outline of dissertation on obesity

7/27/2019 Outline of Dissertation on obesity

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What is your aim?

What is your question and what are your objectives?

TITLE: The nurse practitioner roles in prevention of obesity among

teenagers.

It is sad to know that obesity among teenagers is a rising problem in our world.

Many students from primary school and high school are suffering from this disease

and this is an important topic which needs our attention. Overeating, consuming

junk food, drinking carbonated drinks and lack of exercises are few of the reasons

which cause obesity among teenagers.

In this dissertation paper, the writer provides a background of teenage obesity,

examine factors contributing to overweight and obesity in teenagers, review the

literature describing interventions and prevention strategies for childhood

overweight, and describe nursing skills to prevent teenage obesity.

The title of this dissertation is the nurse practitioner roles in prevention of obesity

among teenagers.

The Research question is how nurses can contribute their role in prevention of

obesity among teenagers.

CHAPTER 1 : Introducing topic/ background

1. Definition:

• Obesity is having an excessive amount of body fat.

It means that a person's weight is higher than what is thought to be

healthy for his or her height. The appropriate weight is measures using

BMI formula. BMI does not measure body fat directly, but is a reliable

indicator of body fatness for children, teens, and adults.

• BMI means Body mass index. It is a simple index of weight-for-height

that is commonly used to indicate whether that person is underweight,

in a healthy weight range, or overweight. It is defined as a person's

weight in kilograms divided by the square of his height in meters(kg/m2).

Issues to be discussed in this topic are related to the problem of obesity

indicating teenagers.

• Definition of teenagers: Teenagers with obesity age range: 15-20 years

old



- Must put citation/quotation about definition of teenage (age range).

• For children and teens, BMI is age and gender-specific in a way it is not

for adults. This is because the amount of body fat changes with age and

the amount of body fat differs between girls and boys during childhood

and adolescence. Teens can calculate their BMI using their weight andheight measurements using a BMI Percentile Calculator for Child and

Teen.

• After BMI is calculated for teens, the BMI number is plotted on a chart

appropriate for that teen’s exact age and gender to get a percentile

ranking. The percentile ranking indicates the position of that teen’s BMI

number among adolescents of the same sex and age. Referring the chart

below, person’s with 95th percentile and above is classified as obese.

Weight Status Category Percentile Range

Underweight Less than the 5th percentile

Healthy weight 5th percentile to less than the 85th percentile

Overweight 85th to less than the 95th percentile

Obese Equal to or greater than the 95th percentile

The following is an example of how some sample BMI numbers would be

interpreted for a 10-year-old boy. (CDC Growth Charts: United States)

http://apps.nccd.cdc.gov/dnpabmi


http://www.cdc.gov/nchs/about/major/nhanes/growthcharts/charts.htm



http://www.cdc.gov/nchs/about/major/nhanes/growthcharts/charts.htm



2. The aim and objectives should be set up to ensure nurses plan to prevent

obesity among adolescents is successful. The main aim is to explore the nurse’s

role in prevention of obesity among teenagers. While 3 other objectives are

i. To enumerate the effects of obesity among teenagers.ii. To illustrate the prevention of obesity among teenagers.iii. To analyses the role of nurse practitioners in the prevention of obesity

among teenagers.

3. Background - side reading

• justification & statistics



- justification must be stated to give reason/cause why this title isselected

- eg. Personal experience, prevalent incident

I chose this topic because now that a weight problem has become a majorhealth problem among teenage students. Moreover, the change in the way of life

has now been changed to make all the work done easily and not using physicalforce. As evidence, Malaysia latest statistic (2011) shows Malaysia has the highestobesity rate in Southeast Asia. In England, in 2010, around three in ten boys andgirls (aged 2 to 15) were classed as either overweight or obese (31% and 29%respectively), which is very similar to the 2009 findings (31% for boys and 28% forgirls).-NHS

The cause of obesity in adolescents is usually attributed to the young age of childhood. But what is worrying, if it is not treated at this age, their chance of becoming has an obese adult. Furthermore, the lifestyle of obese adolescents notonly interferes with social complications but also in other aspects which includesphysical, psychological, emotional, economy. This will have an impact on not only inthe adolescent, but in fact related to obesity later in adult life. In addition,

teenagers who are overweight often have adaptation problem in social relationespecially for youth because they just starting an independent life.

