Category: Childhood Obesity

1. Introduction

Childhood obesity is a global issue, and an increasing number of children are becoming overweight and obese. There are approximately 216 million children worldwide who are classed as overweight. All countries are seeing a rise in childhood obesity including low- and middle-income settings. (1) There is also an economic burden; the NHS spent £5.1 billion on illnesses attributed to obesity in 201415. (2)

Obese children are more likely to develop cardiovascular disease and low self-esteem which can affect their productivity. This can lead to poorer employment prospects in the future. (1,3) Furthermore, obese children are more likely to stay obese as they become adults. (4)

The National Child Measurement Programme, (NCMP) 201920 recorded that obesity prevalence among children in reception has increased from 9.7% in 2018-19 to 9.9% in 2019-20. (5) Also, obesity prevalence among children in Year 6 has increased from 20.2% in 2018-19 to 21% in 2019-20. (5)

A socioeconomic gradient exists, where individuals living in the most deprived areas suffer from the worst health, compared to those living in wealthier areas. These inequalities exist because of interactions between access to work, outdoor spaces, education, and exposure to hazards in and out of work. Inequalities affect how individuals can deal with these and become healthier (6) These socioeconomic inequalities start in young children and increase throughout life. (7) This is highest among children who live in the most deprived areas. These children are twice as likely to become obese compared to their wealthier counterparts. (5)

Bristol has some of the most deprived areas including Hartcliffe, Whitchurch Park, and Knowle West. (8) The NCMP recorded childhood obesity rates in Hartcliffe as an increase from 28.6% in 201617 to 32.4% in 2018-19, and in Whitchurch Park, the increase was from 24.8% in 201617 to 28.6% in 201819. (5,9) These obesity rates are some of the highest in Bristol and occur in some of the most deprived areas of the city. (8,9) In addition, 21% of children in Bristol live in income-deprived families. (8) The levels of childhood obesity in Bristol are statistically similar to average; one-fifth of children in reception were classed as overweight or obese, and one-third of Year 6 children were overweight or obese. (9,10)

In Hartcliffe and Withywood, only 45.7% of people living here are physically active. Furthermore, only 27.5% of people play sports once a week compared to the Bristol average of 41% (11) In addition, life expectancy in Hartcliffe is lower than the Bristol average. (4)

The Childhood Obesity Plan 2016 identified key actions in reducing obesity which were sugar and calorie reduction, advertising and promotion, and local areas and schools. (12) Therefore, this healthcare promotion program will use interventions that build on schools and local areas, with a focus on children in reception. (7)

2. Interventions

Dahlgren and Whitehead define the structural determinants of health that lead to inequalities as the environment we are born into, grow, and experience. The greatest level of change can be achieved by changing policy or legislation, followed by strengthening communities, and finally individual behavior change. (13) The following program uses a settings approach and is targeted at children who have a low socioeconomic status. (8,14)

This program aims to reduce childhood obesity by increasing physical activity in schools. Goisis et al. proposed that childhood obesity can be reduced by targeted interventions in young children and by addressing multiple risk factors. (7) There is evidence to suggest that interventions to increase physical activity combined with those to improve diet were the most effective at reducing BMI in children aged 0 to 5 years. In contrast, those interventions targeting physical activity alone were more effective in children aged between 6 to 12 years. (15) This program will focus initially on increasing physical activity.

Schools are at the heart of communities and have the potential to become positive centers for health. (16) This program consists of multiple levels for behavior change aimed at the population, community, and individual. These have been proven to be effective if combined. (4,17) The theory draws upon the Behaviour Change Wheel which informs health promotion interventions. (18)

Stakeholders will need to be engaged and motivated to implement the program. The stakeholders involved in this program are children in reception, families, and primary schools in Hartcliffe and Withywood. (19)

The objectives are for primary schools to ensure children receive a minimum of 60 minutes of physical activity during the school day. This will be supported by schools redesigning playgrounds to facilitate creative play for children in and around the school. Finally, schools will need to convey to children the importance of physical activity through lesson times. This can be achieved through PE lessons where play and teamwork are encouraged between older and younger children in the school, thus, creating positive peer pressure. (20)

The intended outcomes of this multi-level approach are to increase physical activity in reception children, and therefore reduce BMI. (14) This is important in Bristol which, has a high population of children under the age of 5 living in areas of deprivation. (4) The goal of this program is for children to be receiving a minimum of 60 minutes of moderate to vigorous physical activity every day. (21)

i. Population-level change

This intervention focuses on policy change which exists on the outer circle of the Behaviour Change Wheel. Interventions aimed at the population by informing policy can have the biggest impact on behavior change as they target upstream factors. (14) Additionally, evidence has shown that changes in policy can result in behavior change at all levels; individual, community, and population. (17)

The government currently provides funding for all primary schools to ensure adequate levels of physical activity are provided during school time. At present, the requirement is a minimum of 30 minutes. (22) NICE guidelines state that children should be getting at least 60 minutes of physical activity daily. (23) However, given that levels of childhood obesity are increasing, the minimum level of physical activity provided by schools should be set at 60 minutes. (5) At present only 17.5% of children meet the minimum of 60 minutes of exercise per day. Furthermore, most of these children are from deprived areas. (16) Primary schools are important in addressing this issue as it has been shown that rates of obesity doubled in children aged between 5 and 11 years old. (24)

By creating this policy, schools will be responsible for children’s physical activity, and ensure it is incorporated into other lesson times as well as PE (21,25) The Chief Medical Officers have recommended that schools prioritize physical activity for all children to ensure they achieve 60 minutes per day. (3)

It has been shown by the active mile’ program that primary schools can be highly effective at increasing levels of physical activity in all children. This program had children running a mile each day. Teachers had flexibility in when the mile was taken, and the school had a route mapped out for children and staff to follow. This was successful in ensuring that children were getting a minimum of 60 minutes of exercise daily. (16,24)

ii. Community-level change

Schools are well placed for improving health, with good facilities for physical activity such as playgrounds and green spaces. Furthermore, children have access to these spaces daily. (26) An example of an intervention carried out by a primary school was to change the playground layout to make it more engaging for students. This led to a 20% increase in community activity and a 36% increase in physical activity across the school’.(16) Furthermore, studies have shown that strengthening communities by using school-based interventions has been effective in reducing childhood obesity. (14) This satisfies Chief Medical Officers’ recommendation on ensuring that play areas for children are built, looked after, and safe to use. (3)

In Hartcliffe and Withywood there are no outdoor spaces for organized sports, and only one school field is available for hire outside of school hours. Furthermore, there is only one children’s play park in Hengrove. (27) This follows the trend where areas of deprivation have fewer green spaces and safe outdoor areas. Access to outdoor spaces has been shown to reduce obesity by increasing physical activity. (24) Therefore, an intervention to redesign and open school playgrounds to the community will significantly benefit the children attending the school, and those living nearby. This adheres to NICE guidance recommendations to ensure schools make their facilities available outside of school hours for the community. (16)

Schools will need to nominate a coordinator and engage the local community. Families and schools must work together as both have a responsibility for ensuring children stay healthy. The primary spaces fund is available for schools to help with set-up costs, but the school can also encourage parents to join the project and help design the new playground. (16,26) This new outdoor space can be utilized by the local community outside of school hours. For example, by families before and after school or community clubs in need of outdoor space. Thus, this will increase the number of acceptable outdoor spaces in Hartcliffe and Withywood and will overcome the barriers faced by many parents who cannot find local, safe spaces for their children to play in. (28)

iii. Individual Level

Individual-level interventions are the least effective at bringing about behavior change. Therefore, it is more effective to combine these with interventions that target the community and the obesogenic environment. (13)

Teaching children in schools about healthy lifestyles should begin in young children to enable them to carry these behaviors through to adolescence and adulthood. As shown by the evidence, obesity increases during primary school years. (5)

An example of a successful school-based intervention aimed at individuals was the food dudes program. This was carried out initially in a group of 450 children who were taught about different fruit and vegetables, they were then encouraged to eat more healthy foods by ‘Food dudes’ and rewarded for trying new foods. The food dudes’ were cartoon characters who were portrayed as positive older role models. The program was successful in increasing the fruit and vegetable intake of children, and this behavior was sustained in schools and at home. (20) The program has since been tested on thousands of children and has been shown to be highly effective in promoting healthy eating. It also showed that positive outcomes can be achieved by creating an environment that is supportive and offers rewards to children. Children look to copy older children so they can be like them. (20)

To promote physical activity in children, a similar model can be applied in schools where older children are seen to be active and taking part in games. Teachers can use this positive peer pressure to show children the variety of physical activities that can take place inside and outside of schools. This model of mentorship is supported by studies on changing individual-level behavior and has proven to be successful in preventing weight gain in children. (14)

Primary schools can look to hold joint PE lessons with older children and encourage them to work together as a team. The seafood dudes program identified that children are more likely to respond to older role models if they are part of a group. Furthermore, children responded well to the program as the food dudes’ were heavily branded. Schools can become a brand by utilizing the school logo on PE kits and choosing a school mascot as a friendly figure that children can respond to.

