Social Influences on Eating Disorders - Coursework Example

Eating Disorders Introduction Overweight and obesity are both addressed to individuals with ranges of weight that are greater than what is generally considered healthy for a given height. Childhood obesity is a major problem and most of the children who are obese tend to grow up to be obese adults with physiological, biological and social repercussions. At present in the United States 15% of children under the age of 6-11 years and 16% of children under the age of 12-19 years are obese and at risk for developing life threatening diseases. Studies point out that obese children are more likely to be poor and live in low-income neighborhoods where access to quality, nutritious, and reasonably priced foods is often limited. These problems also vary among different cultures. For instance, African American and Hispanic children are more likely to be obese than White and Asian children (Sealy, 2006). Furthermore, several researchers pointed out that social and psychological problems such as stigmatization and poor self-esteem are leading to depression and anxiety in obese population. A lack of proper intervention in childhood obesity may result in overweight adolescents and obese adults (Desjardins and Schwartz, 2007). This paper discusses the social influences on behavior resulting in the eating disorder and childhood obesity and also suggests various interventions for how social work practice can be instrumental in improving health outcomes for children. Researches on Obesity Obesity is not a new problem. As early as 1952, the American Heart Association had already identified obesity as a cardiac risk factor modifiable through diet and exercise. Subsequently, a number of federal agencies and private organizations devoted to general health promotion or to prevention of chronic conditions for which obesity is a risk factor—coronary heart disease, cancer, osteoporosis, stroke, and diabetes— issued guidelines advising Americans to reduce energy intake, raise energy expenditure, or do both to maintain healthy weight (Nestle and Jacobson, 2000). Estimates suggest that in the United States alone 33 percent of adults and 20 percent of children are considered obese and the prevalence of obesity continues to increase in the United States for both children and adults. These studies also point out that there are multiple cultural, environmental, genetic, and behavioral factors identified as possible causative agents. Obesity is of great public health concern, because it is directly related to diabetes, hypertension, osteoarthritis, and other chronic conditions. The National Institutes of Healths National Obesity Education Initiative has proposed a classification for disease risk relative to normal weight and waist circumference. These standards have been supported by the World Health Organization. It is important to note that most of the children who are obese tend to grow up to be obese adults are prone to various diseases. Childhood obesity is a major problem and many of the children are exposed to fast foods and junk foods on a day-to-day basis. Factors for Childhood Obesity and Social Interventions Childhood obesity is not a result of single factor rather there are several factors responsible for obesity. It is associated with many negative social and psychological consequences. For instance, obese children are more subject for peer aggression and bullying behaviors. Claude Bouchard, Executive Director, Pennington Biomedical Research Center proposed several hypothesis for this epidemic including behavioral, physical environment, and biological approaches. Behavioral hypotheses include intake of high-calorie foods, high-fat diets, high sugar intake, low calcium intake, low protein intake, and a large amount of time spent in sedentary activities. For instance, children spent most of their time before the televisions and computers rather than in outdoor games. It is therefore essential that social workers together with parents, teachers and other community leaders take the first step to prevent the growth of obesity. Though there are many such studies on the factors responsible for childhood obesity, there in lack of studies in the social aspects linked to obesity. Obesity in general and childhood obesity in particular, has serious adverse health consequences. Obesity causes many health problems such as heart disease, high blood pressure, hardening of the arteries, type 2 diabetes, metabolic syndrome, high cholesterol, asthma, sleep disorders, liver disease, orthopedic complications, and mental health problems are just some of the health complications of carrying excess weight. In the current status there are possibilities that given the increasing prevalence of severe childhood obesity, children today may live less healthy and shorter lives than their parents (Olshansky, et al. 2005). A study conducted by Janssen et al. (2004) found that with the exclusion of 15- to 16-year-old boys, relationships were observed between BMI category and peer victimization. For example, overweight and obese youth were at greater relative odds of being victims of aggression than normal-weight youth. Additionally the study also pointed out that strong and significant associations were seen for relational for instance, withdrawing friendship or spreading rumors or lies and overt behaviors such as name-calling or teasing or hitting, kicking, or pushing victimization especially for the obese group. The study concluded that “overweight and obese school-aged children are more likely to be the victims