Therefore, as a nurse I have the ability to overcome this problem.But before that, I must refer to some resources in preparation and in-depth

knowledge. These resources are found from the literature regarding obesity and

only topic of this dissertation to take upward this area. As a whole, this benefit is

not only being able to add knowledge to other nurses but can even to develop the

practice.

4. Nursing rolesNurses regardless of specialty or work setting, perform basic duties that include

treating patients, educating patients and the public about various medicalconditions, and providing advice and emotional support to patients' familymembers.Roles and Function of a Nurse :

i. Caregiverii. Communicatoriii. Teacheriv. Client advocatev. Counselorvi. Change agentvii. Leader

viii. Managerix. Case managerx. Research consumer

- These nursing roles are taken from my notes. It is basic nursing roles thatneed to be accountable to each nurse. Just explain briefly, but as explain,relate to the topic

Refer:1. Caregiver



• The caregiver role has traditionally included those activities that assist the client physically andpsychologically while preserving the client’s dignity. Caregiving encompasses the physical, psychosocial,developmental, cultural and spiritual levels.

2. CommunicatorCommunication is an integral to all nursing roles. Nurses communicate with the client, support persons,other health professionals, and people in the community. In the role of communicator, nurses identifyclient problems and then communicate these verbally or in writing to other members of the health team. The quality of a nurse’s communication is an important factor in nursing care.

3. Teacher• As a teacher, the nurse helps clients learn about their health and the health care procedures they need to

perform to restore or maintain their health. The nurse assesses the client’s learning needs and readinessto learn, sets specific learning goals in conjunction with the client, enacts teaching strategies andmeasures learning.

4. Client advocate

• Client advocate acts to protect the client. In this role the nurse may represent the client’s needs andwishes to other health professionals, such as relaying the client’s wishes for information to the physician. They also assist clients in exercising their rights and help them speak up for themselves.

5. Counselor

• Counseling is a process of helping a client to recognize and cope with stressful psychologic or socialproblems, to developed improved interpersonal relationships, and to promote personal growth. It involvesproviding emotional, intellectual, and psychologic support.

6. Change agent

• The nurse acts as a change agent when assisting others, that is, clients, to make modifications in their own

behavior. Nurses also often act to make changes in a system such as clinical care, if it is not helping aclient return to health.

7. Leader

• A leader influences others to work together to accomplish a specific goal. The leader role can be employedat different levels; individual client, family, groups of clients, colleagues, or the community. Effectiveleadership is a learned process requiring an understanding of the needs and goals that motivate people,the knowledge to apply the leadership skills, and the interpersonal skills to influence others.

8. Manager

• The nurse manages the nursing care of individuals, families, and communities. The nurse-manager alsodelegates nursing activities to ancillary workers and other nurses, and supervises and evaluates theirperformance.

9. Case manager

• Nurse case managers work with the multidisciplinary health care team to measure the effectiveness of thecase management plan and to monitor outcomes.

10. Research consumer – nurses often use research to improve client care. In a clinical area nurses need to:

• Have some awareness of the process and language of research

• Be sensitive to issues related to protecting the rights of human subjects

• Participate in identification of significant researchable problems

• Be a discriminating consumer of research findings

Expanded role of the nurse :-Nurse administratorA nurse who functions at various levels of management in health settings; responsible for the management andadministration of resources and personnel involved in giving patient care.

5. Theory & practice

6. Research question - explain how do you choose the topic - you refer to PICO Research question: How nurses can contribute their role in prevention of obesityamong teenagers

- Refer to example of dissertation.

7. Search engine-

• examples of search engines used is Google search / scholar



- The purpose is to show that you have many sources of information relevantto the topic.

- Refer to example of dissertation.

CHAPTER 2 :.

- This chapter is to enumerate the effects but briefly explains the cause

This second chapter will discuss the effects of obesity on youth. But before knowingthe effects, we need to find the cause of obesity. There are various aspects thatcause obesity.

Taking in more calories than you burn can lead to obesity because the body stores

unused calories as fat. Obesity can be caused by eating more food than your body

can use. That is why the body needs to do some physical activity. If a teen eats and

drinks more than the body needs, the excess energy stores in the form of body fat.

And, added to this, if the teen is not doing enough regular exercise, it worsens the

problem. Drinking too much alcohol also can cause obesity.