In order to determine if a child is obese or not, their BMI must be measured. BMI is calculated by measuring a person’s height and weight. BMI for age usually corresponds with percentiles. In order for a child to be considered obese, he/she is categorized in the 95th percentile or greater. Children who are obese are above the normal weight for their age and height. Childhood obesity has been something that continues to grow as the years go on. It has been said that 35% of all American children are obese or overweight. Not only this but over 13 million children are affected by this. It is not only in American where childhood obesity is increasing, but in other countries also. The obesity rate in children is expected to rise in the next two decades. Childhood obesity is something that must be resolved before the percentage continues to increase. It would be very hard for someone to reverse the effects of childhood obesity due to many factors that have caused it to rise (Harris, Pomeranz, Lobstein, & Brownell, 2009).

Childhood obesity continues to rise as the years go on. There are specific reasons why this keeps happening. 40 to 50 percent of the money spent on food goes towards outside food sources such as restaurants instead of food inside the home. One cause of the rise of childhood obesity is television. Many food companies tend to market their products to children. It has been studied that children in the United States on average view 15 different food advertisements. That is about 5,000 food advertisements a year. These companies know that children are an easier target to market instead of adults. The second cause of the rise of childhood obesity is genetic factors. A child’s genes can make him/her more susceptible to obesity but also require other factors. Additionally, the lack of physical activity has increased childhood obesity. Since the advancement of technology, many children stay inside on an Ipad instead of going outside and playing. These days children just sit inside and eat instead of burning those calories off when they are done. The environment of the child can also increase him/her to be obese. If a child is raised in a household where the eating habits are terrible, then he/she will have those same habits. The environment can also affect how much the child exercise. There are many factors that can cause the rise of childhood obesity but it can be treated (“Other Factors in Weight Gain”, 2015).

Treatment and Prevention. Childhood obesity can be solved but only the parents are willing to work. I believe that parents usually cause childhood obesity when the children are younger. However, as the child gets old enough to make decisions then it is their fault. There are solutions to this problem. The first solution is having the family as a whole live a healthier lifestyle. If a child is raised in this environment then he/she might continue this healthy living. Additionally, educating the child on food portions and serving sizes could help a lot. In cooperating more water into a child’s diet is very helpful also. These solutions would lower the risk of high blood pressure, sleep apnea, social and psychological problems, etc.

Impacts on Society. Obesity can have an impact on society. Society can have both a social and emotional effect on a child who is obese. Children who are obese might feel left out when it comes to being social with others. Not only this but, bullying could lead the child to fill left out. Childhood obesity could also affect the economy. It was said that the healthcare costs of obesity in the United States are estimated to be over $180 billion (“Obesity Consequences”, 2016). Childhood obesity can impact everyone in this society.

How People Can Help. Childhood obesity can be stopped if people are willing to help. I believe that working out is very beneficial. Going to the gym isn’t something a little kid has to do in order to not be obese. It can be something as little as going outside playing tag, walking around a mall, playing a sport, etc. It’s the little things that can make a huge impact. Additionally, eating healthier isn’t just eating fruits and vegetables only; it’s managing portions and calorie counting. I believe if this situation was made more aware, then people would actually help with this problem.

Childhood obesity is a health issue resulting from excess fats in the body. The result can be observed when the child is above healthy and average weight as of the childhood period. Obesity does not necessarily impact only children but also adults as old age obesity results in heart disease. Thus, obesity is mainly triggered by Childhood behaviors, the surrounding environment as well as genetics.

The first cause of childhood obesity is childhood behaviors. Such behaviors include; eating foods and beverages which are low on nutrients, inappropriate sleeping routine, poor medication as well as inadequate physical activities. Furthermore, individual families have meal tables, mainly composed of sugary food products. Thus, children are introduced early to sugary and bulky food products. As a result, childhood behaviors result in low self-esteem, increased sleeping time, insomnia, lower quality of life experienced, and reduces academic performance of a child as a result of stigmatization.

The next cause of childhood obesity is genetics. Genetics is believed only to affect weight when combined with behavioral and environmental factors. Therefore, genetics only assist in the development of obesity and doesn’t cause the continuous increase in childhood obesity. Thus, genetics can lead to cardiovascular disease due to the presence of high cholesterol resulting in difficulty in breathing as well as high blood pressure. Genetics though not a common factor in obesity, can be passed from one generation to another. Additionally, genetics can lead to medical problems such as muscular discomfort, joint problems, fatty liver disease, and asthma due to breathing problems.

The surrounding environment is another cause of childhood obesity. The first effect of the surrounding environment is depression and anxiety. A situation majorly experienced during children playing time. Daycare and schools play a significant role in childhood obesity. Thus most of the meals children take in schools are more sugar content.

Additionally, hackers and traders sell sugary stuff, for example, ice creams and cakes, which form part of the products liked by the children. The community environment’s lack of playing facilities results in obesity because failure to exercise leads to the accumulation of cholesterol in the body. Moreover, children’s failure to exercise leads to the creation of a weak body as well as weak muscular cells, and such children tend to be bullied and stigmatized by friends.

In conclusion, childhood obesity results from childhood behaviors, genetics, and the surrounding environment. Following these findings, the effects are namely depression, anxiety, low self-esteem, being bullied by friends, stigmatization, asthma, muscular discomfort, and joint problems. Thus, it is clear to state that obesity as a health condition has numerous effects as addressed above and each individual should adopt the necessary measures to curb the causes of childhood obesity. Thus, it includes eating food and beverages of high nutrients, taking adequate physical activities, taking sufficient sleep, and encouraging the installation of physical equipment to be used for exercise sessions. Parents being the major players in a child’s growth should ensure children take appropriate meals in the required quantity to reduce obesity in children.

Childhood/Adolescence

As habits and problems of childhood often follow the individual through adulthood, childhood obesity gets a great deal of ink. The perspectives on the issue, however, vary dramatically. For example, Elizabeth Poskitt and Laurel Edwards wrote Management of Childhood Obesity for Healthcare The upshot of the work suggests that if parents are not willing to change behaviors around food, the healthcare professionals are not likely to succeed. This pessimism is countered somewhat in Fed Up!: Winning the War against Childhood Obesity, by physician and journalist Susan Okie, who provides readable success narratives of communities and parents who boost the activity levels and intake of fresh fruits and vegetables of their children. The storytelling makes it appropriate for lower division undergrads and technical schools, though a bit lengthy for busy healthcare professionals. Preventing Childhood Obesity: Evidence Policy and Practice, published by Wiley, also focuses on the prevention of obesity. For upper-level students and researchers, it is especially helpful for those who are learning how to assess evidence and how evidence is produced. Another perspective focuses more on the contours of the problem.

Obesity and Adolescence: A Public Health Concern, a book edited by four physicians, is more concerned with multiple aspects of the problem of obesity, including medical, sexual, physical, and nutritional, and even the international perspective. The solutions it does propose are social rather than familial in character. While the whole volume will not be generally read, its individual articles are useful even in a community college setting. The vision of childhood obesity as a public health concern that may be responsive to legal remedy is addressed in two books both published by the National Academies Press. The first of these, Legal Strategies in Childhood Obesity Prevention, provides an overview of many possible legal angles to prevent childhood obesity, discussing taxation, civil rights, product liability, and public health policies. While not always easy to read, the work does provide an introduction to different perspectives on childhood obesity. A second title, Local Government Actions to Prevent Childhood Obesity, provides a set of interventions that local governments might enact to combat childhood obesity. This would be a useful volume for professors interested in helping students connect global, national, and local analyses and for schools interested in community-based learning projects. A very different perspective from any of these, Education, Disordered EatingandObesityDiscourse, is edited and written by several academics (primarily education professors), such as John Evans, who teaches sociology of education, and Emma Rich, who lectures in sports education. The work generally argues that the “discourse” about obesity in schools creates more problems than it solves by creating eating disorders in young people without a consequent loss of weight. They suggest that the focus of the discourse is on the control of bodies and moral disapprobation and is not conducive to health.

