The problem of childhood obesity - Research Paper Example

?Chapter I – Introduction ment of the problem The purpose of this study is to explore the problem of childhood obesity and the roles of the parents’ and the state with regards to the health issue. Pertinent questions to be considered are: 1.) How serious is childhood obesity globally? 2.) What are the causes of childhood obesity? 3.) What are the effects of childhood obesity on the child, on the parents and on society? 4.) How can childhood obesity be treated or prevented? 5.) Should parents be held responsible for the obesity of their children? 6.) Should the state be allowed to separate an obese child from the parents? 7.) Should the problem of childhood obesity be confined within the family? Definition of Terms Obesity. Merriam-Webster defines the word as “a condition that is characterized by excessive accumulation and storage of fat in the body…” (obesity) The National Institutes of Health says it is having a “BMI of 30 and above.” (WebMD) Plainly speaking, obesity is being more than overweight. Overweight. A person who weighs “too much or more than what is considered normal, proper, etc.” is said to be overweight. (overweight) The appropriateness of a person’s weight depends on the individual’s age or built. This phase comes between normal and obesity. Body Mass Index (BMI). Used to measure determine obesity, an individual’s BMI is the result of dividing a person’s weight in kilograms by the square of the person’s height in centimeters. (body mass index) The Centers for Disease Control and Prevention (CDC) in the United States define BMI as a “reliable indicator of body fatness for most people and is used to screen for weight categories that may lead to health problems.” (CDC) There are numerous BMI calculators on the Internet to help people determine if they are overweight or obese. Energy Intake. The total number calories an individual takes in daily is the amount of energy in that person’s body available for use. If the person takes in more calories than he uses up, this leads to being overweight and obese. Brief Review of Related Literature Childhood obesity is believed by medical practitioners as a strong factor in sicknesses manifested by obese adults. Supposedly, obese children eventually grow up to be obese adults. Together with the fat, these adults develop diabetes, heart problems and other weight-related health problems. A study was conducted to explore the relationship between childhood body-mass index and the risk of coronary heart disease in adulthood. (Baker, J., et. al., 2007) It was discovered that children with a high BMI had a greater risk of coronary heart disease as adults. The reasons children are obese are attributed to genetics or external factors such as unhealthy eating habits or lack of physical activity. However, doctors (Boland, W., 2010) argue that genes do not necessarily cause obesity, saying that if this was the case then the same number of individuals would be overweight since they inherited the genes causing obesity. They cite instead “innumerable environmental changes that foster eating more frequently” such as the availability of high-energy food, fast food, increased marketing of snack foods and increased time for socializing with food and drink. Because it is the parents who are tasked with the well-being of their children, they are often held accountable for their children being overweight and obese. The parents claim they only want and provide what is best for their children. However, studies seem to prove otherwise. Research on public health interventions in the United Kingdom (Clark, H.R., et. al., 2007) show that when it comes to feeding their children, parents do monitor, put pressure to eat and restrict. Nevertheless, the research concluded that parents may unconsciously encourage weight gain because their child-feeding practices are wrong. Moreover, a study comparing parental control and support of families with overweight and non-overweight children showed inadequate control strategies and less parental support from the latter group. (Moens, E., et. al., 2007) Because obesity in children poses as a threat at that stage and later on when the child becomes an adult, the state has found in necessary to step in and take the obese child from the parents. As a consequence, parents and social groups have found this measure a drastic move and disapprove of it, claiming that children need to be with their parents at this troublesome time. A study on state involvement in childhood obesity has been done, focusing on judicial opinions and commentary from legal and medical groups. It shows that interference by the state should only be done when these four factors are met as they mean short-term loss of life or a current risk of serious harm. These considerations are: “the severity of the child’s illnesses associated with obesity; the degree to which medical treatment can mitigate the resulting adverse health effects; an assessment of the child’s complete physical and mental health; and when the just answer remains unclear, the child’s risk of remaining obese as an adult.” (Mitgang, M., 2011) Highlights of Methodology This research will utilize random sampling in order to gather actual practices and opinions of parents. A