Obesity in Children is Defined by Ogden and Flegal

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Emmet and Chandra (2015) state, “Many healthcare professionals have stated that obesity is a major problem in the United States. The rate of obesity in young people has been rising until just recently, when it was reported to have leveled off.” Boero (2007) states, “Increasingly the term ‘epidemic’ is being used in the media, medical journals, and health policy literature to describe the current prevalence of overweight in the United States.” Obesity in children is defined by Ogden and Flegal (2010) as a, “BMI of greater than or equal to the age- and sex- specific 95th percentile of the 2000 Centers for Disease Control and Prevention growth charts.

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” In a survey it was found that nine out of ten parents understand that childhood obesity is a problem; however, half of these parents failed to see that their own children were obese (Howe 2008).

Doctors begin to use the BMI chart from the ages of 2 up to the age of 19. The purpose of the BMI chart is used as a measuring tool to evaluate whether a child is underweight, healthy, overweight, or obese.

Using a BMI chart for children is sometimes viewed as controversial since children are changing body shape because they are growing. Also utilizing bmi it does not distinguish between having fat or muscle (Lazarus, Baur, Webb, Blyth, 1996). Obesity in children is a very complex and serious issue that has serious health consequences. The obesity epidemic corroborates with obesity-related diseases such as: hyperlipidemia, hypertension, and type two diabetes mellitus (Treas, Wilkinson, Barnett, Smith 2018). Hyperlipidemia is a high concentration of fats in the blood.

Hypertension is a condition in which the blood pressure is high above 130/80. Diabetes mellitus type 2 is a condition where the body is affected in the way that it process glucose.

Researchers have determined that it is vital to have clearly defined policies and procedures that can help in prevent childhood obesity (Reed, Viola, and Lynch 2014). Neglect can cause obesity in children because of, “food of poor quality, erratic eating patterns, and poor supervision of the diet (Treas, Wilkinson, Barnett, Smith 2018)”. It is essential to teach parents about obesity and how to resolve it.

Demographics

This paper focuses on health problems that are caused by obesity in U.S. children from the ages of two to eighteen. This paper is not specified to a certain age, gender, race, ethnic group, or developmental level. The essence of this paper is to understand what childhood obesity is, why it occurs, and how to combat it so that children can be healthy. Education is needed to explain how to become healthy and reduce obesity rates which is directed to all U.S. parents and legal guardians.

Incidence in Target Population

According to the CDC, “In 2015-2016, the prevalence of obesity in youth was 18.5% (Hyattsville, 2017).” The way the obesity is broken down is that in children from two to five years it is 13.9%, in children from six to eleven years it is 18.4%, and from twelve to nineteen years it is 20.6% (Hyattsville, 2017). The prevalence of obesity is seen to be higher in Hispanic and black children compared to white children (Hales, Caroll, Fryar, Ogden, 2015-2016). The NCHS report states, “There was no significant difference in the prevalence of obesity between boys and girls overall or by age group (Hales, Caroll, Fryar, Ogden, 2015-2016).” This concludes that gender and age do not have a strong correlation with obesity in children.

Role of Nurse

Assessment

The nurse needs to promote health and understanding by implementing solutions to decrease childhood obesity. It is vital that the care given to every parent and guardian is individualized and appropriate to ensure proper understanding and willingness to participate. The nurse needs to have an understanding of what the parent knows by establishing a foundation. To establish this foundation they should ask questions that include: whether the guardian understands why their child is considered obese, the diet that their child sustains, and the amount of activity that their child participates in. Also it needs to be established whether the parent acknowledges that their child is obese and what implementations they have done to help their child lose weight. If during this research it is found that the parents are not fulfilling the basic responsibilities that they should be then referrals need to be implemented prior to teaching. With the preliminary knowledge obtained the nurse proceeds to learn if there are any obstacles that can restrict success. One of these obstacles may be the socioeconomic status of the family. This is vital information since some parents believe that eating healthy is too costly and time consuming. Financial concerns can be answered by explaining that with preplanning and meal prepping the food provided would be more nutritious and cost effective. By establishing the current role that the parents are partaking in the nurse can then focus on the areas where the parents need guidance. Special considerations should be implemented in making learning beneficial. This is established by finding the most effective teaching approach. Some parents may learn better visually while others are auditory learners. The developmental level of the guardian must be established. If the parent has a rudimentary understanding of writing and reading, then they may not be able to read brochures so a different approach would be used.