Non-food-related behavior can also lead to obesity. These behaviors are sedentary

behaviors such as sitting or sleeping for long hours, using lifts as compared to stair-

walking, driving to places that are within walking distance. On the most part now

there are computers, television, and video gaming systems replacing exercise and

sports

Other factors that affect weight include quitting smoking. Most people who quitsmoking gain 4 - 10 pounds in the first 6 months after quitting. Some people gain

as much as 25 - 30 pounds.

Sometimes, medical problems or treatments cause weight gain, including

underactive thyroid gland (hypothyroidism) and medicines such as birth control

pills, antidepressants, and antipsychotics

Other things that can cause weight gain are stress, anxiety, feeling sad, or not

sleeping well

The effects that teen obesity has on health can begin during the teen years andextend throughout a lifetime if not checked. Some of the common health conditionsthought to have teen obesity as a risk factors are Type 2 diabetes, asthma, heartdisease, hypertension, sleep problems including sleep apnea, and orthopedicproblems due to an inability of the developing bones to support the excess weight.

Obesity can affect a person’s physical ability to a great extent. An obese personwould find it difficult to walk, run and do tasks which involve physical effort.

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000689/

http://www.ncbi.nlm.nih.gov/pubmedhealth/n/pmh_adam/A000353/

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000689/

http://www.ncbi.nlm.nih.gov/pubmedhealth/n/pmh_adam/A000353/



Additionally, teenage obesity can lead to psychological problems associated withnegative body image and social issues associated with being treated as an outcast.

Obesity has also been associated with low self-esteem in some adolescents. Obesechildren with low levels of self-esteem are more likely to report feelings of loneliness, sadness and nervousness. This causes them more likely to eat more,

smoke and consume alcohol. They also having problem in relationship skill whetherin peers or romantic relation. Incidents of bullying, discrimination and socialisolation are more likely among overweight teens than normal-weight teens. Thedepression and social isolation that obese teenager suffer from can influence theiracademic success too for example lack of interest in learning or do not want to goto public school In future, this matter can cause difficulties upon college application& working interviews.

CHAPTER 3

Illustrate the prevention of obesity among teenagers

- This chapter is to indicate the intervention of obesity generally.

Most parents claim that they would readily change their own habits if it would help their teenagers avoid obesity. This gets at one of the main means of preventing obesity: familyinvolvement. It is important to help teens acquire healthy lifestyles through family activities andparticipation.

How to reduce weight?

1. Nutrition

i. Base your meals on starchy foods such as potatoes, bread, rice and

pasta, choosing wholegrain where possible.

ii. Eat plenty of fiber-rich foods such as oats, beans, peas, lentils, grains,

seeds, fruit and vegetables, as well as wholegrain bread, and brown

rice and pasta.

iii. Eat at least five portions of a variety of fruit and vegetables a day in

place of foods higher in fat and calories.

iv. Choose low-fat foods.

v. Avoid foods containing a lot of fat and sugar, such as fried food,

sweetened drinks, sweets and chocolate. Some takeaways and ‘fast’

foods contain a lot of fat and sugar.



vi. Eat breakfast.

vii. Watch the portion sizes of meals and snacks, and how often you are

eating.

viii. Avoid taking in too many calories in the form of alcohol.

Concentrating on replacing unhealthy foods with healthy food choices can

significantly reduce teen obesity, as can increased physical activity. Family

activities such as walking, biking, hiking and even just playing games outside can

help teens lower their risk of obesity

2. Physical activity

i. Small everyday changes can make a difference. You don’t have to join

a gym or sports club (although it can help). Below is some more advicefrom the NICE guidance.

ii. Try walking or cycling to the shops.

iii. Avoid sitting for too long in front of the television, at a computer or

playing video games. You could try gradually reducing how long you sit

down in front of a screen by setting some time limits.

iv. Adults could try to build physical activity into the working day. For

example, you could take the stairs instead of the lift, or go for a walk

at lunchtime

3. Behavior Modification

Guiding a teen to gradually change eating habits -- while encouraging a more active

lifestyle -- can be effective. Eating slowly, developing a routine, planning healthy

meals, using portion control, eating meals as a family, and attending support groups

4. How parents and carers can help children and young people to keep to a

healthy weight

Parents and carers are important role models for children and young people

and can help them to stay healthy. The NICE guidance offers extra advice to

help you keep your children at a healthy weight or, if necessary, to help

them to lose weight.



