childhood obesity: complications and implications

Childhood Obesity: Childhood Obesity: Complications and Complications and

ImplicationsImplicationsAmanda Mendez, RN, MSN, FNP-CAmanda Mendez, RN, MSN, FNP-C

Daurice Ring, RN, MSN, CNPDaurice Ring, RN, MSN, CNP

Introduction to Obesity Introduction to Obesity Obesity as defined by the CDCObesity as defined by the CDC Today we will discuss complications Today we will discuss complications

of childhood obesity and implications of childhood obesity and implications for adulthood.for adulthood.

We as school based health advocates We as school based health advocates have the obligation to be aware of have the obligation to be aware of these complications.these complications.

ObesityObesity ComplicationsComplications

– PhysicalPhysical– PsychologicalPsychological

ImplicationsImplications– During ChildhoodDuring Childhood– During AdulthoodDuring Adulthood

Body Mass IndexBody Mass Index BMIBMI Children’s BMI is an age and sex Children’s BMI is an age and sex

specific percentile.specific percentile.– Varies as they ageVaries as they age– Varies between sexesVaries between sexes

Body Mass IndexBody Mass Index It is the most widely accepted It is the most widely accepted

method for screening.method for screening. It is relatively easy to obtain.It is relatively easy to obtain. It is non-invasive.It is non-invasive. It is NOT diagnostic because it is not It is NOT diagnostic because it is not

a direct measure of body fatness.a direct measure of body fatness.

Obesity Obesity OverweightOverweight

– >85% Body Mass Index (BMI) but <95% >85% Body Mass Index (BMI) but <95% BMIBMI

ObesityObesity– >95% BMI>95% BMI

Prevalence of Obesity* Among U.S. Children and Adolescents(Aged 2–19 Years)

Survey Periods NHANES

II1976–1980

NHANES III

1988–1994

NHANES1999–2002

NHANES2003–2006

Ages 2 through 5

5% 7.2% 10.3% 12.4%

Ages 6 through 11

6.5% 11.3% 15.8% 17.0%

Ages 12 through 19

5% 10.5% 16.1% 17.6%

Obesity Obesity Among preschool-aged children, aged

2–5 years, the prevalence of obesity increased from 5.0% to 12.4%.

Among school-aged children, aged 6–11 years, the prevalence of obesity increased from 4.0% to 17.0%.8, 46

Among school-aged adolescents, aged 12–19 years, the prevalence of obesity increased from 6.1% to 17.6%.

ObesityObesity The prevalence rate of obesity was The prevalence rate of obesity was

higher among Mexican-American higher among Mexican-American boys (22.1%) and Non-Hispanic black boys (22.1%) and Non-Hispanic black girls (27.7%).girls (27.7%).

Contributing FactorsContributing Factors Imbalance between calories Imbalance between calories

consumed and calories used to consumed and calories used to support growth and developmentsupport growth and development

GeneticsGenetics Behavior/LifestyleBehavior/Lifestyle EnvironmentEnvironment

Genetic FactorsGenetic Factors Susceptibility to retain excess body Susceptibility to retain excess body

weightweight Rare genetic disordersRare genetic disorders

– Prader-Willi syndromePrader-Willi syndrome Cannot be solely geneticCannot be solely genetic The genetics of our population have not The genetics of our population have not

changed significantly in the last 30 changed significantly in the last 30 years, yet childhood obesity has tripled.years, yet childhood obesity has tripled.

Behavior/Lifestyle FactorsBehavior/Lifestyle Factors Energy intakeEnergy intake

– Large portionsLarge portions– Calorie dense foodsCalorie dense foods

Physical ActivityPhysical Activity– Decreased 14% in 13 years in schoolsDecreased 14% in 13 years in schools– Less than 28% in high school meet Less than 28% in high school meet

minimum recommendations for physical minimum recommendations for physical activity.activity.

Behavior/Lifestyle Factors Behavior/Lifestyle Factors (cont.)(cont.)

Sedentary BehaviorSedentary Behavior– TelevisionTelevision– Video gamesVideo games– MoviesMovies– ComputersComputers– Cell PhonesCell Phones

Environmental FactorsEnvironmental Factors HomeHome Child careChild care SchoolSchool CommunityCommunity

Physical Complications of Physical Complications of ObesityObesity

Type 2 DiabetesType 2 Diabetes Metabolic SyndromeMetabolic Syndrome High blood pressure High blood pressure Asthma and other respiratory Asthma and other respiratory

problems problems Sleep disorders Sleep disorders

Physical Complications of Physical Complications of Obesity (cont.)Obesity (cont.)

Liver disease Liver disease Early puberty or menarche Early puberty or menarche Eating disorders Eating disorders Skin infectionsSkin infections

Physical Complications of Physical Complications of Obesity (cont.)Obesity (cont.)

Type 2 DiabetesType 2 Diabetes– Glucose intoleranceGlucose intolerance– HyperinsulinemiaHyperinsulinemia– Acanthosis NigricansAcanthosis Nigricans– Overt DiabetesOvert Diabetes– Cardiovascular DiseaseCardiovascular Disease– Kidney FailureKidney Failure

Physical Complications of Physical Complications of Obesity (cont.)Obesity (cont.)

Metabolic SyndromeMetabolic Syndrome– High blood glucoseHigh blood glucose– High blood pressureHigh blood pressure– Abdominal obesityAbdominal obesity– Low HDL, elevated cholesterol and high Low HDL, elevated cholesterol and high

triglycerides triglycerides

Psychological Complications of Psychological Complications of ObesityObesity

Depression Depression Behavior and learning problemsBehavior and learning problems Low self-esteem and bullying Low self-esteem and bullying

Psychological Complications of Psychological Complications of Obesity (cont.)Obesity (cont.)

Obese children and adolescents are Obese children and adolescents are targets of early and systematic social targets of early and systematic social discrimination.discrimination.

This type of social stigmatization This type of social stigmatization may hinder academic success, social may hinder academic success, social functioning, and may impact functioning, and may impact adulthood.adulthood.

Schools and ObesitySchools and Obesity Free and reduced mealsFree and reduced meals

– Lower socioeconomic statusLower socioeconomic status– May contribute more than 50% of caloric May contribute more than 50% of caloric

intakeintake Alternative foodsAlternative foods

– Snack barsSnack bars– Student storesStudent stores– Vending machinesVending machines

Schools and Obesity (cont.)Schools and Obesity (cont.) Programs to encourage physical Programs to encourage physical

activityactivity– Regardless of athletic abilitiesRegardless of athletic abilities– Health related fitness classesHealth related fitness classes

Programs regarding nutrition and Programs regarding nutrition and weight controlweight control– Healthy food choicesHealthy food choices– Portion controlPortion control

Schools and Obesity (cont.)Schools and Obesity (cont.) Many factors outside of school Many factors outside of school

influence obesity.influence obesity. The education system alone may not The education system alone may not

overcome obesity.overcome obesity. Schools may be able to provide an Schools may be able to provide an

opportunity for prevention. opportunity for prevention.

SummarySummary Obesity is 95% or greater BMIObesity is 95% or greater BMI Physical ImplicationsPhysical Implications Psychological ImplicationsPsychological Implications What we can do?What we can do?

Where to Get More Where to Get More InformationInformation

http://www.cdc.gov/obesity/http://www.cdc.gov/obesity/index.htmlindex.html

http://www.who.int/topics/obesity/en/http://www.who.int/topics/obesity/en/ www.sparkpeople.comwww.sparkpeople.com