Category: Obesity

Abstract

Aim

The study aims to conduct an integrative review synthesizing and interpreting existing research results on the interrelation between these two types of disorders.

Background

Obesity is a serious chronic disease that complicates the functioning of internal organs, leads to other serious diseases, and negatively affects the quality of life in general. At the same time, direct medical costs for obesity in the United States are estimated at $ 92.6 billion, ranging from 5.5 to 9.1% of total healthcare costs (Lee et al., 2018). A review of existing research will help develop a more detailed and targeted formulation of policies on different levels to improve the epidemiological situation with obesity and, accordingly, reduce health care costs in this area.

Design and data sources

Studies for further analysis were searched for in the PubMed and Cochrane Library databases using a combination of keywords most relevant to the research question. The inclusion criteria were peer-review journals and articles reporting the findings related to the research question, i.e., answering the question about the interrelation between obesity and mental health.

Review Method

A five-stage integrative review method includes the formulation of the problem, the search in the databases, evaluation and processing of the initial sample, synthesis of the final sample, and an evidence table.

Results

The research supports the hypothesis about a statistically significant correlation between various mental issues and obesity. Most of all, this applies to depression and anxiety disorder.

Conclusion

The integrative review of the existing literature demonstrates that there is strong evidence supporting the existence of the association between obesity and mental disorders. At the same time, their causal relationships are bidirectional, which strengthens the first statement. In practice, it would mean that decision-makers would need to address mental health to lower the costs of population health-related to obesity.

Introduction

Background. Obesity is a huge social problem and has become an epidemic in recent years. In the United States, as of December 2020, more than 42% of the adult population was obese (Anekwe et al., 2020). Obesity significantly increases the risk of developing other chronic diseases and serious conditions, including type 2 diabetes and cardiovascular disease, as well as some types of cancer (Anekwe et al., 2020). Being overweight also significantly increases the risk of developing severe complications from coronavirus infection (Buscemi et al., 2020). All this places a heavy burden on the healthcare system since the cost of care for patients with cardiometabolic disorders associated with obesity is significantly higher than for patients with normal body weight (Anewke et al., 2020). Studies evaluating the cost of treatment for obesity show that obesity contributes to a significant increase in overall treatment costs (Lee et al., 2018). Direct medical costs for obesity in the United States are estimated at $ 92.6 billion, ranging from 5.5 to 9.1% of total healthcare costs (Lee et al., 2018). In addition to physical health problems, obesity is also associated with a high risk of developing mental problems. At the same time, it is argued that existing mental disorders can lead to eating disorders, including obesity. Given the various existing studies related to the interrelation between obesity and mental health, there is a need for a comprehensive literature review to assess and summarize it.

Thus, the aim of the study is to conduct an integrative review synthesizing and interpreting the results of existing research on the interrelation between these two types of disorders. The research question is: Is there a significant correlation between obesity and mental health and, if yes, what is the causal relation between them? The answer to this question will help to develop a more detailed and targeted formulation of policies on different levels aimed at improving the epidemiological situation with obesity and, accordingly, reducing health care costs in this area. The dependency of the variables varies: in the studies, which will state the previously existing mental disorder and subsequent obesity, the former will be an independent variable, and the latter will be a dependent one. In the research focusing on obesity leading to mental disorders, the variables will transform vice-versa.

Literature Search

Design and Data Sources. A systematic literature review was conducted using the PubMed and Cochrane Library electronic health information databases. The keywords used for the publications search were: obesity & mental disorder, obesity & mental disorder, obesity & depression, obesity & depression, obesity & anxiety, obesity & anxiety, obesity & mental health, Obesity & mental health, obesity & psychiatric disorders. Obesity & psychiatric disorders.

When searching, it was indicated that the keywords should be found in the title, abstract, and/or the text field of the article. The articles no older than five years were reviewed to narrow the research and limit the evidence to the up-to-date results (starting from 2016). The inclusion criteria were peer-review journals and articles reporting the findings related to the research question, i.e., answering the question about the interrelation between obesity and mental health. The articles not focusing on this problem were excluded from the review. Another exclusion criterion was the absence of data (for example, manifest articles). Thus, the final sample consisted of six peer-reviewed articles of 2016 and later presented statistically significant precise findings of the research dealing with the interrelation between obesity and mental disorders and their causal relations.

Methodology Analysis

Review method. The research comprises a five-stage integrative review method. First, the problem and the research question were formulated. Second, the evidence-based medical databases (Pubmed and Cochrane library specifically) were used to search for reliable peer-review articles stating the research findings focusing on the stated problem. The specific keywords were used to obtain the results of the search. Third, the general sample was evaluated and processed. Fourth, the final sample was analyzed, synthesized, and interpreted. Finally, the results were formulated in a concise evidence table.

The final sample of the articles analyzed was appropriate for the research question and hypothesis since it combined both systematic and/or meta-reviews and specific research findings. The latter used statistical analysis, which included descriptive statistics and logical regressions. Also, the Pearson calculations, t-tests, Mann-Whitney U tests, and chi-square tests were employed to analyze specific research questions.

The main gap in the sample is that the literature mainly focuses on studying the links between obesity and depression or anxiety disorders, thus dismissing a variety of other mental disorders which might influence obesity as well. This gap might exist because the research findings target the outpatient population with the most common mental health disorders. At the same time, however, a significant inconsistency across literature lies in the fact that different researchers and research teams can conclude about depressions existence based on different criteria.

Synthesis and Interpretation

Results. The final sample consisted of literature reviews and specific research dealing with the association between obesity and mental disorders. Thus, the research assessed utilized secondary data and original research. However, disregarding the difference in research quality, the studies seconded and supported each other in terms of results. In general, the research supports the hypothesis about a statistically significant correlation between various mental issues and obesity. Most of all, this applies to depression and anxiety disorder.

The literature reviewed also demonstrates a bidirectional causal link between obesity and mental illness. For example, Fox et al. (2016) determined that obese people with depression are 3.5 times more likely to develop severe obesity than those without partially due to emotional eating. Similarly, Lincoln (2020) supports these findings suggesting that obese people who suffer from stress, lead an unhealthy lifestyle, eat junk food, and are not satisfied with their bodies are more likely to develop a related psychiatric disorder. Thus, obesity is likely to be caused by mental instability. At the same time, the association may arise vice versa. For example, Weinberger et al. (2018) demonstrate that personal appearance evaluation among obese people is likely to cause depressive symptoms. Following statistical analyses, researchers reveal that both men and women tend to be unsatisfied with their appearance, which positively correlates with depression. Besides, the meta-review of longitudinal and cross-sectional observational studies conducted by Sutaria et al. (2019) adds to these findings since it establishes the influence of obesity on developing mental issues among children. Moreover, the review of Rajan and Menon (2017) indicates that psychiatric disorders and obesity, especially ED and depression, are closely linked and have a bidirectional relationship. The reviewed studies demonstrated two primary mediators influencing the development of mental disorders from obesity: victimization (Van Vuuren et al., 2019) and personal appearance evaluation (Weinberger et al., 2018). Although these findings bear crucial importance to understanding the causal link between obesity and mental disorders, future research is needed to address other mediators that lead to different mental disorders.

Ethical Concerns. The sample studies were conducted following all national and international ethical standards. Studies were not supported by third parties that stood to gain financially from the results of the research.

Conclusion

Strengths. The studies strengths are their aim to go beyond finding the correlation between obesity and mental disorders and study its causal relationships. The original studies focused on analyzing and outlining potential mediators, whereas the literature reviews demonstrated existing results on the topic.

Limitations. The main inconsistency prevalent in this stream of research is the absence of generally accepted definition and measurement tools of mental disorders. At the same time, the studies predominantly focused on the most common disorders  depression and anxiety.

