The Causes, Consequences, Risks and Complications of Obesity - Research Paper Example

Obesity in Adolescents This paper discusses the topic of obesity in adolescents by examining several aspects of the topic. Firstly it looks at what is obesity and the statistics of the incidence of obesity to emphasize the significance of the issue and to show the high frequency of this condition. Next the paper examines the causes of obesity. The consequences, risks and complications of obesity will form the major body of the paper; looking at the physical and health risks and the emotional and psychosocial consequences. Finally the paper will discuss some of the interventions that are suggested for preventing and treating obesity in adolescents. In order to examine the issue of obesity in adolescents and the significance of the problem we must first have a clear understanding or definition of the term. The American Academy of Child and Adolescent Psychiatry (2008) points out that obesity in not just a few extra pounds of weight that a person has. They explain that a “child is not considered obese until the weight is at least 10% higher than what is recommended for the height and body type”. This child may also indicate a tendency to gain weight easily, and therefore signal the need for changes in diet and exercise. Obesity commonly begins in the childhood stage between the ages of five and six, and also during the adolescent phase. The frequency of the incidence of obesity in adolescents also is a cause of concern and indication of the need for addressing the issue. Figures for occurrence have been given by various concerned parties, particularly for the US. However the issue is a global one. The American Academy of Child and Adolescent Psychiatry quotes figures between 16 and 33% of children and adolescents as being obese. Merten et al (2008) also claim that 31% of the US population is obese, with a figure of 30.4% and 15.% of adolescents being overweight and obese respectively. These figures they quote from the American Obesity Association. More detailed statistics are provided by Lawrence et al (2010) who show that the prevalence of overweight and obesity in children and adolescents as being three times higher than it was in the 1980s. According to these authors, prior to the 1980s the percentage of overweight and obese children was only 6.5% for children and 5% for adolescents. By 2004 however these figures increased to 18.8 % and 17.4 % respectively. They also point out that in addition to these figures, 31% of children under age 18 are at risk of being overweight. The rising incidence of obesity is also seen in many countries including Sweden, China etc. Lawrence et. al. (2010) define obesity as a body mass index for age ranging from 85th to greater than the 95th percentile. These figures are alarming and of concern especially since the “the child who is obese between 10 and 13 yrs old has an 80% chance of becoming an obese adult”(American Academy of Child and Adolescent Psychiatry, 2008). It is important therefore to address the issue from early childhood. Marten et al (2008) also point out that earlier the onset and the more severe the problem, the greater the likelihood that the childhood obesity will persist into adulthood. Obesity is considered a chronic condition with a complicated cause or causes. The cause can include various factors ranging from genetic, through biological, behavioral and cultural.. In other words there are physical and environmental factors that seem to intersect to result in the condition. It is difficult to separate out the individual causes; and this also makes treatment and prevention difficult. Obesity is basically the result of a person eating more calories than their body burns up. In few instances this is a physical problem of the body, but can be considered more of a behavioral issue where the adolescent needs to burn more calories because he/she is not active enough. More exercise may not completely resolve the issue however. This suggests a genetic factor. In some cases when a parent is obese the child has a 50% chance of being obese; this increases to 80% when both parents are obese. The American Academy of Child and Adolescent Psychiatry suggests several factors that can be related to obesity, apart from the common duo of poor eating habits and lack of exercise. Some medical illnesses such as endocrine or neurological problems and some medications (e.g. steroids and other psychiatric drugs) have been shown to affect weight gain. Depression and other stress causing incidents in life have also been known to lead to a weight gain. The consequences of obesity in adolescents are numerous and serious. The risks can be classified as physical or biological and emotional and psychosocial. The most devastating consequence of obesity and overweight in everyone, not only the adolescents however is morbidity and mortality. Obesity is responsible for hundreds of deaths every year. The list of physical consequences of obesity is long. Perhaps the most crucial is the effects on heart diseases. Obesity is linked with increased risk of heart diseases and heart failure, diabetes, certain cancers, breathing problems, high blood pressure. Merten et al (2008) also mention such risks as lower-body disability, hypertension, orthopedic