History/ Discourse

Discourse analysis is much less unusual in the humanities-based view of obesity. For example, Alcohol Tobacco and Obesity, an anthology edited by Kristen Bell, pools the expertise of anthropologists, sociologists, and public health professionals from various parts of the world to examine how alcohol, tobacco, and food came to be viewed as “problems” and their users as problem citizens. This is an anthology that brings into question the reigning narrative of obesity as a public health issue. Similarly, another anthology, Biopolitics, and the ‘Obesity Epidemic’: Governing Bodies, takes as its starting point a Foucauldian view of discourse as a method of control. Edited by two professors of education, Jan Wright and Valerie Harwood in Australia, it provides fourteen different articles by multiple social scientists who analyze the discussion of obesity as a means to control bodies. In addition to these contemporary perspectives, Culture of Obesity in Early and Late Modernity: Body Image in Shakespeare, Jonson, Middleton, and Skelton by Elena LevyNavarro provides cultural studies that look back at the early modern period in England. There we see that “fatness” has not always been understood with the moral disapprobation from which it is stigmatized today. Sander Gilman also provides a history of various cultures’ understanding of obesity in his works, Fat: A Cultural History of Obesity, and Obesity: The Biography. Though they cover much of the same territory, Obesity: The Biography is organized chronologically using accepted historical periods, beginning with the ancient world and moving through the Medieval and Renaissance, etc., while Fat: A Cultural History of Obesity is organized thematically, looking at concepts such as epidemic obesity, childhood obesity, etc. These titles provide a useful cultural studies humanities framework for students of this issue, whether lower-level undergraduates or researchers, with less specificity than Levy-Navarro’s and therefore of more interest to a general audience. A more contemporary history of obesity and cultural analysis is provided in Rise of Obesity in Europe: A Twentieth-Century Food History by Derek J. Oddy and Peter J. Atkins, both of whom are professors in the U.K., along with Virginie Amilien, Senior Researcher at the National Institute for Consumer Research (SIFO) in Oslo, Norway. Less focused on a discourse analysis, this book is broken into three sections—trends in food consumption, industrial and commercial influences on food consumption, and social and medical influences. While it focuses on Europe, the book addresses many of the issues current in the United States, including issues about labeling, public assistance, and consumer choices. The question of whether or not obesity really is an issue we should be concerned with is nicely set up in two anthologies that are quite appropriate for junior college. DebatingObesity: CriticalPerspectives, edited by Emma Rich, Lee Monaghan, and Lucy Aphramor, is a two-hundred-page volume published by Palgrave Macmillan that calls into question the urgency of the fat crisis in fourteen essays. These essays regard askance many of the basic premises of the reigning discourse, including whether or not being obese is really bad for one’s health, whether we need to be so concerned about childhood obesity, and other such issues. This volume might serve as a useful starting point for debates for some lower-level students. Similarly, Obesity, a title from the “Opposing Viewpoints Series,” edited by Scott Barbour, addresses whether obesity is a true problem, what may be its possible causes, with whom the responsibility for obesity lies, and alternative methods of reducing obesity. These are basic texts that address some of the major components of an issue and are useful in teaching young people the elements of an argument. The additional reading list is also a plus. Another historical perspective is provided by Evolution of Obesity written by Michael L. Power and Jay Schulkin. These writers, both from the American College of Obstetricians and Gynecology, take us slowly through the evolutionary biology of weight. They expose the reality that our bodies are meant to store fat and discuss the changes in our environment regarding food and exercise in light of this biological fact. Though it will be useful even to graduate students, it is written for a general audience.

Epidemiology/Global Perspectives

Concerns about obesity as a public health and epidemiology problem are also regularly addressed in the literature. For example, in the anthology Geographies of Obesity: Environmental Understanding of the Obesity Epidemic, edited by Jamie Pearce, the focus is on how the environment, rather than personal choice, affects obesity rates. The collection begins with an introduction suggesting why we should think of obesity in these environmental or geographic terms. The second two sections of the book correlate with the immediate causes of obesity—including three essays on energy in or food eaten, and an additional three essays on the energy out or exercise done. The fourth section of the book builds upon these two elements of the environment to define what makes an “obesogenic” environment and how policy can ameliorate these conditions. The final section of the book suggests new pathways for exploration. Meant for those in public health, it may still be useful for junior colleges with allied health and nursing programs. Similarly, Obesity Epidemiology: From Aetiology to Public Health, a collection from Oxford University Press, covers major questions associated with obesity from the health profession’s point of view, including trends in obesity, its physical, psychosocial, and economic consequences, its causes, and methods of prevention, and whether targeting individuals or the physical environment or the food industry is appropriate. This is an overview for anyone in the health sciences interested in obesity. But while the two previous texts focus on “first world” issues, there are also a number of volumes that focus on “third world” obesity. For example, Emerging Societies—Coexistence of Childhood Malnutrition and Obesity is a collection of papers presented at a nutrition workshop sponsored by the Nestle Corporation. The articles shed light on why obesity often coincides with malnutrition among the poor in emerging economies. Contributors include researchers from India, China, Gambia, the U.S., the UK, Australia, and Brazil among other nations. The papers are broken into four parts: epidemiology, origins of malnutrition and links to obesity, mechanism of metabolic damage, and prevention of the epidemic of non-communicable diseases. The material represents a distinctive collection of interesting points of view. Though quite advanced for lower-level undergrads, it may be useful to include an international perspective.

The Economics of Obesity

If one chooses to forego the Nestle collection, however, there are other titles that could provide an international perspective from a vantage point that is more critical of the international food industry. Raj Patel’s Stuffed and Starved: The Hidden Battle for the World Food System (2008) looks at the global food network, its enormous power, and local resistance movements around the world. Similarly, Marion Nestle’s Food Politics and Paul Roberts’s The End of Food provide strong critiques of the food industry closer to home. Let Them Eat Junk: How Capitalism Creates Hunger and Obesity by Robert Albritton argues that hunger for profit distorts and renders inefficient the global food market. Because the market’s goal is not to alleviate hunger and provide adequate nutrition, the world’s population suffers from two evils—hunger and obesity. Both of these cost the larger society both economically and emotionally. This is a compelling argument, accessible to undergraduates, that introduces a particular theoretical perspective students can easily grasp within this narrative. Julie Guthman works hard to nuance this vision in her work, Weighing In Obesity, Food Justice, and the Limits of Capitalism. Guthman suggests that the panacea to obesity may not be organic and locally grown foods because they are more expensive and frequently financially out of reach of the pockets of poor people around the country. She further argues for government involvement in the market to make healthy food available to all. This work is easily accessible to all readers. The vision of the food industry as peddlers of obesity for profit, however, is not the only economic response to obesity. Franco Sassi in his Obesity and the Economics of Prevention: Fit not Fat focuses on the costs of the obesity epidemic to society at large. Using statistical information available today and projecting these costs into the future, he appeals to the public policymakers to invest monies to ameliorate the problem and so spare society a larger and spiraling financial burden. Another alternative to the discussion of obesity and economics, still critical of capitalism, comes from Gary Egger and Boyd Swinburne who argue in Planet Obesity: How We’re Eating Ourselves and the Planet to Death that obesity is not a disease but a warning sign of a world out of balance. In this engagingly written book, they suggest that an economic system based upon endless growth and reflected in the endless growth of our bodies is fundamentally unsustainable because the world is finite. The anti-capitalism, pro-government involvement argument is much less apparent in another take on the economics of obesity in Managing Obesity in the Workplace by Nerys Williams. This slim work, written by a physician, provides basic information about managing obesity in the workplace, including basic background information, medical repercussions, possible discrimination, and methods of promoting health in the workplace setting. Written in an engaging manner, it provides students with a different perspective regarding this issue. Another business perspective is provided in the edited collection, Obesity, Business and Public Policy, which includes an introduction by Governor Michael Huckabee. The anthology explores the intersection of business, the individual, and the law concerning obesity, including costs both public and private, obesity and the labor market, taxes, and the similarities to anti-tobacco campaigns. It suggests the importance of public policy concerning obesity.

Psychology/ Exercise

Claude Bouchard edited Physical Activity and Obesity, which covers an obvious element of the obesity problem but about which little is available in monograph form. Therefore this book’s coverage of nine sections, each addressing an aspect of activity and its relation to obesity, is a welcome addition to any collection concerning the issue. Broader in scope and useful for beginners is ChallengingObesity written by Heather McLannahan and Peter Clifton. Both academics working in the UK, this OUP title takes a scientific approach to several aspects of the problem. This work covers energy in and out, food: digestion and absorption, metabolism, brain and behavior, individual differences, consequences, and reducing, treating, and challenging obesity. This is a purely physiological approach and is useful and accessible for beginners. PUBLIC POLICY Two titles about public policy that would be useful for communications students include Leveraging Consumer Psychology for Effective Health Communications and Brian Wansink’s Marketing Nutrition: Soy, Functional Foods, Biotechnology, and Obesity. Wansink’s book is about how to persuade people to do what is healthy for them by being very clear about what gets in the way of doing what works. This is backed up with research and presented in a very readable text. Leveraging includes twenty essays that suggest that how we speak of obesity may determine how effective we are in combating it. Using psychological research both communal and individual, these papers proffer methods of persuasion to influence the countless individual choices that combine to create an epidemic. The individual articles here may aid individual students in limited research projects about obesity. In contrast, other materials about public policy are less about communication than other methods of getting people to change their behaviors. Bridging the Evidence Gap is meant for public policymakers looking at evidence-based options for obesity prevention and interventions on the community level that influence individual choices about food and exercise. While it is not perhaps the best choice for most community college audiences, it does make interesting links between evidence and policy, as well as examines methods of researching and methodologies that seem incredibly important. The strength of all three books is their insistence on evidence to support programs. In contrast, is Neil Seeman’s program outlined in Obesity and the Limits of Shame. He argues for a public policy that would create a financial payoff for losing weight by means of a voucher. Seeman argues that this would persuade everyone to create their own appropriate weight loss program.

