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Childhood Obesity

By
Bosede Adedire
Christiana I
Honorine M

Objectives

By the end of this presentation, the audience will be able to
 Identify background overview
 Identify diagnosis of childhood obesity
 Identify the presenting signs/symptoms and assessment
 Identify the management
 Identify the NP’s role
 Identify the future implementation and benefits

Background
 Obesity is body Mass Index equal to or greater than 95th
percentile OR ''abnormal or excessive fat accumulation
that presents a risk to health'' Centers for Disease
Control and Prevention, 2014).
 Childhood obesity has more than doubled in the past 30
years from 7% in 1980 to 18% in 2012 among children
between the ages of 6-11 (CDC, 2014)
 An obese child has a 70% chance of becoming an obese
adult (Fletcher, Cooper, Helms, Northingtion, & Winters,
2009)
 1/3 of American children who are overweight or obese,
are at an increased risk for obesity-related health
problems (Koh, 2010; CDC, 2014)

Background Con’t
 80% teens do not eat fruits and veg, 63% do <
recommended 60min/day, 5days/wk of physical
activities, 33% watch >3hrs of TV, 25% spend > 3hrs on
nonacademic computer and game activities (CDC,
2013)
 Hospitalizations associated with obesity in children
increased from 2.1% from 1981 to 4.8% during 19971999,costing society about $150 billion every year
(Orszag, 2010; Trasande & Elbel, 2012 ).
 The current First Lady of the U.S, Michelle Obama, has
directly acknowledged this epidemic and launched a
national campaign in February 2010 (Stolberg, 2010).

Diagnosing Childhood obesity
 Risk factors
 Genetics
 Environment: Diet and exercise
 Socioeconomic factors
 Physiological
 Other medical conditions
 Family history

 Screening Test
 BMI
 History of dietary behavior, physical activities, family history
 PE: BP , distribution of adiposity, comorbidities
 Test: Fasting lipid level, thyroid function test, AST and ALT,
fasting serum glucose

S/S and Assessment
 S/S
 Weight increase
 Failure to achieve substantial weight loss
 Complications: pulmonary, cardiac, GI, endocrine, neuro,
orthopedic, dermatology and psychiatric

 Differential diagnosis
 Acromegaly
 Ascites
 Cushing Syndrome
 Hirsutism

Management
 Life style modification
 Self-monitoring of caloric intake and physical activity, goal
setting, stimulus control, nonfood rewards, relapse prevention

 Weight loss programs
 Pharmacological
 Bupropion and Naltrexone (impair dietary intake)
 Orlistat (impair dietary absorption and ONLY approved med
for adolescents in the US)
 Belviq (increase energy absorption)

 Surgery
 Bariatric surgery

Role of the Nurse Practitioner
 Routine assessment
 Identify Children at Risk
 Proactively discuss healthy lifestyle behaviors
 Involve parents
 Behavioral Modification Counseling
 Know your community resources
 Advocacy… Get involved in the following areas:
opportunities for physical activities, food supply and food
drive, research and pilot projects

Future implementations and
benefits
1. Practice
oHealth care professionals are required to address human responses to actual
and potential health
oPromote and maintain good nutrition and healthy body weight and assessment
who are at risk or who are already

for early identification of children

overweight

2. Research
3. Policy development
oPolices to safeguard children, families and strained Healthcare system
oOne policy that could be lobbied for by healthcare professionals is regulation of TV commercials, WIC program

Questions

Learning Assessment

1.

A child is at a healthy weight if his BMI is:
a) less than the 5th percentile
b) at the 5th percentile to less than the 85th percentiles
c) at the 85th percentile to less than the 95th percentiles
d) greater than or equal to the 95th percentile
e) none of the above

2. If your child ate this whole container of Whoppers, how many calories would she
consume?
a) 60 calories
b) 90 calories
c) 150 calories
d) 180 calories
e) 450 calories

3. ………….. is the ONLY medication approved in the U.S for childhood obesity. It can
only be used in ………….(hint: what age group)