i. Ensure your children have regular meals, including breakfast, in a

sociable atmosphere without distractions (such as watching

television).

ii. Whenever possible, eat meals with your children.

iii. Encourage children to play games that involve moving around a lot

like skipping, dancing, running or ball games.

iv. Try to be more active as a family, by walking or cycling to school

and the shops, or going swimming or to the local park together.

v. Encourage children and young people to participate in sport or

other physical activities, and make the most of chances to do this

at school.

vi. Give some written material (like a leaflet)

Other treatment:

• Pills and Supplements, Weight Loss Surgery – Not encourage, costly

Maintainance

• To maintain weight loss, you have to continue eating healthy, exercising and

reducing overeating triggers

• There are health risks associated with being underweight, as well as with

being overweight or obese. So it is important to adopt healthy lifestyle habitswhen it comes to diet and physical activity.

• Don’t skip meals. Eat three meals a day and one or two healthy snacks.

• Replace junk foods in your house with healthy meal and snack-food items,

especially fruits, vegetables and whole grains.

• Limit high-calorie foods, including sugary drinks, fast foods, and packaged

snacks.

• Remember portion control.

• Keep food choices varied. Include foods from all the food groups, including areasonable amount of healthy fats in your diet.

• Exercise at least three times a week.

• Don’t over-exercise.

• Try to cut down on “couch potato” time.

• Ask your friends and family members to join you in living a healthy lifestyle.

• Establish regular family mealtimes.



None of these recommendations can be accomplished without the help and support

of children's family and community.

- briefly relate Virginia Henderson (nursing model) theory which states that

the 14 basic needs

- Refer :

•breathing normally

•eating and drinking adequately

•eliminating body waste

•moving and maintaining a desirable position

•sleeping and resting

•selecting suitable clothes

•maintaining normal body temperature by adjusting clothing and modifying the environment

•keeping the body clean and well groomed to promote integument

•avoiding dangers in the environment and avoiding injuring others

•communicating w/others in expressing emotions ,needs,fears or opinions

•worshipping accdg. to one's faith

•working in such a way that one feels a sense of accomplishment•playing or participating in various forms of recreation

•learning , discovering or satisfying the curiosity that leads to normal development and health, and using available

health facilities

CHAPTER 4

- In this chapter, need to analyze the role of nurse practitioners in the

prevention of obesity among teenagers

- Briefly notify the importance/ need / benefit of nurses involvement in

the intervention.

- What should nurses do? How? Briefly explain, guided by nursing

process, a structured of problem solving approach to nursing practice

and its evaluation. It is a systematic, rational method of planning and

providing nursing care. A process that seeks to identify a client's

healthcare status, actual or potential health problems, to establish

plans to meet the client's identified needs, and to deliver specific

nursing interventions to address those needs. It contain of assessment,

diagnosis, plan, implement and evaluation.

- Refer to my notes:

Characteristics of the Nursing Process



• cyclical and dynamic--> components follow a logical sequence but more than once component may be

involved at one time; responds to the changing health status of the client so there is no absolute beginning or

end

• open and flexible--> meets the unique needs of the client, family, group, or community

• client-centered--> the plan of care is organized according to the client’s health problems rather than

nursing goals

• interpersonal and collaborative--> to ensure delivery of quality nursing care, the nurse shares concerns

and problems regarding the client’s health status; rapport is developed and an open communication is

established between the client and the nurse to carry out the nursing process effectively

• planned

• goal directed

• allows client and nurse to devise ways to solve identified health problems--> decision-making is involved

in every step of the nursing process and nurses are not bound by standard responses; nurses can use their skills

and knowledge to assist the client attend to health-related goals

• emphasizes feedback--> determines if there is a need to revise the nursing care plan

• universally applicable--> it can be used with clients at any age and at any point in the wellness-illness

continuum and can be used in a variety of settings.

• utilizes problem-solving techniques and the systems theory--> decision-making is involved in every

component of the nursing process

So as u mention the intervention, relate it to nursing process. Just inform in brief. At the same timeyou can slot in the points that given below (marked *). Example:

1. Assessment - collecting data. How?- By communicate/taking history from client/parents, observe eating habit/physicalactivity- Document data: body measurement, weight chart.

