I am writing this paper for my English 102 class. A note from my teacher: "Remember that the research paper will run between 8-10 pages, will integrate sources from a diverse array of resources using MLA style, will have a clear thesis/research question as the backbone of the paper, will avoid fallacious rhetoric, and will construct logical arguments to advance the ideas in the paper."
Christopher Denton
English 102
Prof. Elisabeth Borchers
4 August 2012
Childhood Obesity: Searching for a Way Out
For years now, today's society has been combating- rather ineffectively- a very serious condition. It runs rampantly throughout the Western World, and acts as seed for a plethora of additional serious conditions and diseases. It's also considered to be a sensitive and intimidating subject for many individuals, often causing emotional issues to arise as well. At this time, a clear solution to the epidemic does not exist. However, steps can still be taken in the right direction, shedding more light on a topic that seems insurmountable. Obesity is a big problem indeed, and like a weed, it needs to be pulled out by the roots. Therefore, the most effective target for resolving the issue is the children of our society. As they are still in their developing years and learn how to live healthier lifestyles, they will, in-turn, raise their own children the same way. The major difficulty is knowing how to implement this change.
The two general approaches to resolving childhood obesity- prevention and treatment- are widely misunderstood and misused; appealing, "easy fix" products have been a significant obstacle in building that strong foundation of prevention and treatment knowledge in society today. Products that came into existence for a purpose other than losing weight have been advertised to fit that very purpose; what was not advertised was that other physical-health problems were likely to arise when utilizing these fraudulent products. For instance, less than forty years ago, smoking was advertised as a method to lose weight, which put "health educators in the uneasy predicament of having to encourage quitters to believe that the benefits of quitting despite the expected risk of weight gain outweigh the perceived benefits of slimness" (O'Dea). The battle of obesity should be considered a battle for good health overall, not a battle for weight loss at the expense of other areas of health. It would seem rather pointless for the world's obese population to take up smoking in an effort to lose weight and then still die prematurely from lung cancer or leukemia. Still, many overweight and obese people see the change in body image and remain addicted to these physically harmful products. This is just one example of many in which, due to misinformation and product advertising, the public is presented with false solutions to the obesity problem. Children are affected by these so-called treatments, running from advertising campaigns for "super fruits", shots, over-the-counter weight-loss pills, protein shakes, and even parenting magazines to help parents down-size their children (letsmove .gov).
Another problem with media advertisements are the contradicting messages received by children through the television. Commercials concerning children under 2 years-old encourage nutrition and feeding your child in a healthy manner. However, after that age passes, children "are exposed to an estimated 10,000 advertisements for food per year, 95% of which are for fast foods, candy, sugared cereal and soft drinks" (Schwartz). Two things seem very wrong here: Our children (1) want to consume the multitude of unhealthy foods that they are exposed to the most, and (2) are watching too much TV, thus not getting the exercise that they need to burn off the calories of the unhealthy foods that they consume! Obviously, there exists a huge imbalance of consideration for the health of our children. How can we expect the children of today- especially the obese ones- to live healthy lifestyles while they are being bombarded towards the other end of the spectrum?
A darker side exists to this media-medicated prevention and treatment. Inadvertent effects stem from the media's focus on both ends of the health spectrum and can have a debilitating impact, particularly for young girls. The mixed messages of the media are a major factor behind the self-medication for obesity. As shown from the "quick fixes" contrasted with the child-directed ads, children receive a few clear messages: "It's bad to be fat" (which can quickly translate into "If I'm fat, I'm bad" in a child's mind) and"If I'm fat, I need to fix it" (whether through a product, a diet, or an adopted health regime). This can easily spiral out into inappropriate weight control techniques and disorders, ranging from the abuse of laxatives and slimming pills to anorexia and bulimia. Even for adolescents who do not engage in these behaviors, the effect of these media-based "answers" can cause depression and discourage them from trying to fight for a healthier lifestyle (Schwartz). Sadly, these mixed messages come not only from the media, but occasionally from the medical community as well. In a recent evaluation of two posters aimed toward improving the body image of teenaged girls, "up to 30% of 15- to 18-year-old girls reported adverse effects such as reporting that the posters were not helpful to them because they made them feel more self-critical of their bodies, 35% reported not liking the posters, 69% did not want their own copy, 8% did not know what message the posters were meant to portray and another 8% perceived an incorrect or harmful message from the posters" (O'Dea).
