppose that fitness programs do not help them preferring to blame society in low morals and advertising agencies in misleading information (Garbe & Hoot 2004). The evidence of increasing fatness in children suggests that more adults will become obese at earlier ages over the next two or three decades, causing more human suffering and greater health care costs. physical activity has a critical role to play in both the prevention and treatment of obesity. It is particularly pertinent in children where greater levels of physical activity may help prevent the development of obesity. It is also even more important for maintenance of health in those who are already overweight or obese. Physical activity is a health behavior similar to eating or smoking. In order to facilitate long-term behavioral change, many people need professional assistance. With regard to exercise, obese individuals often have low levels of awareness and expertise and do not have the behavioral skills necessary to maintain behavioral change. There is a clear role for the exercise specialist or health professional who has sound experience with counseling skills, educational strategies, motivational psychology and behavioral and environmental change strategies and who can apply them sensitively to this challenging and dominating health problem. Typically, the merits of physical activity are presented in terms of its effectiveness in promoting weight loss. However, in recent years there has been a general shift in emphasis in obesity treatment from large weight losses to moderate weight loss and improved health or metabolic status as the key outcome. Particular emphasis should be placed on working towards healthier levels of blood pressure, blood lipids, glucose tolerance and insulin sensitivity and the role of weight loss in achieving these changes Garbe & Hoot (2004). In sum, literature review suggests that Social Health Policies is aimed to introduce preventive measure at schools in order to prevent obesity at its early stage. School-based interventions increase physical activity and decrease sedentary behavior patterns. The research shows that school and parents are he main parties responsible for childhood obesity, thus the government is responsible for lack of strict laws and regulations which affected food market. A clear understanding of the goals to be achieved is essential. Clearly articulated goals against obesity allows to identify the true purpose of intervention programs and facilitate public understanding and debate around legitimate health purposes, and reveal prejudice, stereotypical attitudes, or irrational fear and exploration of more intrusive measures are permissible where clearly necessary. The secular trend in overweight and obesity shows no sign of slowing down. Throughout the last decade, evidence has accumulated to show that physical activity has a key role to play in both normal weight and obese individuals in terms of reduced risk of mortality and several diseases. Active living represents normality and it is perhaps not surprising that years of sedentary habits lead to loss of functional capacity and increased probability of serious health problems. Inactive living carries an independent 2-fold risk for all-cause mortality, and this is similar to the risk of hypertension, hyperlipidemia, and smoking. Several major health authorities across the world are now convinced that physical inactivity should be regarded as a fourth primary risk factor for coronary heart disease and stroke. Physical activity has additional health benefits which include reduced risk of colon cancer and improved physical fitness and psychological well-being. The traditional physician-centered model of care is ill suited to successful management of overweight and obesity. Obesity requires a coordination of care from multiple health care providers with a multi-disciplinary group with varied expertise working together as a team to assist child care. In theory, reducing fat stores should be simple; eat less and exercise more. However, as our understanding of obesity has increased so it has become evident that the condition is not simply the result of eating too much and exercising too little. The regulation of body weight is controlled by a complex, and as yet incompletely understood, number of physiological processes which interact with various environmental and societal factors. Bibliography 1. Anderson, P. M., Butcher, K. F., Levine, Ph. B. 2003, Economic Perspectives on Childhood Obesity. Economic Perspectives, vol. 27, iss. 3, p. 30. 2. Cawley, J. 2006, Markets and Childhood Obesity Policy. The Future of Children, vol. 16, iss. 69. 3. Daniels, S.R. 2006, The Consequences of Childhood Overweight and Obesity. The Future of Children, vol. 16, iss. 1, p. 47. 4. Garbe, C. L., Hoot, J.L. 2004, Weighing in on the Issue of Childhood Obesity. Childhood Education, vol. 81, iss. 2, p. 70. 5. Lindsay, A.C., Sussner, K.M., Kim, J. 2006, The Role of Parents in Preventing Childhood Obesity. The Future of Children, vol. 16, iss. 1, pp. 169-170. 6. Martin, S.S. 2005, From Poverty to Obesity: Exploration of the Food Choice Constraint Model and the Impact of an Energy-Dense Food Tax. American Economist, vol. 49, iss. 2, p. 78. 7. Staveren, T., Dale, D. 2004, Childhood Obesity Problems and Solutions: Food Choices and Physical Activity, at School and at Home, Underlie the Childhood-Obesity Problem. What Role Can Schools Play in Finding a Solution The Journal of Physical Education, Recreation & Dance, vol. 75, iss. 7, pp. 44-45. 8. Story, M., Kaphingst, K. M., French, S. 2006, The Role of Child Care Settings in Obesity Prevention. The Future of Children, vol. 16, iss. 1, p. 143. 9. Story, M., Kaphingst, M. 2006, The Role of Schools in Obesity Prevention. The Future of Children, vol. 16, iss. 1, pp. 109-110. 10. Yoder, S.D. 2002, Individual Responsibility for Health: Decision, Not Discovery. The Hastings Center Report, vol. 32, iss. 2, pp. 22-24. Read More