Social Class/ Gender/ Ethnicity

The questions of public policy tend to look at rates of obesity in different populations. We have then a number of studies that use these statistics go forward to either make policy recommendations or explain the distinctions among populations. In our country, public food assistance is often linked to obesity and hunger. Two books are available to look at this paradox. Hunger and Obesity: Understanding a Food Insecurity Paradigm from National Academies Press, is a workshop summary that addresses public nutrition assistance programs that include both hungry and obese people, analyzing this health dilemma sociologically through individual, familial, environmental, and institutional lenses. It is a useful introduction to sociologists and health fields. It raises the question that Obesity among Poor Americans: Is Public Assistance the Problem? addresses head-on by examining several alternative arguments within the debate including the idea that public assistance causes obesity; conversely, that obesity causes the need for public assistance; or that poverty causes both obesity and public assistance, dissecting each argument using empirical evidence from a variety of disciplines. The book does not come to a final conclusion, but its method is instructive in teaching argumentation. In contrast to the food assistance debate, another perspective looks at food culture in different ethnic groups and how this culture affects obesity rates.

In today’s society, a lot of kids no longer get involved in any type of physical activity, because of technology. There is also a big unavailability of healthy foods for families that are struggling with low income. Children also struggle with obesity because of issues from within such as low self-esteem and confidence issues which could often lead to eating disorders, which then would lead to obesity in some cases. Childhood obesity is an issue that many people have to deal with. There are many causes and effects of childhood obesity, but there are also many different solutions for this ongoing issue.

Physical activity is something that is good for everyone, and if children were to start at a young it could possibly encourage good habits for later in life. The Center for Health and Health Care in Schools suggests that “one of the leading causes of this epidemic (childhood obesity) is a marked decline in physical activity and athletic participation”. Children tend to fascinate by playing video games, watching TV, or simply just browsing the internet are just a few of the things taking over children’s free time during which they could be physically active. Therefore, schools should make it mandatory for some sort of physical activity to take place in the classrooms all across the country, this will help reduce the lack of activity for children which then would be one step closer to preventing childhood obesity. Another way to help increase physical activity in children is to put limits on the amount of screen time they have. New technology is a big reason why children don’t get as much physical activity as they used to so in order to stop this there should be limits on the amount of screen time a child has per day. If this were to happen more kids would engage in physical activity just by going outside and playing around because they know their electronic time is up.

Food is a big aspect of the obesity epidemic, especially the unavailability of more healthy foods. Healthy foods tend to be unavailable to some people because they are simply too expensive for them to afford. Typically fast foods are very cheap and sometimes it is the only thing a family can afford so they have to get it. Another reason why people tend to lean towards fast food more than healthy food is because of the appeal. Many people don’t want to eat healthy food because it doesn’t look as good as fast food. With that being said healthy foods also aren’t a trend because they aren’t convenient enough for some people. People would much rather spend a few minutes in the drive-thru at a fast food restaurant than in the kitchen at home slaving over the stove. All of these things have solutions to them, in order for people to be able to afford them the prices could be lowered slightly. If healthy foods were cheaper more parents would be able to afford them for their family. Stores could also offer more coupons for healthier foods to help increase the number of people that actually buy the foods. The second solution for the unavailability of healthy foods would be to simply make them more appealing. There are even websites that allow you to order the food and all the ingredients can be sent to your house to make the food and it will look just like it did on the TV screen. Finally, a way to make healthy foods more available is to make them more convenient. There are so many fast food restaurants that serve unhealthy foods, but there aren’t any places that focus solely on healthy foods. Spending hours in the kitchen cooking after a long day at work is not something that many people want to do, so they typically go pick up food from a fast food restaurant.

There are so many causes of childhood obesity, more than just the stereotypical ones like not getting enough exercise and not eating properly. A child could become obese from other things such as eating disorders and confidence issues. Being insecure and self-conscious about your weight can cause a person to become depressed which could then lead to bad eating habits and after that comes obesity. In order to prevent a child from feeling this way you just need to give them a little affirmation, this helps a child feel much better about themself. Once a child has become secure and confident with themselves then they can achieve any goal they wish to, which might be losing weight or starting to develop better eating habits to avoid obesity. This not only could help reduce the number of children that are obese but it could also help reduce the number of children that are bullied in school because of their weight. Bullying can deteriorate a child’s self-confidence a lot which was also be a contributing factor to depression and bad eating habits. So a solution for childhood obesity would be just to encourage a child and make them feel good about themselves and let them know that they can accomplish anything.

Childhood obesity is an issue that more people need to take seriously in order to prevent the issue. The solutions listed above are just a few ways that we can try and solve childhood obesity. Children don’t have enough knowledge on the issue to where they can be held accountable for their actions, it is unfair that they have to inherit the physical issues and health issues that their parents did. Childhood obesity is able to be avoided if parents implement the proper diet and an adequate amount of physical activity in their child’s life. There are many causes and effects of childhood obesity, but there are also many different solutions for this issue and if everyone learns of ways to prevent this issue, we could end the ongoing epidemic. Typically if a person is obese as a child it usually tends to lead into adulthood as well. This is why it is so important to keep kids from becoming overweight and to help obese kids lose weight. Due to the number of parents that are obese increasing, new technology, the lack of supervision at home after school, and unhealthy school lunches can be to blame for the number of obese children increasing in society.

Childhood obesity, an ongoing disease burden in various parts of the world, is a serious medical condition where the body stores excessive body fat. It has been investigated by experts, researchers, and medical professionals because its prevalence has been increasing annually. However, plans have been implemented by governments and other institutions to aid in lessening its recurrence. Undoubtedly, children who are obese are prone to developing serious incurable diseases such as cancer, diabetes, and hypertension. Additionally, there are factors that contribute to childhood obesity, which are mostly family-related, and certain socio-emotional and physiological consequences that these individuals encounter in life; however, there are methods that can be used to help reduce and prevent it.

The causes of childhood obesity are intricate, but domestic factors seem to be most associated. Childhood obesity or being overweight begins at home since it is where children are provided with approximately two-thirds of their daily food intake (Curtis, 2017). Additionally, Curtis (2017) pointed out that parents have limited knowledge about healthy portion sizes that they should provide for themselves and their families. Curtis (2017) further explained that parents having limited knowledge about healthy portion sizes is not a shocker because there are insufficient public health resources on this subject matter. This shows that since parents are the ones who are responsible for providing their children with food, their health can be affected by their parent’s incomprehension of healthy eating habits.

Moreover, easygoing parents, those that allow their children to do as they please, tend to have children who consume less healthy foods such as fruits and vegetables, but more unhealthy foods that are high in fats and sugars (Fiese and Bost, 2016). Curtis (2017) discussed that because of parent’s low self-confidence, they have failed in maintaining their own weight and this can also contribute to their inability to manage their children’s weight. Also, Curtis (2017) expressed that communication between parents and children was an issue because parents found it difficult to speak to their children about smaller portion sizes to maintain their weight. As a result, children who are obese are associated with parents who do not communicate with them about their weight.

Furthermore, Curtis (2017) emphasized that not only parents, but grandparents and significant others can be a barrier in regulating their children’s eating habits since they provide them with extra food. These research findings indicate that family, especially parents, play a significant role in their children’s eating habits and most so their weight management. Consequently, due to the severity of childhood obesity, affected individuals will experience certain consequences.

Childhood obesity affects children negatively by disrupting their socio-emotional health. Children who are obese have lower self-esteem than children who are not obese (Krushnapriya et al. 2015). Furthermore, Krushnapriya et al. (2015) explained that because of their weight, obese and overweight children get ridiculed regularly and are bombarded with challenges such as prejudice, social exclusion, and negative stereotypes. These social issues can lower their self-esteem, self-confidence, and self-image and cause them to withdraw from peers and close family members. Also, Curtis (2017) determined that communication is difficult for parents because they are afraid that it will cause anxiety in their children. Therefore, anxiety is another socio-emotional consequence that obese children can face. Apart from disrupting a child’s social and emotional health, childhood obesity has physiological consequences.

Chronic illnesses can arise from childhood obesity and can progress into adulthood; they can affect the normal functioning of the body. Childhood obesity is associated with many medical ailments such as fatty liver disease, apnea, asthma, high cholesterol, orthopedic problems, and gallstones and some of these conditions can lead to death (Krushnapriya et al. 2015)

Additionally, Knight, Cole, Dodd, and Oakley (2016) stated that one of the highest rates of childhood obesity was found in the state of Mississippi and that the frequency of obese and overweight students in K-12 increased to 41.8% from 40.9% in 2011. They concluded that Mississippi has one of the highest rates of chronic illnesses such as hypertension, atherosclerosis, and diabetes. Therefore, where ever there are high rates of childhood obesity, the rate of chronic illnesses is certain to be elevated as well. However, there are certain precautions that persons can adhere to reduce and prevent childhood obesity.

Since the causes are childhood obesity is mainly related to family issues, developing better family structures can aid in its prevention. A child’s genetic risk for childhood obesity can be lessened through family communication and by helping them control their feelings and fullness when eating (Fiese and Bost, 2016). They also stated that families who are involved in direct forms of enlightening communication and show an authentic interest in each other are less likely to have children who are obese and are involved in unhealthy eating practices. Likely, Curtis (2017) said that parents’ communication and problem-solving skills should be improved so that they can be able to resolve their issues with food. This will eventually benefit their children since they will be able to speak to them about weight management issues.