In spite of all the false ideas that exist about the management and prevention of childhood obesity, society recognizes at least the need for prevention and treatment. It is clear that prevention plays a key role in the solution to childhood obesity. For young children and for future generations, prevention before obesity development is more effective than management and treatment after obesity has already developed (O'Dea). Prevention nips the problem in the bud, addressing the issue before it leads to complications associated with obesity. Children who suffer from obesity are likely to suffer from related health problems like diabetes, heart disease, cancer, asthma, hypertension, dyslipidemia, insulin resistance/diabetes, fatty liver disease, and psychosocial complications and high-blood pressure (Letsmove .gov). Doctors and patients have more difficulty (and less success) in curing and treating these related problems than they have in preventing them in the first place by managing diet and exercise. Not only can steps of prevention save lives, it can save money, too. Studies show that it is more financially beneficial to spend on prevention than it is to spend large amounts to fix the problem. 147 billion dollars are spent each year on obesity-related health care and, as shown in Michelle Obama's campaign, the government considers it more cost-efficient to invest in prevention. The government aim is, through preventive lifestyle changes, to eliminate obesity in the next generation (letsmove .gov).
Clearly, we understand the need for prevention. Proper prevention can be broken down into two halves: education and action. Professionals in medical and nutritional fields agree that, first and foremost, correct knowledge of the medically-approved, study-proven methods of combating weight gain will result in a solid foundation, thus more effectively combating the issue in western civilization. This knowledge is particularly important to parents, educators and other care-givers for children, since much of a child's lifestyle is monitored by the adults in his/her life. To review the causes of obesity: fat reserves are created when, in an oversimplified equation, more calories are taken in than energy expended. This is common among our children because, as a society and particularly as children, we tend to eat foods high in sugar and rich in energy, while expending minimum energy and physical activity due to our sedentary lifestyle (Karnik). To stop this pattern, our society must up our energy expenditure through more physical activity (a recommended minimum of sixty minutes daily for children under 12) and lower our sugar-rich, additive-rich, and fat-rich intake by eating healthier foods, especially fruits and vegetables (letsmove .gov). This formula is key both to prevention and treatments.
Prevention is multi-level and measures can be instituted at "household, institutional, community, and health care levels" (Han). Controlled studies of children, combined with a close look at the physiology of the human body, have revealed several important ways parents can aide their children in growing up healthily. As previously stated, humans in general and children in particular are genetically wired to prefer sweet, salty, and fatty foods, and in many cases children have lacked the discipline to refrain from over-consumption of such foods. It is up to parents to model regulated intake, offer healthy food options, foster physical activity, and create an environment composed of healthy choices and behaviors, in order for the children to develop proper health habits themselves (Schwartz). Unfortunately, in many circumstances, parents do not have the education or resources to create this kind of healthful environment. Low-income families, particularly those of African-American and Hispanic descent, struggle to escape the environment in which it is more affordable to buy a value-menu burger than to create a healthy, home-cooked meal.
Although nothing can replace the home environment, school administrations can establish measures within the public school system to prevent adolescent obesity. Pilot programs instituted in both France and Italy have shown what a huge role a school/community intervention can play in the fight against adolescent obesity. When the Epod Program (Ensamble Prevenons l'Obesitè des Enfants) was insituted in France, the first phase of the project was a physical and nutritional "educational intervention" within the school system. Strategies included providing low-calorie school breakfasts and lunches, emphasizing balanced diet, providing nutritional information via classroom instruction, recruiting sports trainers, and maximizing the physical education and sports programs in schools. The result was that, where before there had been an initial trend toward child weight gain, the prevalence of overweight children declined to 8.8%, as compared to 17.8% in control towns (Segel) However, it is important to note that this data was not collected until after the school movement had snowballed into a community movement that included weight-loss amongst even the parents of overweight children. The program has spread from France to include Belgium, Spain, and Greece with "encouraging results" (Segel).
