September: National Childhood Obesity Month
Last night, my third lecture topic for Obesity and Weight Management was Pediatric Overweight and Obesity. In case you couldn’t tell by former blog posts I have written, I get pretty fired up about this topic.
Last year, I wrote a blog post about the first annual National Childhood Obesity Awareness Month in 2010, which is September. September of 2009, I also wrote Mindful Eating and Obesity and a few months prior, about the F as In Fat report.
Today, September 1st 2011, I thought it would be fitting to write a post with some information from last night’s lecture on pediatric overweight and obesity because it is National Childhood Obesity Awareness month, yet again. What a coincidence, huh? I do write that with a slightly sad face because we have a month dedicated to obesity awareness in children but I feel like awareness is crucial in prevention and treatment.
Studies investigating the origins of obesity are becoming much more important (and prevalent) because the prevalence of overweight and obese youth (children and adolescents) in the U.S keeps increasing, despite prevention efforts. The large amount of prevention research and initiatives make sense because obesity and overweight is preventable! It is also much more difficult to treat in adolescence and adulthood because eating habits, behaviors and physical activity have been reinforced through many years of repetition.
Prenatal determinants are fascinating on so many levels, at least in my opinion but especially in regards to obesity and overweight. I’m not talking about genetics, though research indicates there is a genetic component to obesity. Maternal weight gain that exceeds average recommendations appears to increase the risk of childhood obesity, as well as having a Body Mass Index upon pregnancy that classifies as overweight and/or obese.
Adult BMI
Having a BMI of greater than 25-29.9 is considered overweight, 30 to 34.9 is stage 1 or mild obesity, 35-39.9 is stage 2 or moderate obesity, and 40+ is stage 3/ extreme obesity. There are limitations to these classifications because BMI is measuring weight for height, it is not an exact measure of body fatness and it is not ideal for an individual diagnosis. However- it is a good indicator, an effective assessment tool and marker for complications and risks in regard to overweight and obesity. Gestational diabetes and maternal smoking are also prenatal determinants that appear to have a strong association with increased BMI in childhood.
BMI for Age-Gender
For childhood classifications, BMI for age and gender are plotted on CDC/WHO percentile charts that correlate to the classifications in adulthood. 85th- 94th percentile correlates with “overweight”, 95th -98th percentile correlates to “obese”, and 99th percentile to “extreme obesity” for youth. These terms have recently been accepted for use by the Expert Committee although terminology has been arbitrarily debated for awhile due to the social stigmatization and implication of terms in childhood. Should we call a spade a spade or call it an upside down heart with a stem…. ?
Children grow naturally and these charts/percentiles are a helpful assessment tool to stay on the “healthy track”. When we can track weight gain in excess of linear growth, (courtesy of these charts)… we have a marking point or a cutoff that essentially flags potential problems or cause for concern and assists in literature, research, policy, etc.
I had a respectful debate regarding an article that was posted just two days ago on Can Childhood Obesity be classified as Abuse? after an extremely obese child, that was unable to breathe, died.
Some students felt that defining it as abuse is necessary to essentially give parents a “wake up call” to reality. Give the nation a wake up call, the shock effect so to speak (or type). The debate continued because if we were to legalize that definition, the ramifications would be questionable and insurmountable. If we remove children from their home environment because of this neglect or abuse, where do these children go?
17% of America’s youth are overweight or obese. 17 out of 100, if there are billions of children… do you see where I go with this? Is there a feasible way to go into every home where a child is extremely obese, remove them from the home and find a “better environment ” to put them for achieving successful treatment?
The consequences of obesity and overweight seem to have not enough impact with their descriptions or in reality to prevent the issue of “abuse” from even being a debate. Prevalence rates exponentially increasing are not enough of a shock effect for the nation, not enough to arrest the rates and not enough to prevent a child from dying as mentioned in the article we read in class. That article was posted two days ago, but Huffington Post wrote a similar column last year, and the year before that… USA Today posted a case on the abuse debate as well.
In that USA Today case, the VP of policy and public affairs for the Child Welfare League of America says that she thinks she would “draw the line at a place where there are serious health consequences for the child …”
My problem with that is the “minor medical consequences” of pediatric overweight and obesity are reduced lung capacity, vascular resistance impairing blood flow, sleep apnea preventing quality sleep, lowered ability to dissapate heat (just to name a few for ya). The matter is not ” if there are serious health consequences” …. the matter is there ARE serious health consequences. I haven’t even mentioned the “significant complications” we discussed in class last night either such as heart palpitations, psychological effects, hypertension, metabolic syndrome, and most closely associated with obesity is Type 2 Diabetes.
The VP does mention that if efforts to work with the family have repeatedly failed in conjunction with the health consequences, that it is time to step in. If a child is to the point of obesity, I’m pretty sure family effort has already failed. Either the family is unaware of how to address the issue or unable to address the issue (limited resources, lack of education…) or addressing the issue as parents see fit because parents have the right to raise their children how they see fit.
This might be the most controversial post I have written but I would love to hear the opinions of my readers on the subject! It was a great discussion last night that continued to draw parallels from other articles I had posted for class to read- one regarding Soda purchasing using SNAP benefits being banned, and the Effect of Food Prices on Childhood BMI.
To lighten the mood …. It is also National Honey Month. September is also.. National Cholesterol Education Month. Lastly, most importantly, September my Birthday Month!