Planning

In order for the goals to be realistic and client-catered it is vital that the nurse selects the most appropriate teaching method. Parents and guardians need to be given both short term and long term goals that are clearly defined and attainable. The nurse needs to be prejudice free, supportive, and respectful in the views of the parents. A short term goal would be that after teaching, the parent is able to communicate what the US dietary guidelines are for their child’s age and height. Another short term goal would be for the child to have a food diary for a week where they track the consumed food and then analysis will be done to determine where the child can improve their eating habits. The most important long term goal would be for the child to obtain a healthy BMI in the ranges of 18.5- 25. Another long term goal would be for the whole family to eat one meal at the table together to demonstrate that they are united in helping the child. It is essential to establish good eating habits at the dinner table since the child watches and mimics their parents. To the child the parent is a role model that they strive to mirror, so if a parent can show the child that they are eating healthy then the child will in effect be pushed to replicate the same healthy eating. The final long term goal would be for the child to remain active every day for at least sixty minutes.

Implementation

Learning should occur in an environment that has few distractions and is productive for understanding; however, teaching can be done whenever it is possible. The tone of voice used should always be calm, respectful, and understanding. The age of the guardian should be taken into consideration because if the parents are older they may require multiple breaks to prevent exhaustion. When teaching about obesity the client should be provided: videos, discussions, a list of programs that enforce healthy eating, pamphlets and a time for any final questions to be asked. The first teaching method is a pamphlet that clearly states what a body mass index (BMI) is and why it is important. This will help to ensure that the parents understand why their child is considered to be clinically obese. For parents who are technologically adequate they should be shown MyPlate on a computer. The nurse can then show the various links and resources that MyPlate provides. The parents will be able to input their child’s information in order to receive a daily recommended allowance. Also MyPlate provides tips for parents to eat healthy while being cost effective. If the parents are more auditory then visual learners, then they can be shown the British show Supersize vs Superskinny kids edition. This show can be watched by both the parent and the child. The premise of the show is to show two extremes of when children do not eat properly. While explaining how the diets are bad for the child the show provides various ways to eat healthier. The knowledge that the guardian receives should be urged to be spread to others. By spreading the information received then the childhood obesity rates can be lowered.

Evaluation

Teaching the parent is very important; however, if the parent did not grasp the information then it is essentially useless. When the nurse finishes teaching then they should assess on how effective their teaching was. If the parent shows full understanding then they will be able to show desired outcomes; however, if they are confused then new implementations must be made. The nurse can give an exam that focuses on obesity and healthy eating. With the results of the exam the nurse can see what areas the parent may need assistance and relearning. The nurse can then have the parent make a calendar of the days that would work best for the whole family to eat together or to meal prep. The parent could also explain how they will ensure that their child is eating healthy and exercising by having a journal.

Summary

Child obesity rates have increased throughout the years in children who range from the age of two to nineteen. There is no correlation in the gender or the age that impacts these rates. Obesity has caused the children to have an increased risk in obtaining: hypertension, hyperlipidemia, and type two diabetes. By providing the parents teaching and establishing clear attainable goals it allows the nurse to see improvements in the child’s goals.

This paper helped me to understand how important our role is in health promotion. Obesity in children is a growing problem that we as health care workers need to decrease. I have learned that in order for me to be successful I must find the teaching approach that will be most helpful for the parent. Once I finish teaching I need to evaluate how well the parent has learned. If an evaluation is not done it can mean that the child will not be successful in losing weight. It is our responsibility to be very professional and to only use evidence based research when teaching someone. By using non-evidence based research we are allowing the parents to receive misguided information that can impact the success of the care plan.