Validity and Reliability. The Level of evidence in each study was reviewed for validity and reliability. The strongest LOE for this research was a meta-analysis, and the weaker studies were primarily qualitative reviews. Although the sample studies results supported each other, further consistent research is needed to ensure external validity since the age groups, sociodemographic characteristics, and research questions varied.

Implications. The integrative review of the existing literature demonstrates that there is strong evidence supporting the existence of the association between obesity and mental disorders. At the same time, their causal relationships are bidirectional, which strengthens the first statement. In practice, it would mean that in order to lower the costs of population health-related to obesity, decision-makers would need to address mental health as well.

References

Anekwe, C. V., Jarrell, A. R., Townsend, M. J., Gaudier, G. I., Hiserodt, J. M., & Stanford, F. C. (2020). Socioeconomics of obesity. Current Obesity Reports, 1-8.

Buscemi, S., Buscemi, C., & Batsis, J. A. (2020). There is a Relationship Between Obesity and Coronavirus Disease 2019 but More Information is Needed. Obesity, 28(8), 1371-1373.

Fox, C. K., Gross, A. C., Rudser, K. D., Foy, A. M., & Kelly, A. S. (2016). Depression, anxiety, and severity of obesity in adolescents: is emotional eating the link?. Clinical Pediatrics, 55(12), 1120-1125.

Lee, S. M., Choi, I. S., Han, E., Suh, D., Shin, E. K., Je, S.,& & Suh, D. C. (2018). Incremental treatment costs attributable to overweight and obesity in patients with diabetes: quantile regression approach. Obesity, 26(1), 223-232.

Lincoln, K. D. (2020). Race, obesity, and mental health among older adults in the United States: A literature review. Innovation in Aging, 4(5), 1-10. Web.

Rajan, T. M., & Menon, V. (2017). Psychiatric disorders and obesity: a review of association studies. Journal of Postgraduate Medicine, 63(3), 182-190. Web.

Sutaria, S., Devakumar, D., Yasuda, S. S., Das, S., & Saxena, S. (2019). Is obesity associated with depression in children? Systematic review and meta-analysis. Archives of Disease in Childhood, 104(1), 64-74. Web.

Van Vuuren, C. L., Wachter, G. G., Veenstra, R., Rijnhart, J. J., Van der Wal, M. F., Chinapaw, M. J., & Busch, V. (2019). Associations between overweight and mental health problems among adolescents, and the mediating role of victimization. BMC Public Health, 19(1), 1-10. Web.

Weinberger, N. A., Kersting, A., Riedel-Heller, S. G., & Luck-Sikorski, C. (2018). The relationship between weight status and depressive symptoms in a population sample with obesity: the mediating role of appearance evaluation. Obesity Facts, 11(6), 514-523. Web.

Appendix A

Table 1. Summary Evidence Table.

In their speech, the speaker raises the current problem of obesity in the United States and describes what health consequences it carries. The purpose of this speech is to inform people about the current issue, as well as what effect obesity can have on health. The awareness lies in the fact that some people may confuse overweight and obesity, which does not allow them to respond to the danger in time. Although the media are trying to convince people that obesity is harmful to health, in the United States, there is a tendency to increase the number of people with obesity.

The hook used by the speaker is quite convincing and leads to the main problem of the speech. The speaker does not use statistics or an introductory story in the introduction but only demonstrates the apparent fact that obesity is a severe problem that hurts peoples health. The opening is not outstanding or memorable, but it clearly defines the topic of the further speech, its relevance to the audience, and focuses on the main aspects of the upcoming discussion.

The presentation focuses quite precisely on the research, it is structured and provides information about the current data. The speaker offers statistical data that determines which diseases can follow obesity. The organization of the speech is convenient, it is easy to follow, and it excludes complex professional phrases and words that may be incomprehensible to an ordinary person who is not a specialist in the medical field. The speaker uses smooth transitions and allows listeners not to lose the thread of the presentation.

The central part of the presentation is divided into two parts, between which the transition is carried out. The first part focuses on the current problem of obesity, and the second part describes the role of the media in working with people. The first part identifies the problem and provides statistics, as well as the listed obesity-related diseases. In the second part, the speaker talks about the positive and negative aspects of the work of the media. The positive ones are that people can create communities that help people unite and work together to fight the problem of obesity. Various social media platforms can help develop similar communities and groups.

The negative effect of the media is that through the broadcasting of various programs, people may form an incorrect perception of the problem of obesity. Subsequently, this will also affect their health and physical wellness. The mass media can spread unreliable facts that people can believe. These data make it possible to make the speakers speech convincing and convenient for perception and further reflection. In this part of the speech, citations of studies and people taking an active role in these studies are actively used.

The conclusion summarizes the main results of the speech and repeats the thesis given at the very beginning. The ending does not contain practical recommendations and does not encourage people to monitor their body weight and their physical health. The speaker very briefly sums up his speech and focuses on the fact that their presentation was focused only on residents of the United States. The conclusion is not memorable and vivid, which can reduce the correct perception of information by listeners. To correctly summarize his speech, the speaker needs to form several recommendations for people prone to obesity, as well as encourage people to monitor their health, especially in current conditions.

Community Description

This study was conducted at Ramsey County, Minnesota. Based on the 2000 National Census, the County had a population of about 511,000 people in 18 cities, one township, and two unincorporated areas within 170 square miles. This is the smallest County, yet among the most densely populated in the US. Ramsey County has 206,000 homes, which consist of single families, detached and attached housing, custom homes, condominium, and apartments. It has several public parks and other recreational facilities.

There are 67 percent White, 10.8 percent Blacks, 11.6 percent Asian, 0.6 percent Native American Indian, 7.2 percent Hispanic or Latino, and 2.8 percent of other races. These percentages could be more or less with small margins. Several residents are German and Scandinavian ancestries, but lately many Asians, mainly Hmong, African (Somali) and Latin American immigrants have increased in the County.

More than 25 percent of the population are aged 18 years, 62 percent are aged between 18 and 64 years while 11.6 percent are 65 years old and above. There is 93 male for every 100 female. Families have close links as majorities of children, parents, and grandparents live in the same area.

The County consists mainly of the middle class from the mid-century and new homeowners, but there are also high-end residents. There are distinctions in terms of housing design, family size, and density.

Ramsey County is usually snowing and cold with wind chill for more than six months in a year. These extreme weather conditions prevent most outdoor activities and socialization. Families and neighbors seem to know each other for many years, but they limit interaction with newcomers. The local culture of Ramsey County is not much oriented toward foreigners, foreign cultures or other exotic materials. This culture has complicated studies, especially in which one has to determine the required resources. In addition, the culture of exclusion prevents recent immigrants from seeking help or resources to assist them in cases of ill health or obesity. Obesity has become a major health challenge for many foreigners because of changes in diets by adopting the new American diets and lifestyles. Immigrant populations also reflect the same obesity and overweight characteristics and statistics as natives after living in the county for many years. However, the case of Somali immigrants is exceptional about obesity because the condition is not associated with DM, HTN, and hypercholesterolemia.

Health concern in the County

Description of the Health Issue

According to the US Surgeon General, obesity is responsible for nearly 300,000 deaths in the US (US Surgeon General, 2010). Obesity has become a national health problem. Today, it is linked to other chronic diseases, such as hypertension, coronary heart diseases, diabetes, stroke, osteoarthritis, and some types of cancers. The obesity problem is both at the local and state levels in Minnesota. Although several factors could be responsible for obesity in Minnesota, poor diets and a lack of physical activities, seem to be the major contributors to obesity.

Working-class and other older adults are prone to obesity risks due to a lack of appropriate support, interventions, and other socioeconomic factors. In the past, the children and seniors have received support and attention in the fight against obesity. However, parents and other working populations have not received similar attention. Gallup-Healthways Well-Being Index observes that 59.2 percent of obese people in the US exercise once a week as compared to 69.9 percent of overweight people and 73.8 percent of people with normal weights.