and perpetrators of bullying behaviors than their normal-weight peers” (Janssen, et al. 2004). There are also studies that indicate that sometimes stress or emotions can stimulate obesity among children. It is a common tendency for children and even adults tend to eat more when they are upset, anxious, sad, stressed out, or even bored. For instance, children who are obese do not involve themselves in outdoor games because they are not entertained by other children of the same age. Therefore they restrict themselves to their house and get bored. In order to overcome their bourdon, they eat more and more. Increases in television and computer game use have led to a sedentary life style among children. Most of the parents are working and they are unable to find the time or energy to cook nutritious meals or supervise outdoor playtime (Paxson, et al. 2006). Obese children suffer more in term of social stigma and issues such as privilege, oppression, discrimination. Their huge bodies restrict their free movement when compared to other normal children. As a result many of them feel embarrassed to be a part of their peer group as they are always a subject of humor. Several times an obese child may develop peer-related phobias due to harassment from classmates that create additional stress on them and makes them eat more and more. Social workers can play an important role to create awareness in the schools to be more compassionate towards these individuals and help them to fight obesity. Teachers especially the physical trainer need to see to it that obese children undertake special physical training in exercise and help them to monitor their eating habits. Obese children tend to develop social stigma over a period of time. This may include verbal types of bias such as mockery, joking, verbal abuse, stereotypes, offensive names, or pejorative language. Physical stigma such as touching, grabbing, or other aggressive behaviors are also experienced by these children. Additionally in social assemblies barriers and obstacles due to weight such as medical equipment that is too small for obese patients, chairs or seats in public venues which do not accommodate obese persons, or stores which do not carry clothing in large sizes.  Children attribute several negative characteristics to overweight peers including being stupid, ugly looking, unhappy, lazy, and having few friends. As a result of such behaviors, studies show that children who are victims of weight stigma internalize negative attitudes and engage in self-blame for the negative social experiences that they face. Additionally, there are also studies on adolescents that point out that weight-based teasing is linked with low self-esteem and depression, and are more likely to be socially isolated. Studies also point out that in recent years the suicidal tendency among obese youth in increasing (NAASO, 2007). Social workers can help the parents monitor the calories intake and the amount of physical activity they do. As lives become busier, there is less time to cook healthy meals, so more and more people eat at restaurants, grab takeout food, or buy quick foods at the grocery store or food market to heat up at home. All of these can contain lots more fat and calories than meals prepared from fresh foods at home. Social workers and nutritionists can help to prepare personalized charts for families where obesity is a problem. In most cases, weight problems arise from a combination of habits and genetic factors. Certain illnesses, like thyroid gland problems or unusual genetic disorders, are uncommon causes for people gaining weight (Gavin, 2007). Child’s environment also plays a significant part. Children tend to have high-fat diets, often putting taste and convenience ahead of nutritional content when choosing meals. While most of them have no more psychological disturbance than normal weight children, about 30 percent of them who seek treatment for serious weight problems have difficulties with binge eating. During a binge eating episode, people eat large amounts of food while feeling they cant control how much they are eating. Those with the most severe binge eating problems are considered to have binge eating disorder. These people may have more difficulty losing weight and keeping the weight off than people without binge eating problems. Some will need special help, such as counseling or medication, to control their binge eating before they can successfully manage their weight (Indiadiets.com, 1999). Childhood obesity is a medical condition that affects children and is characterized by a weight well above the mean for their height and age and a body mass index well above the norm. The obesity epidemic is particularly evident in developed countries where many people live sedentary lives and eat more convenience/fast foods that are typically high in calories and low in nutritional value. In just two decades, the prevalence of overweight doubled for U.S. children ages 6 to 11 — and tripled for American teenagers (Mayo clinic staff, 2006). The ways a social work could begin their intervention is by identifying relevant issues such as privilege, oppression, discrimination, and other factors that promote change in childhood development. Once the obese children are able to overcome their negative feelings regarding themselves, they will be open towards improving their health and eating habits. It is not surprising to note that dietary patterns have changed significantly over the past few decades. In earlier days malnutrition and under nutrition was commonly heard but now these terms have