questionnaire containing common eating practices in the household will be made available to two groups of parents, one with obese children and the other without obese children. Limitations of the study There may be several limitations to the study. As the problem of childhood obesity is widespread, the results to be gathered would only make up a small percentage of the total number of parents in the world. Also, as parents would not want to be seen as inefficient in caring for their children, they may not answer the questionnaire truthfully. Furthermore, although results may prove to be in favor of state intervention, parents may still disagree as to do otherwise may make them appear to be bad parents. Research Expectation The study will attempt to present the opinions of parents with or without obese children regarding state intervention in this family health issue. It is hoped that this research will enlighten the parents regarding the dangers of childhood obesity and their role in the prevention or treatment of the problem so as to discourage the need for the state to interfere. Chapter 2 – Review of Related Literature In the United States, research done by The National Health and Nutrition Examination Survey shows that childhood obesity in the country was already noticeable as far back as 1963 with the cases of obese children just continuing to increase through the years. (Marks, S., 2011) The survey focused on children aged two to nineteen. While obesity is considered an epidemic in the United States, the World Health Organization says the severity of the problem differs from country to country. (Miller, 2011) Since it is easier in some areas of Mexico to get a soda than a clean glass of water, the percentage of overweight or obese Mexicans have tripled from 1980. (Harrod, H. & Mitting, F., 2012) In Nauru, an island in the Pacific, “97 per cent of men and 93 per cent of women are overweight or obese” because the people now eat imported processed foods instead of fish, coconuts and root vegetables. (Marks, K., 2010) In Jamaica and Mauritania, heaviness is associated with happiness and heavy women are considered attractive, respectively. (Harrod, H. & Mitting, F., 2012) Thus, almost 50 per cent of the population is overweight. Experts say obesity can be caused indirectly by “social and economic development, modernization, urbanization and globalization.” (Mo-suwan, L. & de Silva-Sanigorski, A., 2010) Technology, though not solely to blame, has influenced the younger generation into spending more time in front of the television or the computer. A study of kindergarten kids and the effect of television watching and frequency of family meals showed a direct relationship between these activities and a child’s weight. (Gable, S., et. al., 2007) Mass media has also contributed in making unhealthy food appealing to children. Research in Australia regarding the impact of television food advertising on children shows that 63 out of the 96 food advertisements aired on TV were about high-fat/high-sugar food. (Kelly, B., et. al., 2007) A 2004 survey of the World Health Organisation discovered that British children are getting bigger because they snack on chocolate, sweets and carbonated drinks. (Laurance, J., 2006) Children seem to have lost the interest to engage in physical activities. A search and study of controlled trials of school-based lifestyle interventions revealed that physical activity and proper diet may prevent children from becoming overweight in the long-term. (Brown, T. & Summerbell, C., 2009) They are now more preoccupied in checking emails and social networking sites, elevating their ranking in combat games or texting. Instead of burning energy, the calories continue to pile up. Being obese can lead to more serious problems. Obese children are more likely to continue being obese as adults. Once older, they have been known to manifest health problems such as high blood pressure, type 2 diabetes, elevated blood cholesterol levels as well as low self-esteem, negative body image and depression. (American) Because of this, the state has stepped in, claiming an obligation to look after the welfare of the child should parental care be lacking or not contributing to the well-being of the latter. Alexander Draper, a 14-year old who weighs 555 pounds, was taken from his mother and placed in foster care while his mom is being charged of child neglect and endangerment. (Associated Press) A third-grader from Cleveland who weighed more than 200 pounds and a 3-year old girl who weighed 90 pounds were placed in foster care as ordered by the juvenile court. (Newcomb, A., 2011) The act of removing an obese child from his parents as suggested by a medical expert has quickly become controversial as some people disagree and believe the separation can cause further problems. (Rochman, B., 2011) It is a common saying that parents’ know what is best for their children. Nevertheless, the state claims that it has the duty to protect everyone, even children, from anything or anyone that is detrimental to their health. This includes the children’s parents. Since the state already separates children from their abusive mother or father, it reasons that the same can be done for obese children. Such action has been met with