In 2009, African Americans were the most obese at 36.2 percent against the national average of 26.5 percent. Obesity rate among Hispanics was 28.3 percent, which was also higher than the national average rate. Obesity is linked to other health conditions like depression, DM, heart diseases, HPT, diabetes, and high cholesterol.

Table 1: Relationship between obesity and other health risks and body weight.

Obesity at the national level relative to Healthy People 2020 (2010)

The role of the Healthy People 2020 is to provide a national objective of improving health status of the public in the US. The project aims to increase the number of people with obesity who visits health facilities by ten percent by the year 2020. This would enhance weight reduction, physical activity, and a proper nutrition of fruits and vegetables. Healthy People 2020 posits that the rate of obesity has risen in the last two decades ( Healthy People 2020, 2013). While there is a slight decline, the figures have remained high as the rate of obesity continues to increase among people of different age groups.

Description of obesity at the national level

In the US, the rate of obesity differs across different states. However, there is no state with obesity prevalence of below 20 percent. The Midwest has a prevalence rate of 29.5 percent, whereas the South has 29.4 percent.

The CDC notes that 35.7% of Americans are obese (Centers for Disease Control and Prevention, 2013). The rate rose steadily between 1990 and 2010. Before the year 2000, no state had obesity rate of more than 30%, but in 2010, 12 states had registered more than 30% increment in obesity. Women are more prone to obesity than men are, but the rates are almost the same (men 35.8% and women 35.5%).

The Minnesota Department of Health observes that child obesity has tripled while the case of adults has doubled.

Description of obesity at the state level

About 63% of adults in Minnesota are obese or overweight based on Trust for Americas Health, but the report indicates that the actual rate of obesity is 25.5 percent of the population (Levy et al., 2013). The rate of obesity in Minnesota is higher than in Ramsey County. Ramsey has obesity rate of 27.8% among men while the rate for women is 23.7%.

Description of the health issue at the local or county level

In 2009, the CDC noted that Ramsey County had obesity rate of 24.5 percent against the national rate of 35.7 percent (Centers for Disease Control and Prevention, 2013). Another report of 2013 by the Institute of Health Metrics and Evaluation noted that men had an increased rate of 3.6 percent while women had 5.1 percent since 2001 in Ramsey County. Obesity is different counties has increased at different rates, but Ramsey and Benton Counties have recorded lowest rates.

The population of interest affected by obesity

The study focuses on working adults aged between 18 and 65 years in Ramsey County, Minnesota. This group makes up about 62 percent of the total population in Ramsey County. People at higher risks of being obese are 10.6% who are below the poverty line. This percentage consists of under 18 and 65 years of age (6.8%). Generally, obesity becomes common among men as their levels of income rise. On the contrary, women with low incomes tend to be more obese than others with high incomes. The condition is common among Hispanic and African American populations relative to whites.

Women with higher education levels have low rates of obesity while highly educated men have higher rates of obesity. Nevertheless, rates for overweight people tend to be similar across different levels of education (Minnesota Department of Health, 2013).

The link between obesity and health inequality

The working class of Minnesota has not received adequate attention in the fight against obesity as compared to children and seniors. The rate of obesity among children has declined because of education, exercise, and nutritional programs. Obesity rate for seniors is 26.3% in Minnesota. This is lower than the rate of baby boomers (45 to 64 years) who are among the working class.

This working-class generation tends to be exceptionally busy. Hence, they prefer quick meals, which are unhealthy. The problem is severe among low-income working class, who do not have adequate disposable incomes for healthy diets and adequate time for recreational and exercise. Moreover, the snowy, cold weather in Minnesota has created limited conditions for outdoor activities.

The major concern is that several obesity programs have excluded working class and show low focus on enhancing healthy living, weight loss, exercise, and general health concerns. As a result, the working class must find their own motivation toward exercise and diets. Moreover, resources are difficult to find or are available in a way that may not meet the specific needs of the working class. A lack of motivation has affected the working class who want to maintain regular diets and exercise just for healthy living.

Few campaigns, public programs, or incentives focus on the working class. Instead, most of these programs aim to reach children, college students, and seniors.

Community resources and partners

Ship

This is a statewide health improvement program, which works with local agencies to prevent some chronic diseases, reduce risk factors, and encourage active lifestyles and healthy diets.

Saint Paul

This is Ramsey County Food and Nutrition Commission, which focuses on operations of local food systems. It aims to create new food policies through open discussions.

Minnesota Center for Obesity, Metabolism, and Endocrinology, PA (MNCOME)

This is an independent endocrinology practice, which provides medical care, provides education, and conducts research.

The Obesity Consortium of Minnesota

This is a multidisciplinary partnership approach that focuses on research, education, and outreach for obese. It has several obesity centers.

Apart from these resources and centers, Minnesota has other several community-based programs to help in managing obesity.

Aspects of the health concern not being addressed

There are several aspects of obesity concerns, which the current system does not focus on despite efforts of the partners involved.

The iodine link

Low levels of iodine intake in the diet lead to sluggish thyroid activities.

Overworked adults

This class has limited hours for vacation or exercise. Others have more than one job. Although some employers have weight reduction programs, such as gym membership and incentives, these programs may not be available in small firms.

Depression

Depression results from economic pressure, vitamin D deficiency, a lack of close family ties, and hormone imbalance.

Finances

Cheap food items have high levels of sugar and simple carbohydrates. Most families choose these foods to save costs. While this is a serious health risk, stakeholders have not addressed it sufficiently.

Availability of healthy food options to low-income families and the homeless

Most available food options are not always healthy. No specific program has addressed this problem thoroughly.

Vitamin D

Minnesota has cold weather with clouds most of the time. Hence, many people do not engage in outdoor activities. Most people tend to avoid outdoor activities during these periods. Many working-class individuals require incentives and resources to take part in such activities.

Information

Although information regarding obesity is available to the public, many working adults cannot easily gain access to it due to a lack of adequate time for searching or reading. Intensive public awareness about obesity should improve awareness and access to information.

Insurance

Many insurance firms have failed to cover obesity and related cases. They should develop covers for obesity because it is now recognized as a disease.

Holistic treatment options

Holistic treatment for obesity includes visits to medical centers, observing diets, and increasing levels of physical activities. Nevertheless, some holistic therapies could help in managing obesity. Some examples of holistic therapies include:

• Chiropractors re-adjust the spine and joints of obese people. They relieve pain and pressure to facilitate exercise.
• A kangen water expert believes that taking highly iodized water helps in weight loss and reduces body acidity levels.
• Reiki involves energy manipulation by a reiki practitioner, who uses his or her hands to direct the energy to ones chakra or energy center within the body to enhance healing. This stabilizes the body and improves nutritional needs and appetite.
• Theta healing relies on thought and prayer through natural intuition and alters brain wave cycles to the theta state. It reprograms the subconscious mind that blocks weight loss.
• Yoga for the mind and body exercise

Outcome Identification

The Ramsey County Community Health Improvement Planning Committee aims to decrease the rate of obesity or overweight from 61% to 56% by 2018. It will focus on improving intake of fruits and vegetables and exercise.

The Minnesotas Statewide Health Improvement Program (SHIP) aims to reduce cases of obesity through enhanced clinical care, physical activities, and healthy diets.

Overall, the goal is to reduce obesity trends through sustained downward trends. There is a need to improve awareness among working adults and encourage them to adopt healthy living. They must understand available resources, nutrition, and support programs. In addition, working adults should engage in regular medical checks, avoid unhealthy foods, take social activities, and seek information about obesity.

Nursing actions to improve obesity (Minnesota intervention wheel)

Continuous public education and awareness

Working-class adults do not easily get relevant information about obesity due to their busy schedules. Nurses should encourage public awareness and campaigns that focus on this population of interest.