Treatment options are indeed available for overweight and obese children, but opinions differ on the effectiveness and success of both formal and informal treatment. The common sense answer is that changes in diet and physical activity (eating the types of healthy food discussed as prevention, exercising, and generally expending more calories than you take in) should cause an obese child to lose weight and revert to normal. But it just isn't that easy. Habits become addicting, failure in fighting addictions is discouraging, and discouragement is self-defeating. Some children are not capable of making the changes necessary on their own. Others are too far gone to be able to exercise without injury. Still others have not been educated in what changes are needed to break the cycle. This plethora of challenges leaves obese children, their parents, and health-care professionals with many options, but a tough battle each way. "The treatment of obesity has a depressing reputation. The reported levels of success are low at all ages with many obese children continuing life as obese adults" (Burnait). Even amongst researchers, opinions vary as to whether formal or informal treatment is more effective. Walter Burnait's book, Child and Adolescent Obesity: Challenges and Consequences states, "Efforts to slim frequently begin without any professional involvement and some, perhaps even many, of these 'self-help' slimmers succeed in their aims to lose weight- and seek no further advice" (Burnait). He further asserts that, due to the emotional toll of being professionally guided through a challenging lifestyle change that does not yield quick results often brings discouragement and depression. The success rate of children are low when it comes to these types of programs and result in the obese child continuing on to become an obese adult. Other researchers insist that the final decision to treat an obese child must be made only by a professional. Jennifer O'Dea says, "Obese children and their parents may misinterpret media reports about child obesity and other weight control messages as a cue for seeking 'quick fix' fad weight loss diets, diet products and weight loss regimes, all of which are unsuitable for growing children . . . prescription of weight control programs, dietary advice or other individual interventions for the obese child should remain the role of the pediatrician, general practitioner, dietitian or other clinically trained staff." A survey of the existing body of literature on the subject shows a tendency of compromise between these sides. Researchers like Joan Han, Debbie Lawlor, and Sue Kimm have amassed findings based on the studies reported in "Interventions for Treating Obesity in Children". After 65 trials comparing pharmacological and nonpharmalogical treatment to back the idea that nonpharmacological treatment, which can often but not always be implemented without help from a doctor or therapist, is the first and foremost way to treat obesity. In their own words, "this review shows that family-based, lifestyle interventions with a behavioural program aimed at changing diet and physical activity and thinking patterns provide significant and clinically meaningful decreases in overweight in both children and adolescents ... in the short- and the long-term" (Han).
As discussed earlier, some cases of childhood obesity are extreme to the point that a nonpharmocological intervention is not enough, and parents and doctors must look to pharmacological and surgical treatments to help children with obesity. Although there have not been standardized, randomized controlled trials of surgical procedures to treat obesity in children, there have been cases where morbidly obese children and adolescents have been treated through Roux-en-Y gastric bypass and laparoscopic adjustable gastric banding, both of which limit the volume capacity of the stomach and therefore curb the amounts of food eaten by the child (Karnik). These kinds of procedures, extreme though they are, are considered helpful because they can save a child from remaining obese into adulthood. However, researchers caution that "long-term prospective studies are needed to establish the safety and efficacy of restrictive and malabsorptive procedures and to determine whether reductions in morbidity and mortality outweigh the risks of serious surgical complications and life-long nutritional deficiencies" (Han). Pharmacological therapy for adolescents include drugs like Orlistat, which blocks fat from the intestine, and sibutramine, which essentially reduces hunger signals to the brain, and sending "full" signals at an earlier point (Karnik). However, neither of these drugs are considered acceptable for children under twelve years of age. These methods of pharmaceutical drugs and corrective surgery are usually only brought into play by health-care providers after time, when children have had the opportunity to try more natural lifestyle adjustments.
With all of the possible physical and emotional complications that come with obesity as well its treatments; with the many different options of prevention and treatment that are available and even customized for the individual; with the contradicting messages and advice from the media; and with prescribed suggestions from qualified and unqualified professionals, it is perhaps an understatement to say that obesity is a difficult issue to solve. However, certain things are sure: prevention- before obesity- must be learned by today's families and taught to future generations; healthy dietary lifestyles must be adopted- preferably with a firm example being set forth by the parents; treatment- when needed- must be done willingly and with the supervision of a professional. Lastly, it is imperative that education about the dangers of obesity are known to all. With a heightened awareness, society will finally be able to more effectively apply these measures into their daily lives. Children are very flexible beings and absorb the details of their environment. It is hard to undo what has already been done, but our children require and deserve more careful consideration of what we let them take into their bodies. They need to know that living a healthy lifestyle brings more overall health, happiness, and self-confidence. It outweighs- in many aspects- the alternative.