disapproval. Fathers and mothers complain that taking their children away during a problematic stage in the latter’s life is not helpful in solving the problem. Moreover, they believe that they are helping their children overcome obesity but resolution does not happen overnight. The preventorium, an institution built when tuberculosis (TB) was still an epidemic, housed children who were taken care of to prevent them from getting the disease. Numerous preventoria were made where the young slept, played and had classes for months or years while most parents stayed at home battling TB. During the time of the preventorium, “boundaries between individual freedom and the need to protect the public’s health…how much control parents should have over their own children, and who should decide what interventions are ‘in the best interest of the child’” (Connolly, C.A., 2011) were issues of concern among parents, medical practitioners and state officials. Indeed the problem of childhood obesity is an issue that warrants much attention by the state. However, as the research done by Mitgang (2011) suggests, state intervention in childhood obesity should be done on a case-to-case basis. For every case, the four factors mentioned in the introduction of this paper should be applied. Only if these considerations are met should the state meddle in the resolution of this family problem. This paper will attempt to further look into childhood obesity as a problem among parents and their children and consequently should be resolved within the family. In line with the studies done on this health issue, this research will also explore the significance of the family’s lifestyle on the obesity of the children and illustrate that no immediate interference from the state is necessary. Chapter 3 - Methodology Overview Childhood obesity is currently listed by the World Health Organization as one of the most serious health problems globally. (WHO) In Asia, studies have shown a dramatic increase in obese children as this part of the world becomes more modernized and its people consume less of its agricultural products. (Staff) In Europe, although knowledge is limited as to the variability of why European youth are susceptible to obesity, there is available data to show that cases of obesity are increasing throughout the continent especially in older children and adolescents. (Livingstone, MBE, 2001) In the U.S.A., childhood obesity tops the parents’ list of health concerns, beating drug abuse and smoking. (American, 2012) More than a quarter percent of Americans below 19 years old are clinically obese. (Boland, W., 2010) Meanwhile malnutrition and being underweight have been replaced by childhood obesity as a major health problem in South America. (Deckelbaum, R. & Williams, C., 2001) Despite current interventions in place to prevent the increase of obese and overweight children, the statistics still show rising numbers. Because of this, attention has focused on the parents as they have a direct influence on their children. In their research, Clark and his companions (2007) read through recent writing about child-feeding behaviours and child weight in the United Kingdom. They discovered that parents may use improper child-feeding attitudes which consequently result to weight gain. This conduct is what encourages the state to get involved by removing the child from what is supposed to be a harmful environment. Restatement of the Problem State intervention in childhood obesity cases has not received favorable responses from parents, the children themselves and some people in the medical profession. To allow the state to interfere in family matters may turn out to be problematic in the future. Questions as to what extent the state can get involved in family affairs and in what situation may arise. As with the use of the preventorium, the state’s action of separating the obese child from his parents and placing him in foster care warrants a closer look. Description of Research Design This research will employ random sampling to discover how parental behavior can influence childhood obesity. Through the prepared questionnaire, the parents’ answers will show similarities and differences, if any, between the lifestyle of families with obese children and those without obese children. With this knowledge, assumptions can be made as to whether parents are a continued threat to their obese children and therefore separation of parents from the obese child by the state is necessary. This approach will be the most suitable for the research as it directly involves the parents who are being partly blamed for the continued obesity of their children. Research has been done on parents’ child-feeding behavior and parental control. However, it is a well-known fact that childhood obesity is not only caused by how parents feed their child and use food as a way to control their children. The family’s lifestyle can also contribute to the health problem of their child. Children are exposed to activities at home that may or may not be allowed by their parents. Such activities may also result to the children gaining weight. Operational Definition of Variables The independent variable for the research will be the group of parents. One group will be the composed of parents with obese