In conclusion, childhood obesity is caused mainly by family factors, it has socio-emotional and physiological consequences but can be prevented through family interventions. It is caused by parents’ lack of knowledge of healthy eating and weight management, and their lenience in regulating their children’s eating habits. These children are socio-emotionally affected by this disease burden because it lowers their self-confidence and self-esteem since they are teased constantly by peers. Physiologically, it can affect the normal functioning of the body and result in chronic diseases such as hypertension, diabetes, and high cholesterol. However, if prevention methods such as family communication and knowledge of healthy practices are improved then the prevalence of this disease burden can reduce. Although childhood obesity is caused by domestic matters and has unfavorable outcomes, it can be prevented through better family practices.

Introduction

Obesity in children is a global epidemic with numbers growing fast in need of action to be put in place. Different policies have been put in place by different countries worldwide touching marketing, economy, schools, etc. to reverse the climbing numbers. The purpose of this research is to determine the information data collected in order to manage and find the treatment of child obesity in school settings and clinical settings. With the question of childhood obesity, this research will look at how to educate parents and societies when it comes to obesity and ways to prevent it. In, the efforts that were put before did not meet the goal of remarkably reducing the number of obese children and preventing more children from falling into this category or health condition. Physical activities have been encouraged in young children especially youth in the past years; nevertheless, this is not adequate and should simultaneously work hand in hand with altering food choices. Some policies have been introduced by the legislature and set in place, but more policies should be applied to implement healthier eating habits and lifestyles. Educating society about obesity and how to tackle the situation very early is very important. Learning the physical, emotional, and mental implications that it has on a child should be made a priority. Creating posters in schools or in education settings can help educate and make the children think about what they eat and maybe have the urge to eat healthy foods and snacks. All of these scenarios can help create awareness and also benefits the children as a whole. The government has created a plan for action when it comes to childhood obesity which consists of things like introducing soft drinks industry levy, taking out 20% of sugar in products, supporting innovation to help businesses to make their products healthier, developing a new framework by updating the nutrients profile model, making healthy options available in the public sector, continuing to provide support with the cost of healthy food for those who need it most, helping all children to enjoy an hour of physical activity every day, creating a new healthy rating scheme for primary schools, making school food healthier, clearer food labeling, supporting early years settings, enabling health professionals to support families, harnessing the best new technology and improving the coordination of the quality sport and physical activity program for school (Gov, UK, 2017).

Rationale

The reason for this research is to find ways to educate parents and society in general on how to prevent and raise awareness of obesity in children. The number of children that have obese has become alarmingly high. Creating posters in schools or in an educational setting can help educate and make the children think about what they eat and maybe have the urge to eat healthy foods and snacks. All of these scenarios can help create awareness and also benefits the children as a whole. The government has created a plan for action when it comes to childhood obesity which consists of things like introducing soft drinks industry levy, taking out 20% of sugar in products, supporting innovation to help businesses to make their products healthier, developing a new framework by updating the nutrients profile model, making healthy options available in the public sector, continuing to provide support with the cost of healthy food for those who need it most, helping all children to enjoy an hour of physical activity every day, creating a new healthy rating scheme for primary schools, making school food healthier, clearer food labeling, supporting early years settings, enabling health professionals to support families, harnessing the best new technology and improving the coordination of the quality sport and physical activity program for school (Gov, UK, 2017). This research will try to find out the best treatment for childhood obesity in order to increase the life expectancy of the affected children and less the burden on the National Health Services.

Research question

The question is ‘how does obesity affect children’ Deciding where the responsibility falls in regards to making sure a healthy life for a child is a priority, is the first ethical concern. Asking questions like do the caregivers, parents, guardians, communities as a whole, etc take responsibility for the children. Are they willing to put them on a healthier diet? Making sure healthy eating habits are encouraged? and considering putting an effort into preventing child obesity. when we look at the obese children that were looked after the pediatric doctors within ten years (2012-2020), the children received treatment by pediatric doctors which includes psychologists (clinical) and a dietician. For example, the research was done by the Midlands Adolescents School sleep education Study (MASSES), ‘the researchers recruited around 800 11-12-year-olds from nine secondary schools in the Midlands. They are following the children for three years, gathering data that will help answer their questions (Action, 2011). The researchers were trying to find out why so many teenagers and young children were becoming obese in such a big number. A quantitative was used to determine the results. Questionnaires were used to collect data and results on this research, as well as collecting data on this research. They measured BMI scores in one of the communities. It was found that 25.5% increase in nutrition knowledge. A limitation of this study was that study lay on classroom and physical education teachers to gather data and implement the programming, they did not always see the value in the research and often had a conflict with scheduling programs around the pre-existing curriculum (Sanders et al., 2015)

Aim

The aim of this research is to show how efficient the questionnaire approach (both quantitative and qualitative methods as they take yes or no answers to a rating scale i.e.. 1-10) is and to determine whether different methods would give different answers when it comes to children’s in school BMI scores comparing to different age groups. The questionnaire method will provide the true results in both numerical and measurable evidence. The purpose is also to examine the literature and identify different approaches according to the evidence for treatment and obesity in children in mainly primary care. Placing the question forward in primary schools and early secondary schools, ‘How does obesity affect young children and the consequences of it? The findings that will be found will lower the presence of obesity in young children especially those in their early years. Furthermore, to find out what is the best solution treatment that will solve this big problem and to find out the long-term solution and longer life expectancy of the children. As well as major diseases associated with childhood obesity continue to be on high, the disease can cause extreme emotional health to a child. Discrimination and bullying are the main and worrying effects that an obese child has to deal with. Because of the weight an obese child would find it hard to participate in physical activities because of shortness of breath. A child who is obese would shut down and not want to involve themselves with other children because of being bullied or picked on. In most cases, this is where the bullying and discrimination start. These feelings continue to affect a child’s emotions and also put some effect on a child’s psyche growing up.

Method

Questionnaires would be appropriate for this research method. ‘A questionnaire is a specific tool or instrument for collecting the data. Designing a questionnaire means creating valid and reliable questions that address your research objectives, placing them in a useful order, and selecting an appropriate method for administration’ Scribbr 2021). I choose this method because it provides privacy, and cost efficiency as it is very cheap and quick to make. Having a choice of either distributing them in person or online. It can be customized to my own liking, I can choose how I want it to be distributed, what kind of questions I can put in it, and have a choice of making it long or short, putting pictures in it, etc. For example in this research, a Printed questionnaire would be provided to the young children and the parents of younger children in school settings or the clinic while visiting the setting, in the clinic setting the trained clinician and a person who does the research would take the height, weight, and the BMI to determine the answers. The relationship between BMI, demographic factors, and the results of the questionnaires about physical activities and eating behavior would be analyzed. The questions on the questionnaire would help to collect the necessary data to quantify the results. Then the results will be applied in to statistics i.e., mean, more, or frequency to outline the collected information. Using a questionnaire as a method of collecting data has its advantages, here are some examples, advantages of using this method include greater validity, anonymity, economical, wide coverage, it is rapid, repetitive information, puts less pressure on the respondent and it is the most flexible tool for data collection. The disadvantage of this method is lack of personal contact, the possibility of manipulated entries, incomplete entries, illegibility, and unreliability.

Participants

This study will look at obese children, what is the cause, better habits of eating, exercise, and how to improve their self-esteem. The general school population especially ages 5 to 14 will be the main focus. Obesity in childhood is also described as ‘one of the most serious public health challenges of the 21st century. In 2016 WHO found that globally the number of overweight children under the age of 5 topped 41 million, and the number between ages 5 and 19 was 340 million’ Gila Lyons (2022) Obesity. if the current trend situation continues the number of obese children worldwide will increase to 70 million by 2025. Without intervention, obese children will more likely continue to be obese during childhood. Childhood obesity has become a predominant situation as numbers are only developing higher and higher. The pressing need for some kind of movement and looking for an effective method of public policy appears to be a positive choice of action; even though attention must be given to addressing the moral and ethical issues. A sample of a good number of children in different settings i.e. clinics or schools would include a high number of children aged between 5 and 18 with obesity with a BMI score that is on or above the 85th percentile. Those children who suffer from genetic diseases that affect body weight or the ones that have made only one visit to the setting (school or clinic) would be on exclusion criteria that have normal BMI or below 85th percentile. When participating in the study research a researcher would make sure that they have changed all the personal detail like address, names, etc. the researcher have to make sure that they protect everybody that has participated in the research and is fully appraised from any risk because of their involvement.

Procedure

The clear wording clarity and sustainability for the answers questionnaire about childhood obesity will be given to the group intended ie. The parents, carers, and the clinics. The intended individual would reply to the closed-ended questions (multiple choices, yes or no, etc.). then I will use the statistical analysis methods to test the familiarity between the variables.

Data Analysis

I will do a lot of research about obesity in childhood in writing, and different ideas that influential writers have come up with and try to understand their reasoning on how to deal with child obesity. This research will then expand deeper, to understand how to deal with child obesity.