Christopher Denton
English 102
Prof. Elisabeth Borchers
4 August 2012
Childhood Obesity: Searching for a Way Out
For years now, today's society has been combating- rather ineffectively- a very serious condition. It runs rampantly throughout the Western World, and acts as seed for a plethora of additional serious conditions and diseases. It's also considered to be a sensitive and intimidating subject for many individuals, often causing emotional issues to arise as well. At this time, a clear solution to the epidemic does not exist. However, steps can still be taken in the right direction, shedding more light on a topic that seems insurmountable. Obesity is a big problem indeed, and like a weed, it needs to be pulled out by the roots. Therefore, the most effective target for resolving the issue is the children of our society. As they are still in their developing years and learn how to live healthier lifestyles, they will, in-turn, raise their own children the same way. The major difficulty is knowing how to implement this change.
The two general approaches to resolving childhood obesity- prevention and treatment- are widely misunderstood and misused; appealing, "easy fix" products have been a significant obstacle in building that strong foundation of prevention and treatment knowledge in society today. Products that came into existence for a purpose other than losing weight have been advertised to fit that very purpose; what was not advertised was that other physical-health problems were likely to arise when utilizing these fraudulent products. For instance, less than forty years ago, smoking was advertised as a method to lose weight, which put "health educators in the uneasy predicament of having to encourage quitters to believe that the benefits of quitting despite the expected risk of weight gain outweigh the perceived benefits of slimness" (O'Dea). The battle of obesity should be considered a battle for good health overall, not a battle for weight loss at the expense of other areas of health. It would seem rather pointless for the world's obese population to take up smoking in an effort to lose weight and then still die prematurely from lung cancer or leukemia. Still, many overweight and obese people see the change in body image and remain addicted to these physically harmful products. This is just one example of many in which, due to misinformation and product advertising, the public is presented with false solutions to the obesity problem. Children are affected by these so-called treatments, running from advertising campaigns for "super fruits", shots, over-the-counter weight-loss pills, protein shakes, and even parenting magazines to help parents down-size their children (letsmove .gov).
Another problem with media advertisements are the contradicting messages received by children through the television. Commercials concerning children under 2 years-old encourage nutrition and feeding your child in a healthy manner. However, after that age passes, children "are exposed to an estimated 10,000 advertisements for food per year, 95% of which are for fast foods, candy, sugared cereal and soft drinks" (Schwartz). Two things seem very wrong here: Our children (1) want to consume the multitude of unhealthy foods that they are exposed to the most, and (2) are watching too much TV, thus not getting the exercise that they need to burn off the calories of the unhealthy foods that they consume! Obviously, there exists a huge imbalance of consideration for the health of our children. How can we expect the children of today- especially the obese ones- to live healthy lifestyles while they are being bombarded towards the other end of the spectrum?
A darker side exists to this media-medicated prevention and treatment. Inadvertent effects stem from the media's focus on both ends of the health spectrum and can have a debilitating impact, particularly for young girls. The mixed messages of the media are a major factor behind the self-medication for obesity. As shown from the "quick fixes" contrasted with the child-directed ads, children receive a few clear messages: "It's bad to be fat" (which can quickly translate into "If I'm fat, I'm bad" in a child's mind) and"If I'm fat, I need to fix it" (whether through a product, a diet, or an adopted health regime). This can easily spiral out into inappropriate weight control techniques and disorders, ranging from the abuse of laxatives and slimming pills to anorexia and bulimia. Even for adolescents who do not engage in these behaviors, the effect of these media-based "answers" can cause depression and discourage them from trying to fight for a healthier lifestyle (Schwartz). Sadly, these mixed messages come not only from the media, but occasionally from the medical community as well. In a recent evaluation of two posters aimed toward improving the body image of teenaged girls, "up to 30% of 15- to 18-year-old girls reported adverse effects such as reporting that the posters were not helpful to them because they made them feel more self-critical of their bodies, 35% reported not liking the posters, 69% did not want their own copy, 8% did not know what message the posters were meant to portray and another 8% perceived an incorrect or harmful message from the posters" (O'Dea).