Collaboration

The culture of Ramsey does not foster inclusion. Hence, foreigners may find it difficult to get relevant information or resources in cases of obesity. Nurses should encourage different stakeholders to work together in the fight against obesity.

Advocate for resources

For a long time, available resources on obesity have focused on children and seniors and neglected the working-class population. Nurses should advocate for resources that meet the obesity needs of this specific group.

Working with the community to improve obesity cases

Continuous education and collaboration are the best approaches to fighting obesity in Minnesota. Nurses should use their knowledge to educate the community about obesity. At the same time, the community members must also cooperate and attend public seminars about obesity. This would enhance creation of awareness and public education.

Public and private partnership

This would involve collaboration among independent stakeholders in the health sector and the government to improve obesity outcomes.

The government should formulate policies that support healthy living and diets. The focus should be on restricting junk foods and other simple carbohydrates among working-class adults. In addition, the government must also finance and support obesity-related programs.

The private sector should support nurses, outreach programs, and provide free medical checkups for Ramsey County residents. They can directly fund such projects or engage in such activities themselves.

Overall objectives for implementing these activities

The major objectives of implementing these activities are to reduce obesity in Ramsey and improve healthy living among the public. These activities would improve access to information, knowledge on obesity, treatment, and medical checkups, and increase intake of fruits and vegetables and physical exercise.

A timeline for the expected outcomes

For every identified case of obesity or overweight, there would be an immediate intervention to control the condition. Hence, most programs will run on a continuous basis because of the nature of obesity. This would include focus on diets and physical activities.

Regular medical checkups would be arranged during the last weekend of the month to facilitate attendance.

Evaluation

The program evaluation would include the use of feedback from the public and specific populations of interest. A survey questionnaire shall be used to gather data related to effectiveness of the nursing interventions on improving obesity and overweight conditions, healthy living, diets, exercise, collaboration, partnership, resource provision, and advocacy programs. Nurses shall use feedback to improve the program appropriately.

Conclusion

Although many programs and informational resources concerning obesity and overweight exist, many working-class adults are not aware of them. These available resources and information require effort and dedication to get them, particularly among working-class adults who may not have adequate time to search for information and resources about obesity.

The problem of obesity has risen among working-class populations but declined slightly among children and senior adults. However, there is a rising trend among high school teenagers, especially girls.

There is a need to improve public awareness, healthy diets, and physical activities in order to curb obesity. A focus should be on preparing and consuming healthy meals for the family, encouraging access to information, collaboration, regular medical checkups, and incentives to encourage outdoor activities.

Ramsey has a low level of obesity (24.5%) relative to the national level, which is 35.7% for adults and 17% for children. These rates reflect a significant increase in obesity compared to rates registered few decades ago. Hence, there is a need to put strong measures and interventions to tackle the rising cases of obesity not only among children and senior adults, but also across different age groups. If left unchecked, obesity would be responsible for several deaths in Ramsey County.

References

Healthy People 2020. (2013). Nutrition, Physical Activity, and Obesity. Web.

Centers for Disease Control and Prevention. (2013). Adult Obesity Facts. Web.

Levy, J., Segal, L. M., Thomas, K., St. Laurent, R., Lang, A., and Rayburn, J. (2013). F as in Fat: How Obesity Threatens Americas Future 2013: Adult Obesity Rates Hold Steady but Remain High. Web.

Minnesota Department of Health. (2013). Overweight and Obesity Prevention. Web.

US Surgeon General. (2010). Childhood Obesity Prevention. Web.

A community genogram/profile reflecting the health status of the community

Obesity is a significant health threat experienced globally due to practicing unhealthy lifestyles and eating habits. In my view, obesity is more of a personal problem than a social challenge. People often make independent choices about the foodstuffs they consume, their daily engagements, and weight management (Burke & Heiland, 2018). Although junk food is readily available in the market, a person can make the right dietary decision and has the power to control what he or she eats. Consequently, obesity emanates mainly from the irrational decision-making process regarding the consumption habit. The primary individual factors that lead to overeating include limited self-control, peer pressure, and automatic functioning. Cohen (2013) argues that eating is an involuntary process, which does not necessitate human awareness or attention. Individuals respond differently to opportunities, and thus, survival instinct may drive them to eat irresponsibly. Additionally, stressful situation compels a person to overeat because negative emotions, such as anger, restrict human self-control. Lastly, people eat irresponsibly due to peer pressure as they try to impress their friends or based on the availability of processed food.

However, it would be irrational to disregard social contributions to the increased obesity rate. For instance, the increased global population has demanded alternative farming methods, which rely on technological innovations and chemicals. Although a person may make a rational dietary choice, it may sometimes be challenging to avoid such food products. As a result, obesity is rising globally, thus posing a health threat to the population because it causes other diseases such as type 2 diabetes, stroke, and heart diseases. The greatest effect of obesity on society is the increased medication costs. According to Cohen (2013), the illnesses associated with obesity require the American healthcare system to use approximately $147 billion annually. The figure becomes enormous with the consideration of its impacts globally. The government can use this revenue to deliver other services to the population. Therefore, people have to embrace healthy eating habits and other alternative techniques of controlling stressful situations instead of overeating.

References

Burke, M. A., & Heiland, F. W. (2018). Evolving societal norms of obesity. JAMA, 319(3), 221-222. Web.

Cohen, D. (2013). A big fat crisis: The hidden forces behind the obesity epidemic-and how we can end it. Hachette UK.

Dbrowska, J., Wójcik, M., Samek, I., JaDczyk, M., Bator, D., & Milanowska, J. (2020). Obesity and mental health. Journal of Education, Health and Sport, 10(6), 199. Web. 

This review aims to accumulate and analyze existing and new data on obesity and its impact on mental health. To review the literature data, the authors conducted the search of corresponding articles on the PubMed database using specific keywords. The researchers found several studies that show the relevance between obesity and some mental health issues, including depression or anxiety. Moreover, the authors of the article claim that the relationship between depression and obesity is bidirectional as obesity increases the risk of depression while depression increases the risk of obesity. This article will help me with the essay because it provides data to support one of the areas in my topic that I will be writing on, namely the impact that obesity and mental disorders may have on each other. The importance of this article for my research is justified by the fact that the dependencies discovered in that review will help organize new therapeutic methods to treat patients and reduce potential risks. Therefore, this article can be helpful to analyze further the potential of the future treatment of patients with obesity and mental health issues.

Penn Medicine. (2019). Three ways obesity contributes to heart disease. Web.

This article was put together on the Penn Medicine website. It provides a better understanding of the connection between obesity and heart diseases. The researchers believe that heart disease is one of the most dangerous consequences that obesity can pose, and many health professionals claim that obesity and heart diseases are strongly associated. The article identifies three significant ways in which obesity can cause heart disease. These include increasing levels of cholesterol, elevating blood pressure, and increasing the risk of diabetes. In addition, the article contains information on health improvement and recommendations on what to do to prevent cardiac issues. I chose this webpage as a source for my own work because the heart is the most significant organ of the human body, meaning that it is vital to address possible heart issues related to obesity. This article is significant for my research because it directly provides information on health issues that may be caused by obesity, namely cardiovascular diseases and diabetes. Therefore, the study conducted by Penn Medicine can be helpful for my work as it describes the possible consequences of obesity.

Vilarrasa, N., San Jose, P., Rubio, M. Á., & Lecube, A. (2021). Obesity in patients with type 1 diabetes: Links, risks, and management challenges. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Volume 14, Web.

This article provides information on patients that suffer from obesity and have type 1 diabetes. The authors provide characteristics of those patients, including resistance to insulin along with high insulin requirements, cardiometabolic risks, and increased risks of chronic complications. The researchers emphasize the difficulties associated with the dual treatment of obesity and type 1 diabetes, stating that there are currently no particular guidelines for such treatment. The conducted review gathered existing evidence in the current literature and highlighted that the knowledge is insufficient in all aspects of treating patients that suffer from obesity and type 1 diabetes. However, the authors believe that the near future is promising with new strategies being developed that appear to be more effective in anti-obesity treatment along with diabetes. This article is significant for my research as it demonstrates how obesity affects the human organism when another severe health issue is involved. I will be able to analyze the challenges associated with the dual treatment of obesity and type 1 diabetes. Moreover, this article examines an obesity-related issue that is not yet appropriately researched, making it even more significant for my work.