been replaced by over-nutrition (Kendall, et al. 2006). Lack of knowledge on how to obtain optimum health is another significant problem. Today there are a lot of sources such as advertisements, television shows that promote unhealthy eating habits among children who are easily mislead. It is the responsibility of parents, teachers, social workers and the society as a whole to educate the kids and create awareness among them on good health. The programs social worker sets behavioral goals for each child, and helps parents devise a reward system to reinforce children when they follow nutritional guidelines and increase their activity by exercising. Family involvement is also an important part of the program. Obese children also suffer socially, and depression is not an uncommon affliction (University Specialty Clinics, 2002). Obesity can have social, psychological and emotional consequences on children. Social and psychological consequences may include stigmatization, discrimination and prejudice. Research has linked obesity with low self-image, low self confidence and depression not only in children but also in adults (POSTNOTE, 2003). As mentioned earlier obese children often are treated differently in their peer groups that may be the most disturbing effect of obesity. Obese children may feel isolated and lonely and can result in self-esteem and identity problems (Kendall, et al. 2006). There are several programs to create awareness. For instance, in the film “Super Size Me”, Filmmaker Morgan Spurlock explores the horror of school lunch programs, declining health and physical education classes, food addictions and the extreme measures people take to lose weight and regain their health. It also brings out the fact that 37% of American children and adolescents are carrying too much fat and 2 out of every three adults are overweight or obese. It also tries to answer questions such as is it our fault for lacking self-control, or are the fast-food corporations to blame? How to improve children’s diets is one of the most pressing food policy questions in today’s society. Increasing trend in diet-related disease are to some extent attributable to profound shifts in the ways the children and families eat, which have occurred over the past two decades. Due to the busy state of parents, more meals are consumed outside of the home and are often purchased directly by children. Food products are also heavily promoted to children, targeting them directly and tapping the ‘pester power’ of younger children. Increases in diet-related disease are partly attributable to profound shifts in the ways the children and families eat, which have occurred over the past two decades. It is clear that child’s diets are substandard and that diet-related ill-health and obesity are on the increase. Parents should be responsible for the diets of their children, and need to control them. If parents discharge this duty sincerely by ensuring sufficient home diets, they also can reasonably be held responsible for what their children eat outside the home? (MacMillan, et al. N.D.). Toddlers and preschoolers spend more time eating at home than they do in school. Their food choices and food preferences are thus largely dependent on what their parents and caregivers provide. When children are young, their parents and families have greater control over what they eat. As they get older, however, what their friends eat in the school environment, and what is available to them in school and elsewhere, will have an impact on what they eat. What children eat at school is dependent on many factors, including the cafeteria environment, peer pressure, administrative support, teacher participation, cafeteria staff, and the quality of food choices offered. Several school have negotiated exclusive contracts with fast food and beverage companies to provide their products to students, with a portion of the revenues or profit going to the schools. Consequently, cafeteria and vending machine lunches commonly include pizza, burgers, chips, soda, candy, and ice cream. Exacerbating the situation, about twelve thousand schools (with eight million students) show Channel One, which features commercials promoting junk food. Children need nutritious foods to grow and to function. Many American adolescents skip breakfast by choice either because they do not have the time to eat or in order to lose weight. Additionally, many school-aged children depend on junk foods for their nourishment. Studies on American adolescents show that, they have inadequate intake of fruit, vegetables, and whole grains. More than one-third of their daily intake comes from eating snacks between meals that include high-fat fast-food items such as cheeseburgers and potato chips. American teens consume more than a third of their calories from saturated fats. The Centers for Disease Control and Prevention has reported that 70.7 % of high school students do not eat five or more servings of fruits and vegetables during the day, that 72.6 % do not attend physical education class daily. As a result of these factors childhood obesity is increasing. Globalization and free trade have brought fast-food eating establishments to most countries, especially to developing nations. McDonalds, Pizza Hut, Burger King, and places like these are commonly found in Europe, Asia, Australia, the Caribbean, and Latin America. Vegetable oils and fats are cheap and easily available, and more food products high in fats are accessible even to those of low-income persons in developing countries. Consequently, even poorer nations are no longer