In spite of all the false ideas that exist about the management and prevention of childhood obesity, society recognizes at least the need for prevention and treatment. It is clear that prevention plays a key role in the solution to childhood obesity. For young children and for future generations, prevention before obesity development is more effective than management and treatment after obesity has already developed (O'Dea). Prevention nips the problem in the bud, addressing the issue before it leads to complications associated with obesity. Children who suffer from obesity are likely to suffer from related health problems like diabetes, heart disease, cancer, asthma, hypertension, dyslipidemia, insulin resistance/diabetes, fatty liver disease, and psychosocial complications and high-blood pressure (Letsmove .gov). Doctors and patients have more difficulty (and less success) in curing and treating these related problems than they have in preventing them in the first place by managing diet and exercise. Not only can steps of prevention save lives, it can save money, too. Studies show that it is more financially beneficial to spend on prevention than it is to spend large amounts to fix the problem. 147 billion dollars are spent each year on obesity-related health care and, as shown in Michelle Obama's campaign, the government considers it more cost-efficient to invest in prevention. The government aim is, through preventive lifestyle changes, to eliminate obesity in the next generation (letsmove .gov).
Clearly, we understand the need for prevention. Proper prevention can be broken down into two halves: education and action. Professionals in medical and nutritional fields agree that, first and foremost, correct knowledge of the medically-approved, study-proven methods of combating weight gain will result in a solid foundation, thus more effectively combating the issue in western civilization. This knowledge is particularly important to parents, educators and other care-givers for children, since much of a child's lifestyle is monitored by the adults in his/her life. To review the causes of obesity: fat reserves are created when, in an oversimplified equation, more calories are taken in than energy expended. This is common among our children because, as a society and particularly as children, we tend to eat foods high in sugar and rich in energy, while expending minimum energy and physical activity due to our sedentary lifestyle (Karnik). To stop this pattern, our society must up our energy expenditure through more physical activity (a recommended minimum of sixty minutes daily for children under 12) and lower our sugar-rich, additive-rich, and fat-rich intake by eating healthier foods, especially fruits and vegetables (letsmove .gov). This formula is key both to prevention and treatments.
Prevention is multi-level and measures can be instituted at "household, institutional, community, and health care levels" (Han). Controlled studies of children, combined with a close look at the physiology of the human body, have revealed several important ways parents can aide their children in growing up healthily. As previously stated, humans in general and children in particular are genetically wired to prefer sweet, salty, and fatty foods, and in many cases children have lacked the discipline to refrain from over-consumption of such foods. It is up to parents to model regulated intake, offer healthy food options, foster physical activity, and create an environment composed of healthy choices and behaviors, in order for the children to develop proper health habits themselves (Schwartz). Unfortunately, in many circumstances, parents do not have the education or resources to create this kind of healthful environment. Low-income families, particularly those of African-American and Hispanic descent, struggle to escape the environment in which it is more affordable to buy a value-menu burger than to create a healthy, home-cooked meal.
Although nothing can replace the home environment, school administrations can establish measures within the public school system to prevent adolescent obesity. Pilot programs instituted in both France and Italy have shown what a huge role a school/community intervention can play in the fight against adolescent obesity. When the Epod Program (Ensamble Prevenons l'Obesitè des Enfants) was insituted in France, the first phase of the project was a physical and nutritional "educational intervention" within the school system. Strategies included providing low-calorie school breakfasts and lunches, emphasizing balanced diet, providing nutritional information via classroom instruction, recruiting sports trainers, and maximizing the physical education and sports programs in schools. The result was that, where before there had been an initial trend toward child weight gain, the prevalence of overweight children declined to 8.8%, as compared to 17.8% in control towns (Segel) However, it is important to note that this data was not collected until after the school movement had snowballed into a community movement that included weight-loss amongst even the parents of overweight children. The program has spread from France to include Belgium, Spain, and Greece with "encouraging results" (Segel).