References

Dbrowska, J., Wójcik, M., Samek, I., JaDczyk, M., Bator, D., & Milanowska, J. (2020). Obesity and mental health. Journal of Education, Health and Sport, 10(6), 199-205. Web.

Penn Medicine. (2019). Three ways obesity contributes to heart disease. Web.

Vilarrasa, N., San Jose, P., Rubio, M. Á., & Lecube, A. (2021). Obesity in patients with type 1 diabetes: Links, risks, and management challenges. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 14, 2807-2827. Web.

Despite hypertension and obesity are being major life threats, there are safer lifeways that one can use to combat the problem.

Including Physical Activity

Any mobility that requires calorie expenditure either for work or fun, daily tasks, or commute time is classified as a physical workout. Bodily exercise is good for ones wellness since it aims to minimize overweight and manage high blood pressure. Using a balance of workouts and a nutritious diet to drop fat is more beneficial than relying alone on lifestyle modification. Activities serve to lower cholesterol and blood pressure, which can help one avoid cardiac arrest. Workout has already been shown to improve self-esteem and well-being, potentially lowering emotional and behavioral rates that lead to weight gain. Exercise is beneficial for obesity treatment. Exercise can improve your health or the amount of energy you use every day. It can also help you keep and gain body weight, enabling you to lose more weight throughout the day.

Weight Management

Heavy salt consumption is a known cause of high blood pressure and overweight, which can contribute to heart issues. People who consume less than 5 g of sodium chloride a day have lower blood pressure and a lower risk of heart disease, cerebrovascular disease, and myocardial cardiac arrest. One should take the DASH diet as one of the measures to reduce the intake of sodium-rich foods. The DASH nourishment is a nutritious eating strategy that can allow you to cope or avoid high blood pressure (hypertension). Foods high in calcium, magnesium, and potassium are included in the DASH diet. These nutrients aid with blood pressure management and restrict sodium-rich, concentrated fat, and sugar-rich foods.

Decreasing Salt Intake

Various exercises that can aid in preventing and managing hypertension include:

• Visiting the gym regularly
• Bicycle cycling
• Brisk walking
• Swimming

The majority takes far too much salt  912 grams each day (a double the daily limit!).

DASH is an abbreviation for Dietary Approaches to Stop Hypertension.

To manage body weight, one has to do the following health practices. Processed carbs have been shown in research to cause a quick jump in glucose levels, resulting in hunger, urges, and elevated food intake a few hours later. Obesity is significantly connected to refined carbohydrate consumption. As a result, eating carbs with their cellulose fibers is not recommended as a weight-loss strategy. Otherwise, it is recommended to eat fruits and vegetables with few calories, thus preventing weight loss.

Reference

Hjørnholm, U., Larstorp, A., Andersen, M., & Høieggen, A. (2019). Directly observed therapy before ambulatory blood pressure measurement (DOT-HTN) in uncontrolled hypertensive patients  Effect on blood pressure, safety, and patient perception. Blood Pressure, 28(5), 327-335. Web.

In the article Overweight and Obesity Statistics by the USDHHS, the dire situation concerning excessive weight in adults and children is discussed. It is pointed out that various causes can increase the chances of an individual becoming overweight, of which environmental and individual factors are the most prevalent. Nevertheless, in the context of the United States, the widespread access of the population to various types of unhealthy foods can result in the excessive consumption of calories, leading to overweight and obesity (USDHHS, 2021). The first thing learned from the article is that the expansion of the fast-food industry is an environmental factor that makes it easier to gain weight. The second thing learned was that the United States have shown to spend around $39 billion in obesity-related medical expenses, which presents a significant financial burden for the healthcare industry (USDHHS, 2021).

After reading the article, it is important to communicate the fact that all foods, including those from fast food chains, should be eaten in moderation. Such foods can significantly compromise the nutritional status because the dependence on fast foods means that a person must be highly physically active to burn all the calories that were consumed. If a person has some risk factors for obesity, they should significantly limit their intake of high-caloric products. To measure whether junk foods may be negatively affecting health, control of the diet by a healthcare provider is necessary. Notably, cultural differences play a significant role in the choice of ones diet. For example, Americans have been shown to depend on starches and red meats, while in the Japanese or Korean culture, fish-dominated and even vegetarian diets are more prevalent. Overall, attention to nutrition education must be given in order to help the population become more aware of their food consumption habits.

Reference

USDHHS. (2010). Overweight and obesity statistics. Web.

Introduction

The occurrence of obesity is growing around the globe at a disturbing rate in both developed as well as developing countries (World Health Organization, 2000). In the European countries, the prevalence of obesity ranges between 10 and 20% in men and between 15 and 25% in women, while in the US the prevalence of adult obesity currently stands at 28% among men and 34% among women. Overweight is the sixth most significant risk factor that causes the global health burden.

Obesity increases the risks of type 2 diabetes, hypertension, cardiovascular disease, dyslipidemia, arthritis, and several cancers (Haslam and James, 2005, p.1199) and is believed to lessen the average life expectancy. A negative energy balance caused by the management of obesity normally creates a decline in the fat stores and a suitable conservation of lean body mass. A preferential lessening of abdominal fat, a decrease in obesity-related health risks, an enhancement in comorbidity and in quality of life, and a fall in mortality rate are some of the most vital goals of obesity treatment (Anderson, Konz, Frederich and Wood, 2001). An effective treatment programs for obese patients ought to have a significant impact on the utilization of medical resources and on the costs of health care.

Issues/problems

Physicians and other health care providers encounter a great problem in helping obese patients not only to normalize their weight but also to attain weight loss maintenance. Indeed, weight regain is one of the most common problems that obese patients face during their treatment. Ross (2009) argues that, Most patients regain about 30% of the weight lost in the year following treatment and typically return to their baseline weight in 3-5 years, (p.997).

A number of factors such as the type of support offered to the patients, the types of diets followed by the patients and the type and intensity of physical activity performed by the patients affect the ability (or lack thereof) of the patients to maintain the weight loss. It is however important for health care providers to individually tailor the treatment of the obese patients according to their age, sex, degree of obesity, individual health risks, metabolic and psycho-behavioral characteristics, and outcome of previous weight loss attempts, (Hainer, Toplak and Mitrakou, 2008, p.273).

All in all, the goals set in the obesity treatment programs should be realistic because unrealistic goals of weight loss often lead to a failure in weight loss maintenance. In order to reduce weight to a normal level, a low-energy diet, physical exercises and healthcare support programs should be implemented for the obese patients. A normal weight is measured by the body mass index (BMI) which takes into account the height and weight of an individual. Normally a person is said to be obese if he/she has a BMI of 30 or more.

Low energy diet

A low-energy diet commended for the treatment of obesity should be low fat (<30%), high carbohydrate (~55% of daily energy intake), high protein (up to 25% of daily energy intake), and high fiber (25 g/day) (Pirozzo, Summerbell, Cameron and Glasziou, 2003). A moderate decrease in energy intake (-2.5 MJ/day) could lead to a sluggish (~2.5 kg/month) and constant weight loss. So far, many research studies provide evidence that suggest that the total energy intake in diets is a key determining factor of the ability of obese patients to lose weight. It should be noted that diets that provide <5 MJ/day may create shortages of numerous micronutrients, which could have unpleasant effects on nutritional status as well as on the weight management result (Heymsfield, van Mierlo, van der Knaap, Heo and Frier, 2003).