and endocrine disorders. One of the major factors in obesity and its treatment is diet. The physical consequences listed above have been related to the diet even of children. According to Moreno et al (2008), obesity is the most frequent nutritional disorder in transition and developed countries, in which overweight and obesity prevalence has increased in the last decades”(p. 72). The problem of overweight is associated with metabolic complications so that it is important to look at the diet and food consumption early in the lives of children and adolescents. Moreno et al (2008) point out the the obesity is a result of a long-term imbalance in positive energy so that prevention is important. These authors looked at the relationships between the types of food consumed by adolescents and the prevalence of obesity. Though they point out that there are not sufficient longitudinal studies to confirm these correlations, the parallels in the increase in the intake of certain foods and the prevalence of obesity indicate the significance of food intake. The dietary risk factors suggested include the frequency of daily meals, the consumption of snacks between meals and the consumption of soft drinks which has risen over the past decades. The fast food consumption has also been a serious problem because of the increase in size of the portions, the affordable prices and the easy access. The composition of the adolescents' diets has changed over the years and so causes increase in the prevalence of obesity. The type of dietary fat is being looked at as an association with obesity. “Obese children consumed a higher amount of saturated fat compared with non-obese children, and saturated fat intake has been associated with greater body mass index”, (Moreno et al, 2008, p. 74). Carbohydrate intake may also be inversely related to obesity, this is so because carbohydrates have significantly lower energy density than fats. The mother's attitude to sweets is another important factor that could influence the offspring becoming obese. Consumption of fiber in fruits and vegetables must be an important aspect of weight maintenance. With the increased knowledge of the different types of food and how the body metabolizes and uses them, it is easier to control obesity by paying careful attention to what the adolescents eat on a daily basis. Preventing obesity is probably more advantageous than trying to treat it after it has developed. There are also many psychological issues associated with obesity in adolescents. The common emotional problems include low self-esteem, depression and anxiety, obsessive-compulsive disorder, and many other social issues. Fonseca et al (2009) state that “the potentially serious psychosocial and physical consequences of obesity have made overweight and obesity one of the great contemporary public health issues” (p.166). They describe overweight adolescents as more socially isolated and having difficulty making friends. The social stigmatization and marginalization that obese adolescents face is a big challenge to their social and emotional well-being. Overall lower health-related quality of life is characteristic of obese children and adolescents. They report on a study that suggested that dieting for weight loss, poorer body image and lower life satisfaction are all related to overweight and obesity in adolescents. These are not the only psychosocial consequences of obesity in adolescents. They too showed that low self-esteem , body satisfaction and depressive symptoms were more common among overweight than non-overweight teens. The overweight adolescents reported more difficulty in making friends. The authors also reported that “obese teenagers described themselves as havingg a poorer health status, and when they were compared with their non-obese peers, they tended to have significantly lower levels of emotional well-being measures, and reported irritatbility and feeling nervous more frequently than their peers” (p. 172). Merten et al (2008) also examined the psychosocial consequences of obesity and overweight in adolescents. They were interested in the long-term social consequences of obesity. Two important factors they looked at were educational attainment and employment outcomes. They reported that particularly for girls, for whom body image is so important at this stage, the social outcomes were serious. According to them “young adolescent girls with depressive symptoms due to high BMIs have been found to have continued depressive symptoms in adulthood” (p. 1113). They concluded that depression is more likely to be linked to obesity for younger adolescent girls because of the body image issues. The long-term consequences of obesity in adolescents was investigated to point out the significance of obesity in adolescents and that it carries into young adulthood, or in other words, is not only significant and problematic in the adolescent phase. Their study showed that young adults who were obese during adolescence will demonstrate lower attainment in areas of education and jobs. They also pointed out that overweight and obese adolescents especially the girls, were less likely to enroll in college. They do not even aspire to achieve a college or higher education degree. In summary the authors state that “obesity during adolescence puts