children. The other group will be made up of parents without obese children. The dependent variable will be the effect of the parents’ lifestyle on the weight of their children. The weight of the participants’ children will show if the family’s current activities at home have an influence on the size of their children. The participants will be a total of 30 parents with at least two (2) children. The subjects’ children should be between the ages of six (6) to twelve (12), elementary to middle-school level as with Gable’s research on school-aged children. Fifteen (15) parents will have overweight or obese children while the other fifteen (15) will have children of appropriate weight. Negative impact from the family’s activities which may cause obesity will be determined by the similarities between the parents’ answers and the differences found in the answers of the group with obese children. Materials The primary research tool to be used is the questionnaire. (Appendix A) Both groups will be given the same questionnaire containing fifteen (15) “yes” or “no” questions. Answers derived from this questionnaire may help determine if parental behavior actually promotes continued obesity in already obese children and thus warrant state intervention. Selection of Subjects/Sample Subjects will be chosen from parents of school-aged children, obese and not, who attend a local elementary and/or middle school. Procedures Names of ten (10) obese children and ten (10) names of children with average weight will be requested from a local school. The questionnaire will be sent to the children’s parents through e-mail, if e-mail addresses will be available, or post mail. Together with the questionnaire, a form will also be sent describing the significance of the study, the names of the researchers and sponsors, the method of selecting the subjects, the benefits of the research and the incentives for participating in the study. Once completed, participants are requested to return the completed questionnaire via e-mail or post mail. Participants will be then sent gift vouchers for two from a local coffee shop once the completed questionnaires are received by the researchers. Responses to the questionnaire will then be tabulated. (Appendix B) This table will contain all items on the questionnaire, the answers of the participants and the percentage of answers from both groups of parents. Discussion of Data Processing The questionnaire will contain fifteen (15) “yes” or “no” questions about the family’s activities to keep healthy, food choices, etc. Since the questions will be the same for each set of parents, the researchers will be able to distinguish whether or not the parents of obese children are negligent in the well-being of their children. The answers will also manifest which activities of families with obese children are different from those carried out by families without obese children. These differences may be a factor in the children gaining weight. Methodological Assumptions and Limitations Like all other studies, this research comes with limitations as well. It is not a problem to choose the subjects because the choice is based on their children. However, the parents may not take kindly in admitting their children are obese or they knowingly engage in practices that make their children overweight or obese. As such, this group’s answers to the questionnaire may not be as truthful as researchers hope. Ethical Assurances Participants will be assured of utmost confidentiality. Recipients of the questionnaires will not be asked to divulge their names. They will be classified according to their answers as to whether or not they have an obese/overweight child. Appendix A – Survey Questionnaire Parent’s Age: ________ Number of Children: _______ Ages of children: _________ Please encircle YES or NO in response to the following questions: 1.) Do you and your children eat breakfast from Mondays to Sundays? YES NO 2.) Do you and your children have any of the following items for breakfast? If yes, which one(s)? Please cross out. YES NO milk, butter, fried meat, fried eggs, boiled eggs, fruits, bread, juice 3.) Do your children eat at home for lunch? YES NO 4.) If your answer in #3 is NO, are you aware of what your children YES NO eat for lunch? 5.) Do you and your children have snacks? If yes, which one(s)? Please cross out. YES NO popcorn, chips, cookies, pizza, candies, ice cream, chocolate 6.) Do you and your children have at least 1 vegetable dish for dinner? YES NO 7.) Do your children have late night snacks at least once (1) a week? YES NO 8.) Do you have late night snacks at least once (1) a week? YES NO 9.) Do your children spend more than two hours/day on the Internet? YES NO 10.) Do your children spend more than two hours/day watching TV? YES NO 11.) Do your children spend more than two hours/day playing outside? YES NO (example: biking, running, skipping rope, playing tag, etc.) 12.) Do you and your children eat fast food at least twice a week? YES NO 13.) Do your children engage in sports? YES NO 14.) Do you or your spouse engage in sports? YES NO 15.) Do you agree that an obese child should be separated from his/her if there appears to be imminent risk to the child’s health? 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