2. Diagnosis- interpret data- Compare client’s BMI with standard teenage BMI – obesity.

- Take into account of client’s risk, health factors.3. Plan.- Must be designed based on the ability and adolescent health

…..and so on…But when you reach the last process (evaluation) you have to mention about reflective theory.See below..Components of the Nursing Process

Components Purpose Activities

ASSESSING

-Collecting, organizing, validating, and

recording data

To establish a database of client’s response

to health condition and the ability to

manage healthcare needs

-obtain health history

-conduct physical assessment

-review records

-review lit.-consult support persons/significant others

-consult health professionals

-update data

-organize data

-communicate/document data

DIAGNOSING

-Analyzing and synthesizing data

To identify strengths and health problems to

be addressed by collaborative and

-interpret and analyze data (compare

against standards, cluster data, identify gaps



independent nursing interventions

To develop a list of nursing diagnoses and

collaborative problems

and inconsistencies)

-determine client’s strengths, risks, and

problems

-formulate nursing diagnoses and

collaborative problem statements

PLANNING

-Determining how to prevent, resolve,

reduce identified health problems; how

to support client’s strengths and how to

effectively implement nursing

interventions

To develop an individualized care plan

(based on your client needs) that specifies

goals and related nursing interventions

-collaborate with client regarding

priorities and goals

-write goals/outcome criteria

-select nursing interventions

-consult other members of the healthcare

team

-write nursing orders and care plan

-communicate care plan to relevant

members of the healthcare team

IMPLEMENTING

-Carrying out planned nursing

interventions

To assist the client meet desired

goals/outcomes

-Reassess client to update database

-Determine need for assistance

-Perform interventions

-Document care and clients responses; give

verbal reports as needed

EVALUATING

-Measuring the degree to which

outcomes have been achieved and

identifying factors that influenced goal

achievement

To determine whether to continue, modify,

or terminate plan of care

-collaborate with client and collect data

related to outcomes

-determine whether goals have been met

-relate nursing interventions to client

outcomes

-make decisions about problem status

-review and modify care plan as indicated

* The nurse practitioner has a duty to interpret government policy and health

research findings for the public. The work of healthcare providers is necessary in

the area of advocacy at the local and federal level to induce changes in healthcare

policies that impact food supply and physical activity opportunities for children. We

need to find ways to expand our ability as nurses to advocate for policies at the

local, state, and national level that change conditions in society. These changes,

including regulatory action, should be designed so that children and their parents

can make healthier choices about nutrition and physical activity. Nurses in

community-based or public health settings may be the best-positioned healthcare

professionals to take action on the promotion or protection strategies aimed at the

prevention of adolescent obesity.

Found that many nurses consider involvement in policy as an extension of their

roles both in speaking for those who may not be able to speak for themselves, and

in finding new ways to allocate resources that impact the health of individuals,



families, and communities. Since many factors that lead to obesity, such as health

disparities, poor access to nutritious food, and poverty, are often best approached

from a systems and health-determinants perspective, policy may be one of our

most powerful tools for advocating for changes in conditions that contribute to

obesity.

One of the methods can be used is to use social marketing approach. A social

marketing approach means that one must understand what the target audience is

willing to give up or modify in terms of behavior in order to adopt (exchange) the

new behavior for the former behavior. Social marketing can be an adjunct to

traditional health education. Social marketing focuses on the audience (individual,

family, or entire community) targeted for the behavior change, the communication

strategies employed to uncover the barriers and benefits of the desired change, and

the “exchange” the individual, family, or community requires in-order-to make the

desired change.

Consider the case of a public health nurse who is working with a family, the public

health nurse needs to identify “what is in it for them” so that they will make the

behavior change. In this case, the public health nurse would need to begin the

intervention with the following initial steps of the social marketing process:

• Clearly understand the problem (lack of adequate physical activity due in

part to television watching)• Explore the most appropriate actions that would address the problem (finding

alternate desirable activities for the family)• Define the target for the action (parents and adolescents)• Explore with the family the desired exchange (weekly trip to the park)

The exchange chosen must be desirable to the target adolescent because there will

be barriers to pursuing the desired behavior that are not immediately obvious. The

benefits to making a change in behavior may not be obvious either. Because both

barriers and benefits are important to understand, it is important to explore why the

targets (teenagers) behave as they do and determine what is meaningful to them.