Design

When planning the research and determining what the subject would be, the researcher would have what would be the convenient and effective way to get accurate information. A secondary data collection would be involved in gathering the information. For this research, a survey response would be the ideal way to gather the data. The reason I would use this secondary data is because it is cost-effective or sometimes free. For example, there are many sites online that hold data for people to view and use in the research. Search engines like google scholar, online library, etc. do provide previous researches that have been done before based on a specific topic. I could easily create a free account and use the search engine to look into a specific subject. The advantages of using secondary methods are faster research speed, low financial and time costs, faster research speed, easily and rapidly available data, and the ability to scale up results. The disadvantages can be the researcher has no control over secondary research, secondary research data is not exclusive, and secondary research data can be out of date.

Results

With the number of obese children on high to date, ‘the National Child Measurement Programme figures published today show the body mass index (BMI)classification rates for English children in reception and year 6 by age, sex, ethnicity, and region. The results show that 40.9% of children aged 10-11 are living with overweight and 25.5% are living with obesity. of children 4-5, 27.7% are living with overweight (including obesity), and 14.4%are living with obesity (Diabetes). Most children who are obese have been psychologically affected because of the huge burden brought by the stigma associated with obesity. if the health issue of childhood obesity is put forward to discuss public policies things like media especially social media will spotlight individuals who are obese and overweight. This spotlight will bring attention to the youth who are likely to experience stigma and bullying from their friends etc. In addition categorizing these children by BMI can tell who is obese or who is not obese and with the negative implications of the term. Stigma in society will rise if privacy concerns are not addressed. The stigma may be obstructing a factoring in getting action for public policy. Boyd Swinburn describes how stigma may be challenged to get a sufficient body of people to initiate movement, ‘indeed, the stigma associated with being obese means that the public constituency agitating for change is quite small. There is not a groundswell of overweight and obese people calling for action the pressure is predominantly coming from the professional sector. Therefore, it will be important for obesity prevention advocacy to combine with other like-minded ‘movements ‘to get policy action’ (Swinburn, 2008). Stigma takes the attention away from coming up with a solution and advocation for policies to be put in place in order to focus on excluding those who are obese. Children who are overweight or obese tend to build experience stigma which is damaging to their psychological health. This is not the only problem with stigma but it does not serve to draw people to advocate for changes.

Discussion and Conclusion

When completing the research about childhood obesity, I believe that I can give more information to parents that have children that are obese and educate society on how to tackle this pandemic. I will educate society and the parents even though, some primary care providers are very busy and will say that they need more time to see the patients. In my opinion, the only way to overcome this is to educate the service provider on the results that I have gained and answer all the questions that they have. The results that I will hold will change the way that societies, parents, and carers the way they raise their children when it comes to diet and physical activities, which will help their children from becoming obese.

To conclude, I will run a close reading and research on the whole topic of ‘Obese in children’ and make sure that the parents and carers know to deal with childhood obesity. I will not put a limit on my research and that way I can accomplish my goal. From this research, I have learned that obesity is preventable yet it become a worldwide epidemic.

The most important health interventions in East London are physical activities and dietary interventions to tackle obesity and overweight health issues.

In this essay, I will write about health interventions in Tower Hamlet focusing on obesity as a health issue.

In the first paragraph of the essay, I will write about the disease called obesity and how it has affected the lives of many in East London and the United Kingdom; I will also write about different health issues affecting the populations of the borough of Tower hamlet as one of the boroughs in East London, and I will later write about different interventions in place to tackle those health problems focusing on children living in Tower Hamlet.

I will back up my argument with different interventions to tackle childhood obesity in the latter part of this essay, I will conclude my essay in summary of the argument on the interventions.

Obesity is one of the prevalent health issues in the borough of Tower Hamlet in East London and the United Kingdom. According to the World Health Organization, it has recently shown that the increase in childhood obesity has increased from 32 million to 41 million globally (WHO,2012).

A report has shown that 61 percent of adults and 30 percent of children between the ages of 2 years 15 15years suffer from obesity in England

Childhood obesity is reported to be high in Tower Hamlet with 27.1 percent of children, ages (10- 11 years) are revealed to be obese, which is one of the highest in the capital (NHS,2018).

There is a link between obesity and overweight and the rate of deprivation that is prevalent in the borough. The place is rated to be the most deprived boroughs that suffer from health inequalities due to the high rate of poverty, it is known as a place that has one of the highest rates of health issues in East London, like obesity and other obesity-related health issues like cancer. (pubmed.gov/ncbi).

The number of less privileged children is high and obese.

Tower Hamlet has about 300,000 in population with an ethnically diverse population and one of the most densely populated boroughs in East London. It is considered one of the world’s most racially zones with a diverse place of worship for different religions.

The populations of people in Tower Hamlet are more Muslim than Christian living in the community in which religion and cultural differences also contribute to the level of obesity (Tower Hamlet Council,2018).

Other factors affecting the health and well-being of people living in Tower Hamlet vary from psychosocial factors to economic factors and behavioral factors like poor

diet and lack of physical activities. There is an increase in the number of time children spend watching TV and playing computer games which leads to a lack of body exercise, which is the cause of obesity in the UK (Care, UK 2019).`

Obesity is the accumulation of fatty tissues in the body, which leads to chronic and long-term health issues. The increase in body mass index (BMI) as a child increases the likelihood of being obese as an adult. Obesity is one of the greatest threats to health in the developed world

According to the World Health Organization, which states “Obesity has reached an epidemic level globally with at least 2.8 million people dying each year as a result of overweight and obesity” (WHO, 2012).

Childhood obesity starts from the early years (0-4 years) through to their school years in ages (10-11 years) and to adolescence which leads to health complications in adulthood.

According to Care UK 2019, reports have shown that childhood obesity is on the increase in Tower Hamlet. The reports show the strong connections between obesity, Type2 diabetes, and other chronic diseases like cancer and cardiovascular disease, mental health problems, and child dental problems.

Research has also shown that being obese can increase the risk of heart disease, and Obesity has a strong connection to, many chronic health issues like type 2 diabetes, cancer, and chronic respiratory and cardiovascular diseases.

The borough profile 2014-2016, report shows that Tower Hamlet has the highest rate of preventable death compared to London and England; the infant mortality rate is the highest compared to other boroughs in London; 43 percent of children in year 6 were obese in comparison to 39 percent in London.

The level of physical activity of the children in Tower Hamlet has been reported by several metrics to be low and this has resulted in childhood obesity in the borough (JSNA,2010-2011).

It is discovered that people living in the borough start to develop poorer health status ten years earlier compared to the rest of the country; and this is due to the socioeconomic factors, the level of poverty and deprivations in the community, poor housing, air pollution, lack of access to healthy food and lack of green spaces for physical activities.

About 1 in 4 children are obese in Tower Hamlet; with a report of childhood obesity levels of children between the ages of 4 years to 5 years of age and 10 years to 11 years are high in obesity compared to the national level. Tower Hamlet is reported to have a lot of fast food businesses, which encourages poor diet. (Tower Hamlet, 2018).

Therefore, preventing the rise of obesity through an increase in physical activities, a change of diet, and eating healthy will create a positive impact on the community. Factors affecting the increase in Obesity are mostly deprivation, socioeconomic factors, psychological factors environmental factors, and behavioral lifestyle.

Intervention is strategies or approaches to tackle health problems in individual lives and the environment to improve the health and wellbeing of the individual lives.

Interventions can be either preventive measures or therapeutic measures to create a healthier and safer environment, life longevity, and positive behavior and promote the health and well-being of individual lives and the community.

different approaches to interventions could be a behavioral approach, educational approach, medical approach, empowerment approach, social approach, and or combinations of some or all the approaches to solve the health issues that have proven to be effective in health promotions in Tower hamlet.

According to public health, “physical activities refer to any activity that requires force exerted by the skeletal muscle which results in the use of energy beyond resting level”. (PHE, 2017)).

Physical activity has proven to increase the level of confidence and self-esteem of children.

Tower Hamlet’s joint Health and wellbeing strategy was a collaborative effort, by the borough’s health professionals, and health organizations of the governmental bodies to tackle health issues in the community.

Physical activities and dietary intervention prevent the development of disease and promote the health and well-being of families and the community in Tower Hamlet.

Physical activities and dietary intervention improve mental health state and prevent obesity and overweight, cardiovascular diseases, cancer, and type2diabetes which are common health issues in Tower Hamlet.

Working together governmental bodies like Public Health England, NHS England, the Department of Health, and NICE, tackle the problems of obesity and overweight and any other health-related problems.

Some of the health promotion frameworks are “All Our Health”, ”Start for Life”, “Change4Life”, Sugar Smart, “Healthy Weight, Healthier You”.

According to Sir Mamort’s health review in a post in 2010 on health inequality (fair society, healthy lives)reported that “ high-quality support for mothers, good parenting, quality early education, receiving income that is enough for healthy living, living in a good environment, access to quality health and social care services and access to evidence-based programmed that address behavioral risk factors to health are the main factors that support healthy lives”.

The behavioral approach is one of the approaches to intervention to prevent negative behavior, bad habits, and physical inactivity that leads to ill health and obesity. It promotes a physically active lifestyle like cycling, swimming, and a healthy eating habit.