Physical activity

Physical activity should be an essential component of an all-inclusive obesity management program and should be individually customized according to the extent of obesity, age, and existence of comorbidities in each patient. Physical activity contributes to a higher energy spending and fat loss and also protects patients from losing lean body mass, enhances cardiorespiratory fitness, minimizes obesity-related cardio-metabolic health risks, and stirs feelings of general well-being, (Phalan, Wyatt, Hill and Wing, 2006, p.712).

Aerobic physical exercise contributes to enhancement in oxygen flow to muscle, which in turn encourages an increased use of excess fat stores rather than the scarce glycogen stores (Wing and Hill, 2001). The recommended intensity of physical activity is a moderate activity done for 30 minutes, 5 days a week. In a month, such an activity can lead to a loss of 0.5 kg of weight. Patients ought to be familiar with the rational goals regarding the anticipated exercise-induced weight loss in addition to the positive effects of exercise on cardio-metabolic risks. To maximize weight loss, the intensity of physical activity should be doubled to 60 minutes for 5 days a week.

Obesity normally results from a habitual sedentary lifestyle. Thus, patients should be encouraged to undertake activities such as walking, cycling, and stair climbing (Wing, 1999). The use of physical activity to manage weight is positively associated with the level of education and, on the other hand, negatively associated with the prevalence of serious comorbidities, age and extent of overweight. Patients who suffer from severe arthritis and other mobility problems should exercise in heated water. Patients should avoid engaging in vigorous physical activity that can lead to joints overloading, such as jumping (Phalan, Wyatt, Hill and Wing, 2006, p.713).

The protection of lean body mass and minimization of health risks can be done through strength exercise modalities although such exercises do not enhance lipid oxidation. All sorts of regular physical activities symbolize a significant aspect that leads to lasting maintenance of weight loss.

Health care support programs

Besides diets and exercises, weight management in obese patients can be achieved through the receipt of health care support services. Such services can be offered by physicians, nurses, nutritionists, and exercise specialists among others. Research shows that obese patients who are enrolled in a nurse-supported group and who engage in regular contacts with their nurses (both face-to-face and via the telephone) and who are engaged in self-weighing of weight are more likely than others to succeed in maintaining their weight loss (Dale, McAuley and Taylor, 2009). This is because the constant contact with nurses enables the nurses to monitor the progress of the patients on a regular basis than would be possible if the contact was lacking or minimal.

The major challenge of implementing nurse-coordinated support programs lies in the shortage of nurses who may be already overworked. It is therefore important to include other specialists such as nutritionists and exercise exerts to assist the nurse. The advantage of such an inclusion is that the specialists are knowledgeable and skilled in their areas of expertise and are therefore most likely to provide the best possible care to the patients. In addition, such specialists have the relevant training, are no more expensive than nurses, and would be enthusiastic supporters of their nursing colleagues, (Ross, 2009, p.998).

Purpose of the database

The purpose of the database is to:

• Determine the effectiveness of a low-energy diet, physical activity and a nurse-coordinate support program in losing weight.
• Determine the effectiveness of a low-energy diet, physical activity and a nurse-coordinated support program in preventing weight regain among obese patients: Six months after the onset of the program; one year after the onset of the program; three years after the onset of the program; and five years after the onset of the program.

The database will therefore track the progress of the obese patients for five years after they begin their weight management program.

Data flow diagram: weight loss and management program

Data dictionary

From the above issue statement and data flow diagram, five tables will be created namely: Demographics, Low energy diet, Physical activity, Nurse-coordinated program, and Body mass index. The tables will have twenty-one fields in total and fifty records in total.

Reference List

Anderson, J.W., Konz, E.C., Frederich, R.C., & Wood, C.L. (2001). Long-term weight-loss maintenance: a meta-analysis of US studies. American Journal of Clinical Nutrition 74, 579-584.

Dale, K.S., McAuley, K.A., & Taylor, R.W. (2009). Determining optimal approaches for weight maintenance: a randomized controlled trial. CMAJ 180, 1015-20.

Hainer, V., Toplak, H., & Mitrakou, A. (2008). Treatment modalities of obesity: What fits whom? Diabetes Care 31, 269-276.

Haslam, D.W., & James, W.P.T. (2005). Obesity. Lancet 366, 1197-1209.

Heymsfield, S.B., van Mierlo, C.A., van der Knaap, H.C., Heo, M., & Frier, H.I. (2003). Weight management using a meal replacement strategy: Meta and pooling analysis from six studies. International Journal of Obesity 27:537-549.

Phalan, S., Wyatt, H.R., Hill, J.O., & Wing, R.R. (2006). Are the eating and exercise habits of successful weight losers changing? Obesity 14, 710-716.

Pirozzo, S., Summerbell, C., Cameron, C., & Glasziou, P. (2003). Should we recommend low-fat diets for obesity? Obesity Review 4, 83-90.

Ross, R. (2009). The challenge of obesity treatment: avoiding weight regain. Canadian Medical Association Journal 180(10), 997-998.

Wing, R.R., & Hill, J.O. (2001). Successful weight loss maintenance. Annual Review of Nutrition 21, 323-341.

World Health Organization. (2000). Obesity: Preventing and Managing the Global Epidemic: Report of a WHO Consultation. Geneva, World Health Organization.

Introduction

The problem of adolescent obesity is gaining more and more attention as the adverse impact of the health condition affects millions worldwide and in the United States in particular. The obesity epidemic is associated not only with the decreased quality of life of those diagnosed with the condition but also with the serious public health hazard around the world. As mentioned in the National Health and Nutrition Examination Survey, one out of five children (aged between six and nineteen years old) are obese or overweight (Stanford Childrens Health, 2017). In the past thirty years, the problem has tripled in its prevalence, which means that there is no better time than now to address the issue through education, nursing advocacy, and clinical expertise.

This assignment will focus on exploring the issue of adolescent obesity from the theoretical perspective as well as providing a cohesive action plan to propose how to remedy inefficiencies, gaps, and other problems that limited the success of implemented interventions. Also, a case summary will be provided to offer a comprehensive look at the components of the problem. Lastly, the assignment will identify an appropriate research instrument for evaluating the efficacy of the proposed adolescent obesity solutions.

Literature Review

Due to the wide popularity of obesity as an overarching health issue, its coverage in the research literature is vast. Del Mar Bibiloni, Pons, and Tur (2013) conducted a systematic review of the occurrence of obesity in adolescents (10  19-year-olds). The researchers found that obesity in adolescents of this age was more prevalent in males than females, with the International Obesity Task Force (IOTF) criterion being the most frequently used tool to identify the condition in public health research (p. 2). It should be mentioned that gender differences in the occurrence of obesity among individuals aged between ten and nineteen years old were attributed to cultural and geopolitical circumstances, which means that different countries will exhibit different prevalence rates of the condition (Del Mar Bibiloni et al., 2013). Furthermore, the occurrence of obesity in the United States increased as time went by. For instance, in 2003 it increased by 4% compared to previous measurements while in 2007 it rose by 10% (Del Mar Bibiloni et al., 2013). It must be noted that the United States is among the leading countries to have the highest adolescent obesity rates.

Kramer, Raskind, Van Dyke, Matthews, and Cook-Smith (2016) studied the problem of adolescent obesity with the US-specific context and examined the conditions geography. Territorial prevalence of adolescent obesity was seen in the Deep South and Southern Appalachian regions. The disparities are associated with the activity and nutritional environment variables as well as crime rates and the high density of recreational facilities (Kramer et al., 2016). These findings show that the contextual measures that characterize different regions across the United States contribute to either lower or higher rates of adolescent obesity.

