obesity final presentation2

CHILDHOOD OBESITYGROUP B

BIGTHE

PICTURE

The U.S. is in the midst of an epidemic of obesity involving more than one third of the adult population, which is approx.

60 million people.

OBESITY DEFINED

• BMI = [Lbs./ (Height in inches)2] x 703• Or… BMI ≠ accurate predictor of risk

TRENDS

http://www.youtube.com/watch?v=7iBHm5zji_Y

• Continuing with the trajectory of the past 30 years would result in 86% of Americans becoming overweight or obese by 2030, with 1 in every 6 health care dollar being spent on obesity and its sequellae.

• In 2008, only one state (Colorado) had a prevalence of obesity less than 20%. Thirty-two states had a prevalence equal to or greater than 25%; six of these states (Alabama, Mississippi, Oklahoma, South Carolina, Tennessee, and West Virginia ) had a prevalence of obesity equal to or greater than 30%.

1999

Obesity Trends* Among U.S. AdultsBRFSS, 1990, 1999, 2008

(*BMI 30, or about 30 lbs. overweight for 5’4” person)

2008

1990

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

OBESITY TRENDS* AMONG U.S. ADULTSBRFSS, 1985

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14%

OBESITY TRENDS* AMONG U.S. ADULTSBRFSS, 1986

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14%

OBESITY TRENDS* AMONG U.S. ADULTSBRFSS, 1987

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14%

OBESITY TRENDS* AMONG U.S. ADULTSBRFSS, 1988

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14%

OBESITY TRENDS* AMONG U.S. ADULTSBRFSS, 1989

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14%

OBESITY TRENDS* AMONG U.S. ADULTSBRFSS, 1990

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14%

OBESITY TRENDS* AMONG U.S. ADULTSBRFSS, 1991

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19%

OBESITY TRENDS* AMONG U.S. ADULTSBRFSS, 1992

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19%

OBESITY TRENDS* AMONG U.S. ADULTSBRFSS, 1993

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19%

OBESITY TRENDS* AMONG U.S. ADULTSBRFSS, 1994

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19%

OBESITY TRENDS* AMONG U.S. ADULTSBRFSS, 1995

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19%

OBESITY TRENDS* AMONG U.S. ADULTSBRFSS, 1996

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19%

OBESITY TRENDS* AMONG U.S. ADULTSBRFSS, 1997

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% ≥20%

OBESITY TRENDS* AMONG U.S. ADULTSBRFSS, 1998

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% ≥20%

OBESITY TRENDS* AMONG U.S. ADULTSBRFSS, 1999

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% ≥20%

OBESITY TRENDS* AMONG U.S. ADULTSBRFSS, 2000

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% ≥20%

OBESITY TRENDS* AMONG U.S. ADULTSBRFSS, 2001

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

Obesity Trends* Among U.S. AdultsBRFSS, 2002

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

OBESITY TRENDS* AMONG U.S. ADULTSBRFSS, 2003

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

OBESITY TRENDS* AMONG U.S. ADULTSBRFSS, 2004

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

OBESITY TRENDS* AMONG U.S. ADULTSBRFSS, 2005

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

OBESITY TRENDS* AMONG U.S. ADULTSBRFSS, 2006

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

OBESITY TRENDS* AMONG U.S. ADULTSBRFSS, 2007

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

OBESITY TRENDS* AMONG U.S. ADULTSBRFSS, 2008

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

CAUSES AND RISK FACTORS

• Poor diet• Lack of physical

activity• Genetics• Culture• Certain medical

disorders

• Environment Metabolism

• Lifestyle • Psychological

factors• Lack of knowledge

HEALTH IMPLICATIONSCoronary heart disease

Type 2 diabetes

Hypertension

Non-alcoholic fatty liver disease

Increased risk of disability

HEALTH IMPLICATIONS• Also linked with mental health conditions such as :

–Depression–Low self-esteem–Feelings of shame

• Many obese people are discriminated against and the targets of insults and verbal abuse

WHO IS AFFECTED?

Everyone… Even your dog.

HOW OBESITY HARMS A CHILD

• Brain• Heart • Liver• Pancreas • Growth Plates

EMOTIONAL EFFECTS OF CHILDHOOD OBESITY

• Obese White and Hispanic girls 13-14 years old• Significantly diminished self-esteem levels than

non-obese girls– Increased loneliness, sadness, nervousness–More likely to engage in unhealthy activities

(smoking and drinking) -Richard S. Strauss, M.D. (Jan 2000).

CHILDHOOD OBESITY TRENDS

1971-2006

“(A) a physical or mental impairment that substantially limits one or more of the major life activities of such individual [such as walking, or working]; (B) a record of such an impairment; or (C) being regarded as having such an impairment.”

-Americans with Disabilities Act

FEDERAL POLICIES ON OBESITY

“…temporary, non-chronic impairments of short duration, with little or no long term or permanent impact, are usually not disabilities…Similarly, except in rare circumstances, obesity is not considered a disabling condition.”

ADA Obesity protection

FEDERAL POLICIES ON OBESITY

COURT DECISIONS• Cook v. Rhode Island Department of

Mental health, Retardation and Hospitals

• Francis v. City of Meriden• EEOC v. Watkins

OBESITY LEGISLATION UP FOR REAUTHORIZATION IN 2009

• Child Nutrition and Special Supplemental Nutrition Program for Women, Infants and Children Act

• Elementary and Secondary Education Act

• Safe, Accountable, Flexible, Efficient Transportation Equity Act–Supports transportation by “bike, foot,

or other non-motorized means”–Number of children walking to/from

school: 48% in 1969 vs. 16% in 2001

OBESITY LEGISLATION UP FOR REAUTHORIZATION IN 2009

Children’s Health Insurance

Program (CHIP) Act

OBESITY LEGISLATION UP FOR REAUTHORIZATION IN 2009

New Health Care Reform and

Childhood Obesity

OBESITY LEGISLATION UP FOR REAUTHORIZATION IN 2009

STATE OBESITY-RELATED LEGISLATION

School Focused Legislation

INTERVENTIONS• Community programs of health promotion through

lifestyle change• Education programs• Facilitating the development of new habits and

routines• Lifestyle Redesign® programs; recommendation of

home modifications• Adaptations/equipment• Compensatory training in ADL and IADL• Wellness programs for children, teens, and adults;

play and physical education in the schools• Safe patient-handling programs in hospitals and

skilled-nursing facilities; and post-surgical acute-care interventions

EQUIPMENT• Expandable support surface bariatric beds,• Weight-rated portable bedside hoyer lifts, • Weight-rated wheelchairs, • Bariatric bedside commodes and shower chairs, • HoverMat • Bariatric tilt tables • Bariatric rolling and standard walkers, • Bariatric sliding boards, etc.

PEOPLE AND PERSPECTIVES

Who is impacted by childhood

obesity?

PEOPLE AND PERSPECTIVES

Case Study

PEOPLE AND PERSPECTIVES

• Arguments supporting occupational therapists play a role in childhood obesity.

• Arguments against occupational therapists playing a role in childhood obesity.

“AOTA endorsed occupational therapy intervention as a way to meet the needs of children and adolescents who are at risk for overweight status or obesity caused by controllable lifestyle factors.”

AOTA adopted a statement -2006.

OT PRACTICE

PREVENTION• Advocacy/policy• Educational programs

INTERVENTIONS• Working with families• Changing habits• Working with school systems• Environment modification• ADLs/IADLs

Ots = imperative in changing policy to fix the issue that is derived from factors both on a macro and micro level.