Childhood Obesity

Obesity in children and adolescents is a serious issue with many health problems and social problems that carry on into adulthood. Obesity is typically defined in terms of body mass index; this reflects the ratio between weight and height. While there are various criteria, a BMI at or above a certain percentile (85th or 95th) for age and gender is often employed to define overweight and obesity (Wicks-Nelson & Israel, 2003, p.382). Normal BMI is 19-25, overweight is 25-30, and obesity is deemed to exist when BMI exceeds 30 (Morrissette & Taylor, 2002, p. 19). Excessive overweight in puberty was associated with higher than expected morbidity and mortality in adult life (Morrissette & Taylor, 2002, p. 19). When you think of childhood disorders you think of ADHD and conduct disorders, but rarely is childhood obesity brought into that realm of disorders. Before deciding to do research on this subject for my paper, I sadly never really thought of childhood obesity as possibly genetic and so prevalent.

According to the Surgeon General (2005), risk factors for heart disease, such as high cholesterol and high blood pressure, occur with increased frequency in overweight children and adolescent compared to children with a healthy weight. Type 2 diabetes, previously considered an adult disease, has increased dramatically in children and adolescents. Overweight and obesity are closely linked to type 2 diabetes. Overweight adolescents have a 70% chance of becoming overweight or obese adults. This increases to 80% if one or more parent is overweight or obese.

There are many factors that contribute to causing child and adolescent obesity: Lack of regular exercise, bad eating habits, sedentary behavior, environment and genetics (American Obesity Association, 2002). Television, computer and video games don't help in the children's inactive lifestyles. 43% of adolescents watch more than 2 hours of television each day and children, especially girls, become less active as they move through adolescence (Surgeon General, 2005). The worst problem with being overweight as looked at by the children themselves is social discrimination. Children who are obese are often rejected by peers, isolated, and humiliated when social acceptance is such a large part of development. The social problems associated with fatness can be just as severe as the physiological and psychological problems of this condition (Morrissette & Taylor, 2002, p. 20).

The researchers in the first journal article chose to research the treatment and prevention of obesity in the schools. A total of 89 overweight children in grades 2-5 in one experimental and one control school participated in a 12-week weight reduction program conducted primarily by older children trained as peer counselors. In the method section the subjects were 24 boys and 24 girls among 896 students in a Catholic elementary school. There were 12, 3, 18, and 15 subjects in grades 2, 3, 4, and 5. A sample of 41 control children was obtained from another Catholic elementary school less than 3 miles from the target school. No program was conducted in the control school. The 12-week program included counseling and social support provided mostly by the peers. Peer counselors were responsible and well-liked eighth-grade students chosen by the principal and the teachers. The counselors were trained in three 1-hour sessions to weigh the kids, to check the lunchboxes for healthy foods, and to offer their opinions on changes in eating and exercising. Counselors were observed at least once a week by the authors and were given feedback on their performance (Ebstein, Paluch, Kilanowski, & Raynor, 2004).

The obese children met three times a week before school for 15 minutes with their counselors, during which lunchboxes were checked for nutritious and nonnutritious foods. The children were rewarded with stickers and verbal praise for not having any nonnutritious or high in calorie food. The children also attended a weekly 15-minute exercise class to show them that exercise could actually be fun. Children were weighed weekly and were rewarded with special stickers for weight losses of 1/2lb or more. In the results of the experiment the program children lost 0.15kg during treatment, while the control group gained 1.3kg. The advantage for the experimental group was clear when accounting for changes in height; program children showed a 5.3% decrease in percentage overweight, where the control children increased their percentage overweight by 0.3%. Unfortunately, program children gained significantly more weight and showed a significantly greater increase in percentage overweight in an 18-week follow-up than did the controls. The program children did show a significantly greater improvement in self-concept from pretreatment to post treatment than did a group of children from the control group (Ebstein, Paluch, Kilanowski, & Raynor, 2004).

The researchers in the second journal article chose to research the relationship between psychosocial functioning and body fat in preschool children. Subjects were 132 healthy white children (77 boys and 55 girls) ages 3.0 to 5.7 years old and their natural parents. Forty-eight of the children were obese. Because the purpose of the study was to evaluate psychosocial and energy balance correlates of obesity in children, obese children were over sampled. A packet of questionnaires was completed by each subject and brought to the first laboratory session. At each yearly laboratory visit, subjects completed additional measures of dietary intake, physical activity, and adiposity. This procedure was followed for 4 years. All children completed, in an interview format, the 28-item Perceived Competence Scale for Children. This scale assesses four different areas of perceived self-esteem: cognitive abilities, physical activity, peer relations, and general self-esteem (Klesges et al., 1992).

The results of their tests showed that neither family functioning nor self-esteem cross-sectionally correlated with measures of body fat in young children. In addition to initial levels of body fat, levels of physical self competence, father's perception of family functioning, and the interaction of these psychosocial measures with gender predicted body fat at the 1-year follow-up. The only psychosocial measure to consistently predict body fat was the child's level of physical self-competence; as physical self-competence decreased, future body fat increased. Although some investigators have suggested that children develop high body fat levels because of past negative self-esteem and family functioning, this study suggests that these factors do not consistently predict future body fat levels (Klesges et al., 1992).

The researchers in the third journal article chose to research the effect of reinforcement