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Abstract
731
Cardiovascular disease
In addition to T2DM, childhood obesity increases the
risk of heart disease, with an increase of even 1 kg linked
to a 1% increase in the risk for heart disease. Lawlor et
al (2006) found obese children to have higher blood
pressure recordings, greater arterial stiffness and adverse lipid
and insulin concentrations, compared with non-overweight
children. An elevated body fat percentage poses a greater
risk than body weight, as the risk for developing coronary
RATIONALE
Provide information about mothers nutrition, pregnancy (gestational diabetes) and birth
weight
Assess for achievement of milestones
Give an indication of onset, progression of weight gain, and peak weight
Explore previous attempts to lose weight and what worked
Understand the childs energy expenditure
Reveal if obesity is a family problem and if others suffer from related comorbidities
Explore eating disorders, depression and the psychosocial impact of obesity
Assess for comorbidities, current medications and drug allergies
Assess level of overweight or obesity
Assess for indications of comorbidities of obesity
732
childhood obesity
not an exact calculation of adiposy (NICE, 2006). Therefore,
the National Taskforce on Obesity (2005) recommends that
nurses calculate childrens BMI, height and weight as routine
clinical assessment. The severity of overweight, the childs
age and the presence of associated comorbidities will dictate
whether weight stablisation or weight loss is the goal (Budd
and Hayman, 2006).
Health promotion
Sustained lifestyle changes in diet and exercise are the
cornerstones of obesity management. A successful weight
management programme offers strategies for decreasing
caloric intake and increasing physical activity (Budd and
Hayman, 2006; Singhal et al, 2007). Minor changes in food
intake and physical activity can have sizeable effects on
body weight and obesity (Haerens et al, 2010). Changes in
physical activity and diet should be promoted with emphasis
on healthy changes. It is important that restrictive diets and
over-exercising are not encouraged as they may result in the
development of eating disorders and have the potential to
be harmful for adolescents and young people (NICE, 2006).
733
Conclusion
Since childhood obesity is a major health problem, it is
essential that all health professionals, working in hospitals and
community health care, are involved in health promotion and
health education strategies with families (Mayer and Villaire,
2010). Nurses, along with all members of the multidisciplinary
team, must recognise the scale of childhood obesity and, in
their daily practice, help children and families deal with the
problem. The focus should be on strategies that will promote
the health of children within the context of the family, school
and community. In addition to the interventions discussed
in this paper, broader preventative strategies, in the school
setting, community, physical environment and society, are
needed to prevent and reduce obesity in childhood (Hughes
and Reilly, 2008; Heitmann et al, 2009).
Healthcare staff, providers and policy makers have a
responsibility to use the best evidence available to address
the obesity problem. Nurses are in a unique position as they
interact with families across healthcare and community-based
settings and so can help in the prevention and management
of overweight and obesity in children and adolescents. The
link between childhood obesity and adulthood morbidities
has been clearly established. If rates of obesity continue
to escalate unabated, future generations will experience
premature morbidity, chronic ill health and increased
mortality. Childhood obesity represents a serious health and
BJN
economic problem today and for the future.
Conflict of interest: none.
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Key points
n The rising levels of overweight and obesity among children and adolescents
in Western countries is of major concern as childhood obesity has adverse
physical and psychological consequences
n Obesity can lead to serious long-term health problems, namely Type 2
diabetes and increased risk of cardiovascular disease in adulthood
n Obesity affects relationships with peers and leads to stigmatisation and
negative stereotyping, bullying, low self-esteem, and social isolation
n Early intervention in childhood is, therefore, critical to stem this rising obesity
epidemic and healthcare staff can play an important role
n Nurses can help by working with the child and family and combining
educational interventions with behavioural and lifestyle changes
n Nurses should always take a whole-family approach because it is challenging
for obese children to alter their dietary or physical habits if not supported by
their families
735
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Copyright of British Journal of Nursing is the property of Mark Allen Publishing Ltd and its content may not be
copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written
permission. However, users may print, download, or email articles for individual use.