Early intervention is a life course approach that gives a child a good start in life by promoting a healthy lifestyle of a child from infancy to toddler through to adulthood, targeted at children and families that have a high risk of obesity due to generic status or behavioral lifestyle by educating the parent, health promoters and carers which empowers the family and the community to be in control of their health status in later in life.

Breastfeeding mums are being supported in the borough by providing venues and access for them to be able to comfortably breastfeed their baby for a healthy start in life.

The children of school age (10-11years) are prevented from buying unhealthy fatty food by locating the shops 400meteres away from school. Children were encouraged to cycle or walk to school to increase their level of daily active exercise and to reduce air pollution caused by car exhaust emissions.

“Change4life” Is an intervention program launched in January 2019 to tackle obesity. In Tower Hamlet, working together by health professionals, improve the health and well-being of the people and address the level of childhood obesity. It encourages families to make a change through the eat well, Move Well, live well campaign encouraging children to stay active for life.

“Change4Life” A healthy borough program is a partnership program with the collaboration of the NHS and public health to encourage healthy eating in schools by providing fruits and vegetables for example Christ church schools in Tower Hamlet were consistently provided with healthy lunch boxes, fruits, and vegetables at meal times. A Healthy Weight, Healthy Life is a multi-agency initiative to tackle the high level of obesity in Tower Hamlet.

Businesses were also encouraged to sell more fruits and vegetables, to reduce their salt and sugar levels in takeaway foods. Schools were located away from fast food shops of about 400 meters (10 min walk) to discourage the year pupil from purchasing junk foods. Incentives and awards were given to businesses that sell more healthy food. Grants of £500 were given to people to use to set set up an initiate they believe their community needs. Adequate training and posters were given to shops to educate people on healthy eating.

A healthy diet is an important part of health and well-being, it prevents diseases and promotes health.

Change4Life Active play creates an indoor game whereby children can still do indoor exercise, to increase their physical activities and get involved with outdoor activities like sports and exercise to promote their health.

Child and family weight management programed, children between the ages of 5 and 19 are actively supported in Tower Hamlet to ensure healthy lives and have access to health care services and they are also encouraged to actively cycle in school and to adopt a cycling culture to their lifestyle.

“Get Your Skate On” A free program that took place on the 20th of February 2019 featuring Ice skating, sports taster, rides and climbing, basketball, skateboarding, tennis, athletics, arts and crafts at Bethany Green Gardens to encourage people to stay active during the holiday

The Medical approach to intervention is one of the health promotion interventions to tackle obesity and overweight in the community for example, pharmaceutical need assessment (PNA) strategy to increase pharmaceutical shops in the borough of Tower Hamlet.

Although “Research Changes Live” (2014-2019), is a medical approach to intervention, used by the health professional to tackle health problems like Obesity and related diseases.

It uses both scientific areas and experimental approaches to tackle health problems by producing an understanding of the mechanism of obesity and its strong link to diseases to develop an intervention that improves health and wellbeing. It is therefore not the most effective due to cost which results in a lack of funds to sustain it.

Physical active and healthy eating will be more effective in the borough if there are more green spaces and more parks for children to do sports and different activities and hence promote the health and well-being of the children, now and in the future.

The first person that would be selected would be Dr. Lawrence Kring from Canton Primary Care from the Canton-Potsdam Hospital. His experience would be necessary in developing healthy weight loss initiatives for our target populations (children, adolescents, and parents) while taking into consideration individualized needs and incorporating those requirements into a successful treatment plan for the coalition. Specifically, Dr. Kring would serve as an expert. For example, Dr. Kring would help create healthy weight loss plans by reducing empty calorie intake and/or increasing the individual’s energy expenditure, or whatever he sees as most fit (combination of both, or one, etc.).

The second person that would be selected would be Dee Burlingame, a board member of the Canton Day Care Center, and the current president of Early Childhood Specialist with St. Lawrence Child Care Council. Ms. Burlingame would be a valuable member of our coalition as she would serve as a family and child advocate while also providing parents, families, schools, and daycare center staff with the necessary training and knowledge regarding nutrition and physical education. For example, by promoting mandatory active recess in schools, Dee would be encouraging increased physical activity amongst children in efforts to combat obesity. Dee also has familiarity working with the early childhood programs at SUNY Canton and BOCES and is a board member of the St. Lawrence County Community Development Program. Dee’s superior knowledge from working with children, poverty issues, and the community would prove her to be a treasured member as she would be able to be an expert on child care while offering counseling for select populations (such as those children who come from low-income families). She would also be a representative of the communities she is and has been a part of, where she can ensure diversity and varying perspectives/attitudes about childhood obesity prevention.

The third person who would be selected to be a part of the Childhood Obesity Prevention coalition would be Marie E. Loson. As a board member of the Canton Day Care Center, she has helped to prepare the Center for its new capital growth campaign. Additionally, she worked at St. Lawrence University in fundraising for over 10 years, and her experience would be very helpful in acquiring funds to carry out the coalition. Considering her extensive fundraising background, Marie may be responsible for promoting physical activities in the community avenues through signage, worksite policies, social support, and joint-use agreements. Additionally, Marie is also responsible for being an expert in the field of fundraising to have sufficient materials and resources for our coalition.

The fourth person who would be selected to be a part of the coalition would be Kathryn L. Mullaney. Kathryn retired from St. Lawrence University as their Vice President for Finance and Treasurer, and she has been the Director and Treasurer of the Canton Day Care Center. Explicitly, Kathryn would be an expert and she would be responsible for managing finances as well as be responsible for funds available for investment and risk management related to the health improvement activities of the coalition. She could also be able to help increase the number of institutions with nutrition standards for healthy food and beverage purchases.

The fifth person who would be selected to be a part of the coalition would be Barbara Adams. Barbara is the director of Head Start while also a Board Director of the St. Lawrence Child Care Council, Inc. With Barbara’s expertise in providing wide-ranging preschool programs for children of low socioeconomic status, or children with disabilities, her services to the coalition would predominately focus on parental involvement. For example, Barbara may encourage early childcare programs to enroll in programs like the Child and Adult Care Food Program (CACFP) and the Eat Well Play Hard program (EWPH). Barbara would be a valuable member because she would be able to be both an expert and representative of child care, where she would have the opportunity to continue to advocate for a diverse population of children via education and resources to families. Additionally, Barbara would be useful in recruiting other organizations and businesses that would be of great assistance to our coalition considering her experience working for the SLCCC.

The sixth person who would be selected to be a part of the coalition would be Karen Durham, the head Social Welfare Examiner of SNAP (Supplemental Nutrition Assistance Program). Karen’s involvement with goals in reducing hunger and malnutrition of low socioeconomic status families would prove her to be a valuable member regarding business as she would be skilled in assessing and prioritizing individuals that require more urgent attention. Also, her experience with the Temporary Assistance Unit, at St. Lawrence County Department of Social Services, shows Karen to be effective at assisting families to meet basic needs. Also, Karen could help encourage districts to prohibit advertising and promotion of less nutritious foods and beverages. By being an expert and representative of her department, Karen’s responsibilities of identifying and evaluating the fundamental problems within a household would be valued because she would help the intervention effectively identify the social determinants of health within the family setting.

In New York State, St. Lawrence County is a relatively large and mostly rural region that is situated between the Adirondack Mountains and the St. Lawrence River. With a population of 110,007 in 2015, the median age in St. Lawrence County is 37.8 with 15% of residents being over 65. In 2014, the poverty rate was 19%, while the poverty rate for children was 26% which, in comparison to statewide and national rates, are high. Specifically, the estimate for the county’s poverty rate was 19.7% compared to 15.6% for New York State. St. Lawrence Country has a median household income of $43.5k, where it remains lower than the statewide median of $58.7k. Additionally, there is an association between educational level and poverty within the county where 33% of individuals without a high school diploma live in poverty compared to the 7% of those who have a four-year degree.

With elevated poverty rates and its correlation to education attainment, adult and childhood obesity is of high priority. Specifically, 33% of St. Lawrence County adults are obese, which exceeds most other counties in Upstate New York, and above the statewide rate of 25%. Compared to a previous survey (2008-2009) the incidence of adult obesity had increased. Shockingly, when overweight adults were incorporated, the rate rose to 71% (notably higher than the statewide rate of obese or overweight adults of 61%). Particularly, the rate of obesity among children and adolescents is 20%, which also exceeds the statewide (not including NYC) average of 17%. All in all, the county is classified within the top quartile of the state counties for childhood obesity. This suggests that childhood obesity is of significant concern especially considering how obesity is a risk factor for heart disease, stroke, many forms of cancer, kidney disease, and diabetes. If there are no public health measures taken to address this issue within the next 10 years, then the obesity epidemic could surpass smoking as the leading cause of preventable deaths and would have serious personal and economic repercussions. As for the economic repercussions, more money would be put into treatment and care for the chronic diseases associated with obesity. Over time, with a younger population of obese people on the rise, the money that will go into health care treatment may increase substantially. The percentage of obese adults in the county is increasing, which is important because cardiovascular disease is responsible for a near-majority of deaths (46%) of people age 80 or older. Furthermore, 29% of St. Lawrence County residents have been diagnosed with high blood pressure, which implies a heightened urgency to address this issue.