The article by Sousa (2013) mentioned that the existing procedures targeted at addressing the problem of adolescent obesity were insufficient enough to provide any effective results. The author wrote, the standard nursing approach  assessment, diagnosis, planning, implementation, and evaluation  does very little to integrate family members and the patient into the plan of care, and it can be patronizing (Sousa, 2013, p. 12). This points to the fact that teens diagnosed with obesity struggle with getting inspiration to become healthier and make changes when in general, nurses only mention things that they do wrong, thus placing blame and disregarding the unique needs of each patient. Thus, in terms of managing adolescent obesity as a pandemic, standardized procedures and instruction are not enough to make sure that patients are dedicated to solving their health problems.

Steinbeck, Lister, Gow, and Baur (2018) focused on the need for the effective treatment of adolescent obesity. The researchers underlined the importance of behavior management and adjunctive therapies that address multiple barriers that prevent interventions from being truly effective. According to the proposed approach, the effective treatment principle implies long-term behavioral improvements (changes in diet, increased physical activity, work on sleeping patterns, the removal of frequent instances of low activity) accompanied by long-term strategies associated with the management of weight. Importantly, obesity-oriented interventions that deal with adolescents require more engagement and participation than those targeting children.

Theoretical Description

From the theoretical standpoint, obesity is defined as a condition characterized by the excessive or abnormal presence of body fat that presents some health risks to patients who were diagnosed with it. The body mass index (BMI) is the most frequently used method for determining whether an individual is obese; it is calculated by diving a person weight by the square of his or her height (in kilograms and meters respectively). An individual whose BMI is 30, and higher is considered obese. Throughout decades of research, multiple theoretical models and frameworks were developed to explain the occurrence of the condition among the public.

A setting-based theoretical framework implies that people may get obese because of the specific environmental conditions in which they live (Panter, Andersen, Aro, & Samara, 2018). For instance, the wide availability of fast food restaurants in the area increases the chances of poor dietary choices while a sedentary lifestyle contributes to the decreased physical activity. From the genetic theoretical framework, obesity can be an inherited condition, and, in combination with environmental factors, can develop in people whose parents are obese (Hebebrand et al., 2017). Moreover, the cultural theoretical framework points to the links between a persons culture and his or her likelihood to become obese. The cultural context is especially important to note in the discussion about obesity because any changes in the usual patterns can encourage the development of the condition (Sahoo et al., 2015). For instance, in Mexican immigrants who moved to the United States, obesity can become an issue because of the lifestyle changes, social isolation, stress, and anxiety.

Discussion

Based on the findings from the research literature, adolescent obesity is a product of many factors, the combination of which increases the likelihood of the conditions development. The case of adolescent patients is especially complex because, unlike children-patients, they experience a wider range of emotional issues, most of which can be linked to puberty as well as individual psychological characteristics. This leads to the finding that traditional and standardized methods of dealing with adolescent obesity are not effective enough to consider the unique needs of each patient. Furthermore, there is an issue of nurses blaming patients for getting obese without providing a constructive framework they could follow to become healthier. Thus, there is a serious need for developing solutions that will remedy this gap in the treatment and prevention of adolescent obesity.

Another important finding that must be mentioned in the discussion about adolescent obesity is that effective intervention programs require greater participation and engagement of both patients and their relatives. In childhood obesity prevention, the development of an action plan that parents could enforce upon their children was enough. However, with the added emotional aspect of adolescent obesity, nurses have to dedicate more time and efforts to make sure that their adolescent patients are engaged and will comply with the treatment. This point is important because, without a patients participation, interventions are unlikely to be effective. The emotional changes that adolescents go through is a variable that should never be overlooked when developing obesity management interventions.

Summary of the Case

Adolescent obesity presents both physical and emotional challenges for patients, especially because of their aged and the vulnerability toward different external factors. From the standpoint of nursing ethics, adolescent obesity is a problem that requires the application of multiple provisions of the Code of Ethics. The first five provisions are especially instrumental to the problem because they are associated with patient advocacy and responsibility for achieving any improvements in a patients health. This means that in the case of a nurse managing the treatment and recovery of an adolescent patient, he or she should proceed with work by showing compassion and attention for the unique qualities of the patient, be committed to doing the work successfully, protect the individual rights along with health and safety. The case of obesity is sensitive, and the adherence to the ethical standards of nursing will safeguard professionals from making mistakes that will prevent any interventions from being successful.

In addition, it is imperative for a nurse who manages a specific condition or illness to show high levels of responsibility, authority, and accountability, which means that he or she should make decisions and take actions consistent with the duty to provide optimal care (American Nurses Association, 2015). In the context of adolescent obesity management, a nurse is also required to maintain competence and the integrity of character regardless of how complicated the work with the patient may be. It is highly likely that working with an obese adolescent patient will be complicated due to the emotional struggles that come with such age. In some instances, obesity may be linked to emotional trauma that the patient has experienced in the past, which means that poor lifestyle choices can be perceived as a solution to the psychological distress. Therefore, the preservation of nursing ethics in the case is the most important aspect of care to ensure the adherence of a patient to treatment.

Solutions

Adolescent obesity is a problem that develops as a result of multiple reasons and because of this, standardized approaches are not enough to address it completely. Due to the adverse impact of the condition on both physical and psychological health of patients, there is a need for addressing the issue from multiple perspectives. The first gap to be addressed refers to the lack of nurses knowledge on being sensitive to the unique needs of each adolescent patient. As mentioned by Sousa (2013), an action plan that describes the details of nutritional changes is not enough; nurses should offer empathy and acknowledge that losing weight is a complicated task for which patients should not be left unsupervised. Motivation and support can be provided through strengthening collaboration between patients and their health providers. For instance, some nurses have used the motivational interviewing approach to connect with their patients and identify the main challenges that prevent them from making healthy lifestyle choices.

Engagement and active participation of patients within the context of obesity management programs have often been overlooked (Oh et al., 2018). In contrast with interventions that involve children, adolescent-oriented obesity treatment cannot rely only on the commitment of nurses and patients parents. Thus, an important solution to this gap is the introduction of programs that have a place for health consultations with patients. For instance, in their research, Oh et al. (2018) conducted an intervention where a group of patients received health consultations throughout the 24-week period of weight loss. When compared with the non-intervention group that did not receive any consultations, it was found that patients, whose engagement was boosted through continuous communication with their providers, showed better results in terms of healthy lifestyle and dietary choices.

In order to evaluate the efficacy of the solutions for overcoming treatment gaps, it is imperative to define a research instrument that nurses could use. Since engagement is an issue that plays a significant role in guaranteeing the effectiveness of obesity treatments, interviews will be the most suitable research instrument. For collecting data on the positive or negative effect of solutions targeted at addressing the emotional needs of patients as well as engaging them in the plan of obesity management. Interviews represent a systematic way of talking and listening to patients and are effective for collecting information from patients on the basis of their personal reflections and nurses observations. Open questions can be used during interviews to go in-depth with the collected data and account for any feedback that patients have in regards to the improvement of their dietary and activity choices.

The usefulness of interviews as research instruments will be evaluated based on their outcomes as well as the attitudes of patients toward their implementation. If adolescent patients show excitement and are eager to share their experiences on the journey to overcoming obesity, then the interviews should be considered effective. A quick survey to collect patients feedback will be a suitable evaluation strategy. Measuring the impact of health consultations reflects the provisions of the nursing code of ethics as it is associated with showing respect and compassion for patients unique needs.

Conclusion

In the exploration of the problem of adolescent obesity, it was discovered that regardless of the wide availability of solutions and interventions, many health care providers overlook the importance of emotional support and the engagement of patients in the plan of care. The report identified that the lack of respect, compassion, and sympathy for the unique needs of adolescent patients with obesity, which aligns with the provisions outlined in the Code of Ethics for Nurses. Overcoming the identified gaps can be done by implementing engagement-driven interventions such as motivational interviewing to determine health constraints and encourage patients to make healthy lifestyle choices. In terms of future research directions, studies of adolescent obesity should focus on connections between the emotional wellbeing of patients of that age and the poor choices they make thus deteriorating their physical condition.