individuals at risk for a life-long struggle with poor mental health” (P. 1118). Managing and treating obesity in adolescents is important. Generally treatment of obesity has taken two major approaches- reducing food and calorie intake and increasing physical exercise. The general recommendations of the American Academy of Child and Adolescent Psychiatry included changing eating habits and better planning of meals to include controlling portions and consuming less calories; increasing physical activities especially walking and making lifestyle more active; limiting snacks and the use of food as a reward, and eating meals as a family instead of while watching television or being at the computer. While these are all useful and have been advocated by all who are concerned with obesity, there is more that needs to be done. Behavioral issues are connected to making these changes. Increasing physical activity is not confined to a specific amount of physical education in schools on a daily or weekly basis. Cutting down on television watching and computer time is becoming more and more of an effective strategy, since adolescents spend so much time on such a sedentary activity. Reducing the television and computer time hopefully will encourage use of time that involves more outdoor and physical activity. Adolescents must also be encouraged in behavior changes such as walking more and using the stairs more. Many schools are incorporating more physical education as part of the school curriculum. While increasing the physical activity, the calorie intake must also be balanced. Healthy diets are being introduced into school cafeterias, and parents are educated on the value of such diets from early in their children's lives. The removal of vending machines and soda machines as a strategy is increasing in schools; some replacing them with healthy foods. However interventions based on limiting food intake and increasing physical activity is limited according to Lawrence et al (2010). They suggest addressing the problem from an ecological systems perspective. The problem is not simply an individual or even family issue, but is tied to the environment and thus the need for the ecological systems approach. Treatment needs to be more proactive and less reactive. The intervention should start at the primary level since it is at this level that children have difficulty regulating themselves and so are at more risk for obesity. Eating habits form and develop very early, and parents are in control from the beginning. Therefore they are suggesting that parents are provided with guidance from this early stage to help their children make healthy eating choices and develop good eating habits. It is the parents who can control the availability of the fast foods. The prevention and treatment must have a multidisciplinary approach. They cite the example of the EVASYON program in Spain to treat obese adolescents. The treatment included all of the following - nutritional and individual diet counseling, modification of diet and caloric content, increased physical activity and exercise, and active participation in appropriate activities, and group therapy focused on changing behaviors, support and encouragement. These intense and multidisciplinary intervention and prevention programs must have the support and help of several professionals including social workers and/or other mental health professionals, pediatricians, nutritionists and physical activity specialists. This indicates the intensity of the interventions needed to address this serious problem of obesity in adolescents. As stated by Lawrence et al (2010) “Successful methods to treat pediatric overweight and obesity remain a difficult task, but we should not forget that the aim of any program is not only weight reduction, but to change lifestyles and to reduce long-term risk factors associated with obesity” (p.76) Obesity in adolescents is indeed a serious problem and getting more prevalent and serious. It is a global one. It is not only a problem in adolescents but as seen the consequences of obesity in adolescents can be long-term. The effects can be seen in young adulthood and even in adulthood if not addressed effectively. The risks and effects are not only physical but also emotional and psychosocial, thus requiring multidisciplinary approaches to prevention and intervention. References American Academy of Child and Adolescent Psychiatry. (May 2008). Facts for Families. Obesity in Children and teens. Paper #79. retrieved from www. aacap.org Fonseca, H., Matos, M.G., Guerra A., & Pedro, J. G. (2009). Are overweighted and obese adolescents different from their peers? International Journal of Pediatric Obesity. 4: 166 -174 Lawrence, S., Hazlett, R. & Hightower, P. (2010). Understanding and acting on the growing childhood and adolescent weight crisis: A role for social work Health and Social Work. 35 (2), 147-154 Merten, M. J., Wickrama, K.A.S. & Williams, A.L. (2008) Adolescent obesity and young adult psychosocial outcomes: Gender and racial differences. Journal of Youth and Adolescence. 37: 1111-1121 Moreno, L.A., Ochoa, M.C., Warnberg, J., Marti, A., Martinez, J.A. & Marco, A. (2008). Treatment of obesity in children and adolescents. How nutrition can work. International Journal of Pediatric Obesity. 3: 72-77 Read More