Some current interventions taking place focus on increased physical activities and improved awareness of nutritional requirements. Considering elevated poverty rates and the rural geographic isolation of the county, having access to physical activity is inconvenient or nearly impossible for many St. Lawrence County residents. Specifically, the Bridge to Wellness Coalition is currently working to create a community setting that promotes and supports healthy food and beverage choices as well as physical activity. Furthermore, they have created the objective to increase the number of adults with access to schools for physical activity with shared agreements that are advertised throughout the community. Therefore, providing increased access to, or awareness of, facilities offered within the community would be more cost-effective and feasible than constructing new resources/facilities. Furthermore, by increasing access to and awareness of physical health services and creating more spaces for physical exertion, community ties may become stronger and result in reduced health disparities. Also, promoting mandatory recess in schools and increasing the number of institutions with nutrition standards for healthy food and beverages, would help address the issue of childhood and adult obesity within St. Lawrence County.

According to the “Assess- Brainstorm Community Assets” document, one asset from the category of “Organizations” that would help facilitate my Childhood Obesity Prevention intervention would be the associations of businesses. Specifically, associations of businesses may be able to present recommendations to advise industries to support childhood obesity prevention and may be able to assist by developing and endorsing/sponsoring food products and opportunities that will inspire healthy eating choices and routine physical activity. Additionally, associations of businesses may also be helpful by regulating marketing and advertising strategies that would reduce the possibility of obesity in children and adolescents.

The second asset from the category “Private and Nonprofit Organizations” that would help facilitate my Childhood Obesity Prevention intervention would be hospitals (including doctors, health care facilities, and health insurance plans). The influence doctors and health plans can have on an individual’s health choices is very significant. Typically, doctors see their patients for a good portion of their lifespan, and they offer opportunities to advise their patients on healthy eating habits and activities tailored to their specific needs. They prove helpful in facilitating childhood obesity prevention by being role models for healthy lifestyles, and as members of the community, doctors can use their knowledge and position to advocate for beneficial changes that reach individuals outside the hospital. Additionally, healthcare facilities could be helpful in this intervention by making sure that there are not only healthy choices in cafeterias but also bans on fast food, sugary drinks, and similar unhealthy choices. Lastly, health insurance plans can be the most essential influence on the weight control practices of patients because they can cover the cost of obesity prevention and treatment, and they can use their position in the community to encourage and sponsor childhood obesity prevention efforts (like healthy meals in schools, physical exertion events, and the education of policymakers).

The third asset from the category “Public Institutions and Services” that would help facilitate my Childhood Obesity Prevention intervention would be public schools. Considering the area of St. Lawrence County, the majority of the education systems are public; therefore, public schools would prove valuable in this intervention because children spend a great deal of time at school and learn valuable lessons that carry with them later in life. Therefore, schools can incorporate nutrition and physical activity lessons into the curriculum. Specifically, physical education should prioritize getting students to engage in high-quality and routine activities. To improve nutrition, schools can incorporate healthier food options in the lunchroom and remove the promotion of unhealthy foods (like chips and candy in vending machines). To improve physical activity, schools can make safe walking and/or biking paths to school and should encourage active recess time. Lastly, most schools are central data sources on student health where information regarding students’ BMI can help educators and policy-makers decide if the current programs are effective or not and make decisions regarding changes to upcoming initiatives.

The fourth asset from the category “Physical Resources” that would help facilitate my Childhood Obesity Prevention intervention would be vacant lands. By renovating vacant lands within the community and turning them into an area of physical exertion, children within the community will have more opportunities to get active and be outside. For example, transforming a vacant lot into a basketball court would create access and stimulate kids to go and play, and as a result, would increase their physical activity and may strengthen community ties.

The fifth asset from the category “Informal Organizations and ‘Intangibles’” that would help facilitate my Childhood Obesity Prevention intervention would be community reputation. By improving the community’s reputation, more people would be willing to relocate or move to St. Lawrence County. With the influx of more people and subsequent capital, the chances of new businesses starting up would increase, allowing residents more opportunities to get involved in their community. Furthermore, by improving the community’s reputation the ability to attract qualified care providers and potential healthcare partners would increase, which would be beneficial in regards to ensuring adequate care provided at the hospital. Also, enabling reputation in your community allows members to be recognized and rewarded for participating, which may lead to more active community members. For example, considering the poverty levels in St. Lawrence County, providing members with financial incentives to improve their physical health and eating behaviors would prove to be multi-beneficial for the individual and the community.

Child obesity is increasing at such an alarming rate, that health professionals fear obesity will become the new normal. You would think adults have more control over which foods their child consumes, and one would encourage them to eat healthy to prevent obesity right? Well, eating healthy is only the beginning.

On average 1 in 3 children are considered obese or overweight. While most people think child obesity stems from making the wrong choices, that’s not necessarily the case. According to the World Health Organization (WHO), The number of overweight or obese infants and young children (aged 0 to 5 years) increased from 32 million globally in 1990 to 41 million in 2016, (‘Facts and figures on childhood obesity’, 2019) and continues to climb as years go by. Newborn children don’t have command over being corpulent, and shouldn’t be held responsible. The government should execute healthy solutions for kids from birth, and allow them to carry on in existence without the chance of future medical problems.

Billions of dollars are spent on healthcare costs related to obesity. Each year, specialists are diagnosing more young kids with diabetes and hypertension. Diabetes, a disease that influences how sugar is processed by the body, was anticipated by specialists to be more prevalent in children born after the year 2000. Of those children, 70 percent will acquire at least one health factor related to heart disease. They are considered more likely to have a shorter lifespan than their parents. Typical reasons suggest childhood obesity can also be related to genetic background. Research conducted by the University College London shows genetics and obesity are closely related. Chances are, a child inheriting obesity estimates over 50% (‘Study finds strong genetic component to childhood obesity’, 2013). A few experts question whether children born to overweight parents are overly nourished early in life. Are they given bigger portion sizes from the early stages? Or on the other hand, do they emulate whatever propensities seen from their parents?

Given that children look up to grown-ups as good examples, a child displays habits and behaviors from others than themselves. Overweight children experience more psychological consequences than children who are not. Kids of younger age say other children prefer not to play with them, or that they are often picked last for physical games. About 25% of sixth graders said that they’ve encountered harassment, teasing, or are often rejected by their peers because of their size. Among those students, harassment increased by 60% once they attended high school. Parents reported seeing their children being unable to focus in school, failing classes, and being unable to maintain friendships. Moreover, teens are viewed to develop eating disorders due to bullying. The Centers for Disease and Prevention Control (CDC) revealed seeing children being diagnosed with anxiety, depression, and low self-esteem (‘Causes and Consequences of Childhood Obesity’, n.d.). This has increased from the 1970’s by 500%.

The absence of better food choices also contributes to child obesity. Fast food portion sizes have tripled, if not quadrupled since the 1950’s. Instead of a home-cooked meal, more families resort to the quick and convenient option of getting fast food. But the price can also be factored into obesity. For example, a double cheeseburger from McDonald’s costs less than a McDonald’s salad, prompting parents to choose the option that they can afford regardless if it’s unhealthy. On top of that, minors eat a considerably large amount of processed GMO foods instead of organic/plant-based foods leading to significant weight gain. If students eat fatty foods before school, their bodies won’t have the option to perform to their most elevated capacity. Before Michelle Obama executed better nourishment decisions for school lunches, students had the option to eat anything they wanted. I for one, had the option to eat curly fries with nacho cheese, and vending machines stocked with soft drinks each Tuesday. In any case, who’s to express that since schools changed to more beneficial menu alternatives, adolescents shouldn’t be overweight? Consider the possibility that kids decide to pack a sack lunch with undesirable nourishment decisions. Would changing school menus have been in vain?

Speaking of school changes, more students lack the physical exercise needed to maintain a healthy weight. Of the primary schools in the United States, 90% of them don’t have physical education classes. Fewer children walk to school than any other generation. Outside of school, adolescents would prefer to stay in and play video games than do physical activities outdoors. Studies led by Dr. J Renae Norton, show children of this generation spend at least 8 hours every day in front of the television (Norton, 2012). Weight reduction happens when physical movement surpasses the quantity of calories eaten. Without enough exercise, how could one burn off the calories they’ve consumed?

If enough action isn’t taken to give children a more beneficial solution, they will be content with being overweight and display that to future generations. For starters, if we incorporated foods that kids love into plant-based foods, replaced high fructose juices with flavored water, and swapped out greasy chips with 100 calories or fewer snacks we may gain ground with battling child obesity. We as a community need to show kids that with enough drive and assurance, they won’t be labeled as a statistic. Adolescents need alternatives that won’t just assist them with their present weight goals, but keep them dynamic for a considerable length of time to come.

A child’s life expectancy shouldn’t need to be cut short as a result of nourishment and physical action decisions. What’s more, no kid should need to bear coronary issues dependent on their parent’s powerlessness to have cash for better alternatives. If each parent was given the proper knowledge to prevent infancy obesity, and youngsters were without given free gym membership passes along with incentives based on their interests for working out, children may jump at the opportunity to get healthy.