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Childhood Obesity

trends, complications, cost, and prevention


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Definition, prevalence, and trends Causes and other contributing factors Risks – psychological and physical Costs to individual, healthcare institutions, and society Obstacles to shifting the paradigm Recommendations for effecting change Motivational Interviewing

Overview

prevalence. and trends a brief look at childhood obesity .Definition.

Use of Body Mass Index (BMI)  Overweight ≥ 85th percentile  Obese ≥ 95th percentile  Definition of obesity .

Increase in obesity from 1976-2000  No trend from 2000-2008  17% of children aged 2-19 were considered obese in 2008  5.5% were obese in 1976  Prevalence and trends .

Causes & other contributing factors multiple risk factors and reasons for childhood obesity .

but prevalence among school-aged children has tripled during that time  Genetics .At the basic level. obesity occurs when more calories are consumed than are used  Susceptibility to obesity  Genetic characteristics haven’t changed in last 3 decades.

and portion sizes  Less physically active than before  More time in front of the TV or playing video games  Behavioral Patterns .Fast food. family restaurants.

Home. sidewalks. childcare. pools  Environmental Factors . and community influence  Children’s habits reflect parents’ habits  Lack of playgrounds/parks. school. bike paths.

Risks and complications psychological and physical .

Still a negative stigma  Targets of social discrimination  Disrespected and bullied by peers  Lead to low self-esteem and depression  Psychological risks .

hypertension. sleep apnea. fatty liver.May be unable to perform simple tasks  Glucose intolerance. polycystic ovary syndrome  Type 2 diabetes increasingly common  Physical risks . asthma. orthopedic complications. high blood pressure.

Costs individual. healthcare institutions/insurance companies. society .

$147 billion/year for obesity medical costs  $1.500 on a bariatric wheelchair (compared to $150-$330 for regular)  Possible reduced lifespan  Individual costs . healthy-weight individuals  Immobile patients may spend up to $1.400 higher each year for obese vs.

More diseases associated with obesity  Insurance companies may raise premiums  Retrofitting rooms for bariatric patients  ◦ ◦ ◦ ◦ ◦ ◦ Toilets Wider wheelchairs Bigger/adjustable beds Motors to assist nurses & prevent injury Larger waiting room chairs New MRI machines (70cm diameter vs. 60cm) Healthcare institutional costs .

Face complications of epidemic together  May not feel need to change if everyone is obese  Healthcare/insurance obstacles – cost may be directed toward general public through increased taxes and higher insurance premiums  Societal costs .

Obstacles to shifting the paradigm why change isn’t easy .

       Do not wish to/afraid of change Do not recognize need for change/cultural differences Bad habits are not easily broken Takes time & dedication to achieve results Fast food is easier and cheaper Limited access to healthful foods Making excusing is easier than taking action Obstacles for change .

Recommendations for effecting change what we can do as a society or as individuals .

      Educate children about risk factors Focus on healthy lifestyle. not weight loss Limit TV and video games Limit fast food and sweetened beverages Encourage physical activity Have family dinners at the table. not in front of the TV Parents .

More time spent educating about wellness  School nurses  Gym & health classes  Schools and childcare .

Use time to promote wellness and increase awareness  Speak with parents about willingness/ability to change  Motivational Interviewing  Pediatricians and nurses .

Motivational Interviewing and the transtheoretical model .

required for lasting change MI technique .      Patient-centered interaction Explore and resolve ambivalence about change Build rapport with patient and family Collaborate with patient. empowerment Use empathy and encouragement Evoke intrinsic motivation.

 Six stages ◦ ◦ ◦ ◦ ◦ ◦ Precontemplation Contemplation Preparation Action Maintenance Termination Can move between stages  Example: GiGi and dancing  Transtheoretical model .

exercise physiologists.Used if providers have inadequate time  Multifaceted approach  Collaboration of healthcare team: primary care physicians. psychologists. dieticians. nurse practitioners. and social workers  Case Management .

Conclusions and future directions .

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