Treatment options are indeed available for overweight and obese children, but opinions differ on the effectiveness and success of both formal and informal treatment. The common sense answer is that changes in diet and physical activity (eating the types of healthy food discussed as prevention, exercising, and generally expending more calories than you take in) should cause an obese child to lose weight and revert to normal. But it just isn't that easy. Habits become addicting, failure in fighting addictions is discouraging, and discouragement is self-defeating. Some children are not capable of making the changes necessary on their own. Others are too far gone to be able to exercise without injury. Still others have not been educated in what changes are needed to break the cycle. This plethora of challenges leaves obese children, their parents, and health-care professionals with many options, but a tough battle each way. "The treatment of obesity has a depressing reputation. The reported levels of success are low at all ages with many obese children continuing life as obese adults" (Burnait). Even amongst researchers, opinions vary as to whether formal or informal treatment is more effective. Walter Burnait's book, Child and Adolescent Obesity: Challenges and Consequences states, "Efforts to slim frequently begin without any professional involvement and some, perhaps even many, of these 'self-help' slimmers succeed in their aims to lose weight- and seek no further advice" (Burnait). He further asserts that, due to the emotional toll of being professionally guided through a challenging lifestyle change that does not yield quick results often brings discouragement and depression. The success rate of children are low when it comes to these types of programs and result in the obese child continuing on to become an obese adult. Other researchers insist that the final decision to treat an obese child must be made only by a professional. Jennifer O'Dea says, "Obese children and their parents may misinterpret media reports about child obesity and other weight control messages as a cue for seeking 'quick fix' fad weight loss diets, diet products and weight loss regimes, all of which are unsuitable for growing children . . . prescription of weight control programs, dietary advice or other individual interventions for the obese child should remain the role of the pediatrician, general practitioner, dietitian or other clinically trained staff." A survey of the existing body of literature on the subject shows a tendency of compromise between these sides. Researchers like Joan Han, Debbie Lawlor, and Sue Kimm have amassed findings based on the studies reported in "Interventions for Treating Obesity in Children". After 65 trials comparing pharmacological and nonpharmalogical treatment to back the idea that nonpharmacological treatment, which can often but not always be implemented without help from a doctor or therapist, is the first and foremost way to treat obesity. In their own words, "this review shows that family-based, lifestyle interventions with a behavioural program aimed at changing diet and physical activity and thinking patterns provide significant and clinically meaningful decreases in overweight in both children and adolescents ... in the short- and the long-term" (Han).
As discussed earlier, some cases of childhood obesity are extreme to the point that a nonpharmocological intervention is not enough, and parents and doctors must look to pharmacological and surgical treatments to help children with obesity. Although there have not been standardized, randomized controlled trials of surgical procedures to treat obesity in children, there have been cases where morbidly obese children and adolescents have been treated through Roux-en-Y gastric bypass and laparoscopic adjustable gastric banding, both of which limit the volume capacity of the stomach and therefore curb the amounts of food eaten by the child (Karnik). These kinds of procedures, extreme though they are, are considered helpful because they can save a child from remaining obese into adulthood. However, researchers caution that "long-term prospective studies are needed to establish the safety and efficacy of restrictive and malabsorptive procedures and to determine whether reductions in morbidity and mortality outweigh the risks of serious surgical complications and life-long nutritional deficiencies" (Han). Pharmacological therapy for adolescents include drugs like Orlistat, which blocks fat from the intestine, and sibutramine, which essentially reduces hunger signals to the brain, and sending "full" signals at an earlier point (Karnik). However, neither of these drugs are considered acceptable for children under twelve years of age. These methods of pharmaceutical drugs and corrective surgery are usually only brought into play by health-care providers after time, when children have had the opportunity to try more natural lifestyle adjustments.
With all of the possible physical and emotional complications that come with obesity as well its treatments; with the many different options of prevention and treatment that are available and even customized for the individual; with the contradicting messages and advice from the media; and with prescribed suggestions from qualified and unqualified professionals, it is perhaps an understatement to say that obesity is a difficult issue to solve. However, certain things are sure: prevention- before obesity- must be learned by today's families and taught to future generations; healthy dietary lifestyles must be adopted- preferably with a firm example being set forth by the parents; treatment- when needed- must be done willingly and with the supervision of a professional. Lastly, it is imperative that education about the dangers of obesity are known to all. With a heightened awareness, society will finally be able to more effectively apply these measures into their daily lives. Children are very flexible beings and absorb the details of their environment. It is hard to undo what has already been done, but our children require and deserve more careful consideration of what we let them take into their bodies. They need to know that living a healthy lifestyle brings more overall health, happiness, and self-confidence. It outweighs- in many aspects- the alternative.