immune to the ills of Westernization, including obesity. The shrinking world brought about by television and the Internet has created a culture flooded by junk snacks, sodas, pizzas, and convenience foods. Eating a meal at the table is no longer a tradition, as nuclear families are rarer. Teens are used to "grab and run" eating styles, as are many adults. Food manufacturers and franchisers take advantage of this profit-making opportunity to produce more convenience foods, snacks, and beverages that are high in fats and calories. Children and teens prefer popular, tasty, and easy-to-find junk foods. The average American consumes more than forty-two gallons of soda a year (Neill, 2006). Besides, public policy needs to limit junk foods in schools and also encourage families to make healthful food choices for their children. Healthy eating habits are an essential for every individual. It is more so in the case of children as each and every cell in their body has special nutritional requirement for growth. Hence, it is important for children to develop good eating habits in the early stages of their life. Recent years has witnessed this trend and is almost tripling over the past few decades. If this trend continues it is estimated that almost 25-50 % of today’s children will become over-weight or obese adults. The only way to reduce these problems is by modifying the eating habits through good education and by creating awareness among the children. These statistics could be reduced if children learn to make proper food choices. With the busy schedule of parents, children are used to eating outside and are enjoying the food that does not have much of nutritional benefits. Social workers, education institutions, parents and the medical authorities need to find ways to fight childhood obesity. The habit of eating foods of little or no nutritional value such as cookies, candy, chips, and doughnuts contributes empty calories to the diet. Similarly, food such as pizzas, ice creams, and French fries have become their favorites among children. Sometimes, these foods are chosen as rewards by parents to make their child obey them which is a dangerous trend. Though most of the parents know the fact that eating outside may lead to various short and long term problems, they continue to follow this trend. Eating outside usually prevents children from being open to eating the wide variety of fruits and vegetables that provide essential vitamins and minerals needed for growth and good health. Every parent wishes to feed their kids with nutritious food. It is not just the wish of parents but it is also the need of every child that they are well nourished. It is a well known fact that only when children get required and balanced nutrients they have good physical and mental growth. The requirement of energy is high for kids since most of them are always into playing and running around. Though it is the primary responsibility of the parents to provide good nutritious food, it is also important that children themselves are made aware of what good food is and what the bad foods are. It is essential to help them become responsible for their own nutrition and eating habits so that they eat judiciously. If good habits are taught early in life, children tend to continue these habits throughout their lifetime. Social workers also need to work with the patents of obese children to help them fight against the mental depression and other psychological problems the child face. The ways a social work could begin their intervention is by identifying relevant issues such as privilege, oppression, discrimination, and other factors that promote change in childhood development. Additionally, social workers can advocate, challenging policymakers, cabinet members, healthcare providers, voluntary organization and the food and fitness industries to mobilize efforts in response to the obesity epidemic. The foods in restaurants are mostly a combination of color, preservatives and lot of other toxic substances that is harmful not only for children but also elders. Some of these foods also contain some allergens that create serious health problems. In the book entitled “Eat Healthy, Be Healthy-A Practical Guide and Menu Planner to Eating Healthy and Feeling Better” Dianna Barra explains how the health of their family was affected when they were exposed to the restaurant food and how they gained back the health when they retrieved to home made nutritious food. In this book the author says that life threatening diseases such as cancers, auto-immune diseases, hyperactivity and many more are caused due to environmental toxins and poor and contaminated food supply (Barra, 2002). Children’s eating patterns and food preferences are established early in life and as parents it is their responsibility to inculcate good habits into their and their children’s life. It is estimated that problems associated with eating occur in 25% to 35% of all children (Linscheid et al., 1995). Most eating problems are temporary and are easily resolved with little or no intervention. Children’s frequent exposure to fast-food and restaurant food have restricted them from nutritious foods such as fruits and vegetables (Zoumas-Morse et al. 2001). “According to a research conducted by Harvard University from 1996 to 1999, it was found that the number of children who regularly ate meals outside the home increased by two times or more during the three years of the study. This alteration in eating habits was also associated with increasing weight gain in boys, plus restrictions in childrens access to