References

American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. Web.

Del Mar Bibiloni, M., Pons, A., & Tur, J. A. (2013). Prevalence of overweight and obesity in adolescents: A systematic review. ISRN Obesity, 2013, 1-10.

Hebebrand, J., Holm, J-C., Woodward, E., Baker, J. L., Blaak, E., Schutz, D., & Yumuk, V. (2017). A proposal of the European Association for the study of obesity to improve the ICD-11 diagnostic criteria for obesity based on the three dimensions etiology, degree of adiposity and health risk. Obesity Facts, 10(4), 284-307.

Kramer, M. R., Raskind, I. G., Van Dyke, M. E., Matthews, S. A., & Cook-Smith, J. N. (2016). Geography of adolescent obesity in the U.S., 2007-2011. American Journal of Preventive Medicine, 51(6), 898-909.

Oh, B., Yi, G. H., Han, M. K., Kim, J. S., Lee, C. H., Cho, B., & Kang, H.C. (2018). Importance of active participation in obesity management through mobile health care programs: Substudy of a randomized controlled trial. JMIR mHealth and uHealth, 6(1), 2.

Panter, J., Andersen, T. A., Aro, A. R., & Samara, A. (2018). Obesity prevention: A systematic review of setting-based interventions from Nordic countries and the Netherlands. Journal of Obesity, 2018, 1-34.

Sahoo, K., Sahoo, B., Choudhury, A. K., Sofi, N. Y., Kumar, R., & Bhadoria, A. S. (2015). Childhood obesity: Causes and consequences. Journal of Family Medicine and Primary Care, 4(2), 187-192.

Sousa, A. M. (2013). Adolescent obesity. American Journal of Nursing, 113(5), 12.

Stanford Childrens Health. (2017). Obesity in adolescents. Web.

Steinbeck, K. S., Lister, N. B., Gow, M. L., & Baur, L. A. (2018). Treatment of adolescent obesity. Nature Reviews Endocrinology, 14, 331-344.

Pediatric obesity negatively influences childrens health, educational achievement, and quality of life. Obese and overweight children have a high likelihood of proceeding with the problem into adulthood, in addition to the threat of chronic illnesses. Decrease of screen time, consumption of a balanced diet and minimal high-calorie foods, and augmented physical exercise are crucial strategies that have been found fruitful in lessening pediatric obesity amongst school-aged children (Centers for Disease Control and Prevention, 2018). Children should be allowed to participate in games with their peers, play, run, walk, and have other physical exercise practices. The evaluation of a programs effectiveness is crucial since it assists in the development of successful interventions.

Complete Work Plan

Goals

• Decrease screen time for school-aged children to 2 hours per day for six months to prevent pediatric obesity.
• Enhance the physical exercise of at least 3 hours daily for six months among children to boost fitness and self-esteem.
• Promote healthy consumption among school-aged children for three meals each day within one year to prevent childhood obesity.

Measures of Success

• Parents will be encouraged to ensure a screen time of fewer than two hours each day for school-aged children from 6 to 11 years (Silva et al., 2019).
• Parents, schools, and governments will be advised to provide at least one playground for children in all regions across the United States.
• Schools and parents will offer a balanced diet for school-aged children from 6 to 11 years each day while providing less high-calorie food.

Objectives

1. Children will be able to identify at least two practices of preventing pediatric obesity in a six months campaign.

   • Activities Planned to Achieve this Objective: Health professionals will take possession, provide guidance, and engage parental obligation to address pediatric obesity through lessening screen time and upholding all preventive practices (Almutairi, 2020).
   • Data measurement tools: Questionnaire.
   • Timeframe: 6 months.
   • Responsible person:

     • Health professionals.
     • Parents.
2. Children will engage in at least 3 hours of daily physical exercise for six months.

   • Activities Planned to Achieve this Objective: Organize contributions of parents, government departments, and institutions accountable for policies, encompassing, but not restricted to development, sport and recreation, planning, finance and revenue, communication, environmental management, and social affairs to ensure that playgrounds and other facilities are provided in all communities across the US.
   • Data measurement tools: Watch.
   • Timeframe: 6 months.
   • Responsible person: Government.
3. Children will maintain a balanced diet for all the three meals in a day in a period of one year.

   • Activities Planned to Achieve this Objective: Develop school plans, recommendations, measures, and guidelines that suitably engage pertinent sectors comprising the private segment, where appropriate to implement arrangements aimed at offering a balanced diet and promoting healthy consumption with less high-calorie food to reduce pediatric obesity.
   • Data measurement tools: Questionnaire.
   • Timeframe: One year.
   • Responsible person: School administration.

Evaluate the Effectiveness of Program

The success of the program will be evaluated through a thorough check of the attainment of the set aims. The questionnaire will serve as a vital evaluation tool. It will comprise main intervention features, questions associated with the general plan of the program, such as set activities, and engaged stakeholders (Chriqui et al., 2010). Questions regarding implementation will assess performance, program organization, and the success of participation. With the aid of predefined criteria, the questionnaire will establish program that may be considered viable practice and could benefit future endeavors that aim to better consumption behavior, physical activity, and screen time to prevent obesity.

How to Know Effectiveness

In a 6-month awareness campaign, health professionals should have successfully encouraged parents to ensure a screen time of fewer than two hours daily for school-aged children from 6 to 11 years. Caregivers should have fruitfully advised parents, schools, and governments to offer at least one playground for children in all regions across the United States to have roughly 3 hours of daily physical exercise within six months. A scoring sheet will assist in the understanding of the programs effectiveness through the calculation of the scores for each section and the entire plan (Mokdad & Remington, 2010). To begin with, the total score per section will be computed. The figure obtained will then be divided by the full marks for the section to give a score that is either one or less. A score that is 0.8 or more will indicate excellent performance, 0.6 to 0.8, acceptable plan, and 0.4 to 0.6, marginal suitability, while a figure that is less than 0.4 shows low effectiveness (Fry, Nikpay, Leslie, & Buntin, 2018). While establishing effectiveness, differentiation is made between essential questions and general inquiries. Greater weight is considered for essential questions than for the general ones because they are more critical in evaluating a programs effectiveness.

Conclusion

Pediatric obesity undesirably sways childrens health, educational attainment, and quality of life. Lessening screen time, ensuring healthy consumption, and augmenting physical exercise are vital strategies that have been found productive in preventing pediatric obesity. The assessment of a programs effectiveness is critical since it assists in the development of fruitful interventions. Among other preventing practices, parents will be encouraged to ensure that children have a screen time of fewer than two hours daily. A questionnaire will be crucial in the evaluation of the success of the program through an exhaustive check of the accomplishment of the set aims. A score of 0.8 and above will indicate outstanding performance.

References

Centers for Disease Control and Prevention (2018). Developing process evaluation questions [Evaluation Briefs No. 4]. Web.

Chriqui, J. F., Schneider, L., Chaloupka, F. J., Gourdet, C., Bruursema, A., Ide, K., & Pugach, O. (2010). School district wellness policies: Evaluating progress and potential for improving childrens health three years after the federal mandate. School years 200607, 200708 and 200809 (Vol. 2). Chicago, IL: Bridging the Gap Program.

Fry, C. E., Nikpay, S. S., Leslie, E., & Buntin, M. B. (2018). Evaluating community-based health improvement programs. Health Affairs, 37(1), 22-29. 

Mokdad, A. H., & Remington, P. (2010). Measuring health behaviors in populations. Preventing Chronic Disease, 7(4), A75.

Silva, D. F. O., Sena-Evangelista, K. C. M., Lyra, C. O., Pedrosa, L. F. C., Arrais, R. F., & Lima, S. C. V. C. (2019). Instruments for evaluation of motivations for weight loss in individuals with overweight and obesity: A systematic review and narrative synthesis. PloS One, 14(7), 1-13. Web.