obesity final presentation2

CHILDHOOD OBESITYGROUP B

BIGTHE

PICTURE

The U.S. is in the midst of an epidemic of obesity involving more than one third of the adult population, which is approx.

60 million people.

OBESITY DEFINED

• BMI = [Lbs./ (Height in inches)2] x 703• Or… BMI ≠ accurate predictor of risk

TRENDS

http://www.youtube.com/watch?v=7iBHm5zji_Y

• Continuing with the trajectory of the past 30 years would result in 86% of Americans becoming overweight or obese by 2030, with 1 in every 6 health care dollar being spent on obesity and its sequellae.

• In 2008, only one state (Colorado) had a prevalence of obesity less than 20%. Thirty-two states had a prevalence equal to or greater than 25%; six of these states (Alabama, Mississippi, Oklahoma, South Carolina, Tennessee, and West Virginia ) had a prevalence of obesity equal to or greater than 30%.

http://www.youtube.com/watch?v=7iBHm5zji_Y

1999

Obesity Trends* Among U.S. AdultsBRFSS, 1990, 1999, 2008

(*BMI 30, or about 30 lbs. overweight for 5’4” person)

2008

1990

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

OBESITY TRENDS* AMONG U.S. ADULTSBRFSS, 1985

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14%



No Data <10% 10%–14%



No Data <10% 10%–14% 15%–19%



No Data <10% 10%–14% 15%–19% ≥20%



No Data <10% 10%–14% 15%–19% 20%–24% ≥25%


Obesity Trends* Among U.S. AdultsBRFSS, 2002

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%



No Data <10% 10%–14% 15%–19% 20%–24% ≥25%



No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

CAUSES AND RISK FACTORS

• Poor diet• Lack of physical

activity• Genetics• Culture• Certain medical

disorders

• Environment Metabolism

• Lifestyle • Psychological

factors• Lack of knowledge

HEALTH IMPLICATIONSCoronary heart disease

Type 2 diabetes

Hypertension

Non-alcoholic fatty liver disease

Increased risk of disability

HEALTH IMPLICATIONS• Also linked with mental health conditions such as :

–Depression–Low self-esteem–Feelings of shame

• Many obese people are discriminated against and the targets of insults and verbal abuse

WHO IS AFFECTED?

Everyone… Even your dog.

HOW OBESITY HARMS A CHILD

• Brain• Heart • Liver• Pancreas • Growth Plates

EMOTIONAL EFFECTS OF CHILDHOOD OBESITY

• Obese White and Hispanic girls 13-14 years old• Significantly diminished self-esteem levels than

non-obese girls– Increased loneliness, sadness, nervousness–More likely to engage in unhealthy activities

(smoking and drinking) -Richard S. Strauss, M.D. (Jan 2000).

CHILDHOOD OBESITY TRENDS

1971-2006

“(A) a physical or mental impairment that substantially limits one or more of the major life activities of such individual [such as walking, or working]; (B) a record of such an impairment; or (C) being regarded as having such an impairment.”

-Americans with Disabilities Act

FEDERAL POLICIES ON OBESITY

“…temporary, non-chronic impairments of short duration, with little or no long term or permanent impact, are usually not disabilities…Similarly, except in rare circumstances, obesity is not considered a disabling condition.”

ADA Obesity protection

FEDERAL POLICIES ON OBESITY

COURT DECISIONS• Cook v. Rhode Island Department of

Mental health, Retardation and Hospitals

• Francis v. City of Meriden• EEOC v. Watkins

OBESITY LEGISLATION UP FOR REAUTHORIZATION IN 2009

• Child Nutrition and Special Supplemental Nutrition Program for Women, Infants and Children Act

• Elementary and Secondary Education Act

• Safe, Accountable, Flexible, Efficient Transportation Equity Act–Supports transportation by “bike, foot,

or other non-motorized means”–Number of children walking to/from

school: 48% in 1969 vs. 16% in 2001


Children’s Health Insurance

Program (CHIP) Act


New Health Care Reform and

Childhood Obesity


STATE OBESITY-RELATED LEGISLATION

School Focused Legislation

INTERVENTIONS• Community programs of health promotion through

lifestyle change• Education programs• Facilitating the development of new habits and

routines• Lifestyle Redesign® programs; recommendation of

home modifications• Adaptations/equipment• Compensatory training in ADL and IADL• Wellness programs for children, teens, and adults;

play and physical education in the schools• Safe patient-handling programs in hospitals and

skilled-nursing facilities; and post-surgical acute-care interventions

EQUIPMENT• Expandable support surface bariatric beds,• Weight-rated portable bedside hoyer lifts, • Weight-rated wheelchairs, • Bariatric bedside commodes and shower chairs, • HoverMat • Bariatric tilt tables • Bariatric rolling and standard walkers, • Bariatric sliding boards, etc.

PEOPLE AND PERSPECTIVES

Who is impacted by childhood

obesity?


Case Study


• Arguments supporting occupational therapists play a role in childhood obesity.

• Arguments against occupational therapists playing a role in childhood obesity.

“AOTA endorsed occupational therapy intervention as a way to meet the needs of children and adolescents who are at risk for overweight status or obesity caused by controllable lifestyle factors.”

AOTA adopted a statement -2006.

OT PRACTICE

PREVENTION• Advocacy/policy• Educational programs

INTERVENTIONS• Working with families• Changing habits• Working with school systems• Environment modification• ADLs/IADLs

Ots = imperative in changing policy to fix the issue that is derived from factors both on a macro and micro level.

obesity final presentation2

Health & Medicine