healthier foods” (Billingsley, 2005). There is several other studies conducted world over with the increase in childhood obesity, type II diabetics and other life style diseases among children. Most of these studies point at the fact that bad eating habits are the main culprit that is hazardous to children’s health. If this trend continues children will not be able to reach adulthood with a healthy mind and body. Today’s children are tomorrow’s future but it is only possible with a healthy eating habits. In conclusion, it can be said that it is very important to monitor the eating habits of children as if their habits are not good, it may cause serious health problems. As obese children go their adult hood, they continue their eating habits and most of them are prone to lifestyle diseases such as heart diseases, diabetics, joint diseases etc. It is essential to create awareness among parents and children regarding this aspect and take necessary steps to prevent health problems. Social workers can play an important role in helping the parents and obese children. The educational institutions, the food industry, the health care sector, government and non-government organizations and other agencies need to play a major role in creating awareness among the consumers today. Besides individuals need to take charge of their health by controlling the unwanted intake of junk food, unhealthy drinks and also to exercise daily in order to be healthy. Most of these studies point at the fact that bad eating habits are the main culprit that is hazardous to children’s health. If this trend continues children will not be able to reach adulthood with a healthy mind and body. It is important to realize the hazards of children eating outside. Parents and children need to realize these facts and act accordingly. Today’s children are tomorrow’s future but it is only possible with a healthy eating habits. References Barra, D. (2002) Our Story-Our Quest for Better Health. In: Eat Healthy, Be Healthy-A Practical Guide and Menu Planner to Eating Healthy and Feeling Better, Idea Designs: Instructional Designs for every applications, LLC. July 2002, 6-10. Billingsley, J. (2005) More American Kids Eating Deep-Fried Fast Foods, HealthDay News, October 3, 2005. Retrieved on 11 October 2007 from http://epsl.asu.edu/ceru/Articles/CERU-0510-145-OWI.pdf Desjardins, E. and Schwartz, A.L. (2007) Collaborating To Combat Childhood Obesity, Health Affairs, 26, no. 2 (2007): pp 567-571. Gavin, M.L. (2007) When being overweight is a problem, April 2007, Kidshealth.org, Retrieved on 11 October 2007 from http://kidshealth.org/teen/food_fitness/dieting/obesity.html Indiadiets.com, (1999) Causes of Obesity, Indiadiets, Retrieved on 12 October 2007 from http://www.indiadiets.com/diets/Weight_reduction/Obesity/causes_of_obesity.htm Janssen, I. et al. (2004) Associations Between Overweight and Obesity With Bullying Behaviors in School-Aged Children, Pediatrics Vol. 113 No. 5 May 2004, pp. 1187-1194. Kendall, P., Wilken, K., and Serrano, E. (2006) Childhood obesity, Colorado State University Cooperative Extension- Nutrition resources, Retrieved on 13 October 2007 from http://www.ext.colostate.edu/pubs/foodnut/09317.html Linscheid, T.R., Budd, K.S. and Rasnake, L.K. (1995), Pediatric feeding disorders. In: Roberts MC, ed. Handbook of pediatric psychology. Second edition, New York, NY: Guilford Press; 501-515. MacMillan, T., Dowler, E., and Archard, D. (N.D.) Corporate responsibility for children’s diets Retrieved on 11 October 2007 from http://www.ccels.cf.ac.uk/literature/publications/2005/macmillan.pdf Mayo clinic staff, (2006) Childhood obesity, Mayo Foundation for Medical Education and Research, Retrieved on 11 October 2007 from http://www.mayoclinic.com/health/childhood-obesity/DS00698 NAASO, (2007) Obesity, Bias, and Stigmatization, The Obesity Society. Retrieved on 19 October 2007 from http://www.obesity.org/ Neill, K. C. (N.D.) School-Aged Children, Diet of, Retrieved on 11 October 2007 from http://www.faqs.org/nutrition/Pre-Sma/School-Aged-Children-Diet-of.html Nestle, M. and Jacobson, M.F., (2000) Halting the Obesity Epidemic: A Public Health Policy Approach Public Health Reports, Volume 115, 12-24, January/February 2000, Retrieved on 10 October 2007 from http://www.cspinet.org/reports/obesity.pdf Olshansky, J.S. et al. (2005) A Potential Decline in Life Expectancy in the United States in the 21st Century,New England Journal of Medicine 352: 1138–45. Paxson, C., Donahue,E., Orleans, C.T., and Grisso, J.A. ( 2006) Introducing the Issue, In: Childhood obesity The Future of Children Vol 16 No 1 Spring 2006. Retrieved on 10 October 2007 from http://www.futureofchildren.org/usr_doc/Obesity_Volume_16,_Number_1_Spring_2006.pdf POSTNOTE, (2003) Childhood obesity, The Parliamentary Office of Science and Technology September 2003 No. 205. Retrieved on 12 October 2007 from http://www.parliament.uk/post/pn205.pdf Sealy, Y.M. (2006) Childhood obesity epidemic: Public health social work practitioners address the mediating factors pervasive in communities. In: Public health and Human Rights: APHA 134th Annual Meeting and Exposition, November 4-8, 2006, Boston, MA. University Specialty Clinics, (2002) The Childhood Obesity Epidemic, Connections, Columbia, Retrieved on 15 October 2007 from http://specialtyclinics.med.sc.edu/PDF/Connections2002_11.pdf Zoumas-Morse, C., Rock, C.L, Sobo, E.J and Neuhouser, M.L. (2001) Children’s patterns of macronutrient intake and associations with restaurant and home eating. Journal of the American Dietetic Association;101(8): pp 923-925. Read More