The ability to lead change whether at the individual, family, or community level is

an important skill of expert nurses. Leadership at the community level takes a

special approach since community participants are essential for assessing healthissues, understanding the impact of those issues on the health of their community,

and planning approaches that will be met with acceptance and enthusiasm by

community members. Collaborative Leadership (Chrislip & Larson, 1994) is an

approach to leading change that uses a shared leadership model. This model has a

set of tools that helps a group establish shared leadership, trust, insight into the

need for change in the community, an understanding of human behavior and power,

http://nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol142009/No1Jan09/Prevention-of-Childhood-Obesity.html#Chrislip

http://nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol142009/No1Jan09/Prevention-of-Childhood-Obesity.html#Chrislip



and the capacity to use self reflection in understanding how one’s own behavior

impacts others.

What is the role of health care professional in the incident & relevance?

• Healthcare providers may recommend a personal trainer or simple

exercises that you can do based on your health and size.

• Counseling may be included in behavior modification treatment.

• Provide nutritional guidelines based on health and caloric needs. This

may have a team of professionals working with you and your doctor,

including a dietitian or nutritionist.

NICE recommends that the healthcare professional should:

• talk to them about the benefits of being physically active

• suggest how they could fit more physical activity into your everyday life, based on

what they like doing and how easy it is for them to do it

• suggest how they could eat more healthily, based on their own likes and dislikes,

and discuss how easy it is for them to buy food and prepare meals

• help them to come up with some realistic goals and give you some tips on how to

achieve those goals (these might include, for example, how to cope in a situation

where there is a lot of tempting sugary or high-fat food)

• provide you with written information and offer you ongoing support

Reflectioni. What is reflection?

ii. Why are nurses interested in reflection?

Nursing like other professional groups, has recently moved to higher education

which has meant working in an educational system which has traditionally

divided theoretical & practical knowledge.

Nurses develop a ‘feel’ for what they do “practically and bodily so that itbecomes part of the knowing process” but cannot always be verbally expressed

‘we know more than we can say’. Nurses need adequate ways to expressthemselves and reflection is has the potential to prove such means.

iii. Why reflection?

Nursing is a practice discipline; effective preparation of nurses means that wecan effectively and competently care for our patients and continue to developskills over a professional life time.



Nurses reflect because it provides a tool or mechanism “through which they cancommunicate and justify the importance of practice and practice knowledge.”

iv. What does reflection have to offer?

Reflecting on practice provides us with an opportunity to learn from it, to assesseffectiveness and as improvement in the future.

Give 1 example of Reflection theory: Kolb (1984), Gibbs (1988), John (1994), Atkins andMurphy (1994).

CHAPTER 5 : Conclusion

Teenage is an important phase of our lives. It involves several physical and

psychological changes in the body. A teenager experiences radical changes in

perceptions every day. Lack of maturity places teenagers in a state of confusion.

They feel vulnerable from inside. But the growing sense of the concept of ego stops

them from seeking help even from their parents. Expectations of parents and peer

pressure further worsen their situation. Self discipline and a strong resolve are

required to shed body weight. But the low self esteem of the obese teenagers does

not allow them to develop such a positive mind set. As development of a healthy

self esteem is hampered in teenage, a large number of insecurities plague the mind

of these individuals in their later years. If the menace of teenage obesity is notaddressed in teenage itself, its serious consequences affect the adult life of these

individuals too.

Most importantly we need an in-depth exploration of how to assure that nurses are

equipped with the policy, leadership, and behavioral change intervention skills, such

as advocacy, collaborative leadership, and social marketing skills that hold promise

for preventing the critical public health challenge of overweight and obesity in

teenagers.

In summary, important findings that have particular relevance for nursing include:

(a) prevention strategies aimed at the family (parent and teens) are key to

influencing dietary habits of young children; (b) interventions aimed at preventing

or reducing obesity in teenagers must start early in childhood, prior to established

poor dietary patterns; and (c) nurses support and involvement in developing

opportunities for a healthy lifestyle needs to be combined with any intervention

aimed at individuals and families.



http://www.nhlbi.nih.gov/meetings/workshops/child-obesity/index.htm

http://www.overweightteen.com/

http://www.aacap.org/cs/root/facts_for_families/obesity_in_children_and_teens

http://www.livestrong.com/article/506796-the-factors-affecting-obesity-in-teenagers-because-of-

fast-food/

http://www.theyesword.com/obesity_in_teenagers.htm



http://www.livestrong.com/article/506796-the-factors-affecting-obesity-in-teenagers-because-of-fast-food/








outline of dissertation on obesity

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