CHAPTER I

INTRODUCTION

WHAT'S WITH THIS TOPIC ?

The researchers chose this topic for us to widen our knowledge about this matter. We were so curious about this disease because we saw a lot of obese or overweight people everywhere. Now, as we get to know this disease and widened our knowledge about this topic, we expect that everyone of us will know how to deal and prevent this kind of disease so that we can not put our health to risk that will put our lives in danger. Reading this research will give more information about this topic.

WHO DISCOVERED OBESITY ?

According to Online etymology dictionary, Douglas Harper (2010), from French Obesity, which is from Latin obesitas which means "Fatness" and from obesus which means "something thats eaten itself fat. Root words are from "ob" (which means over) and "edere" which means to eat. The Healthy People (2010), objectives identify prevention priorities in this country because it is a major contributor to many preventable causes of death. Obesity is defined as a complex, multifactorial chronic disease which involves the interaction of both genotype and environment. Integrating factors of behavioral, social, cultural, physiological, genetic and metabolic are involved (National Heart, Lung & Blood Institute, [NHLBI], 2006).

HISTORY OF OBESITY

The historian says the first people to commonly recognize obesity as a medical condition were the Greeks. Hippocrates recognized it and stated that not only was being overweight a disease, but it also lent itself to the onset of other diseases. Sushuruto (6th Century BCE), an Indian doctor made the connection between obesity, diabetes, heart failure, and stated that physical work (exercise) would help cure all three diseases. The scarceness of food throughout history, Obesity came to be as a sign of the wealthy, those who could afford to eat.

Starting in the time of the ancient greeks and moving forward, Obesity became a sign of gluttony and was often mocked for being "fat". After Christianity became more widespread, believers found obesity to be the cause of laziness and lust after food, both sins against God and the church. Eventually, Obesity turned into an issue of physical attraction when many people decided that excess weight was not appealing on the opposite sex. No matter what the reason, obese people have been singled out of centuries.

OVERVIEW

The policy statement for the American Academy of Pediatrics defines childhood obesity using BMI (Body Mass Index) as an indicator. BMI in children can be calculated using kilograms (kg) and centimeters (cm) [BMI = (weight (kg) / height (cm) x 10,000] or pounds (lbs) and inches (in) [BMI = weight (lbs) / height (in) / height (in) x 10,000]. Once the BMI s calculated, it is plotted using the Centers for Disease Control CDC growth charts (CDC,2007). A BMI between 5th and 85th percentile on an age/gender appropriate growth chart is considered healthy weight. A BMI between 85th and 95th percentile specific for age/gender is considered at risk for overweight. A BMI at or above the 95th percentile on age/gender specific chart is considered overweight or obese. The AAP advises use of clinical judgment to correlate measurement criteria to patients (American Academy of Pediatrics, 2007). Recommendations by various experts support use of the term "overweight" to be used instead of obesity, so children aren't harmed by negative connotations of the label, "obese" (Flowers & kahwati, 2004).

According to medicine.medscape.com (2014), Obesity in children is a complex disorder. Its prevalence has increased so significantly in recent years that many consider it a major health concern of the developed world. The National Health and Nutrition Examination Survey (NHANES) indicates that the prevalence of obesity is increasing in all pediatric age groups, in both sexes, and various ethnic and racial groups, many factors, including genetics, environment, metabolism, lifestyle, and eating habits are believed to play a role in the development of Obesity. However, more than 90% of cases are idiopathic; less than 10% associated with hormonal or genetic causes.

Childhood obesity is a serious medical condition that affects children and adolescents. It occurs when a child is well above the normal weight for his or her age and height. It is particularly troubling because the extra pounds often start children on the path to health problems that were once confined to adults, such as diabetes, hypertension, and high cholesterol. Childhood Obesity can also lead to poor self-esteem and depression. www.mayoclinic.org (2014)

According to contemporarypediatrics.modernmedicine.com (2013), recent statistics suggest Childhood Obesity rates may be leveling off. The problems associated with Childhood overweight and obesity, however, continue to be a heavy burden on the minds, health, and pocketbooks of society, parents and children, and pediatricians. Childhood Obesity is the number one health concern among parents in the World, topping drug abuse and smoking and with good reason. Excess weight at young ages is associated with higher and earlier death rates in adulthood because of obesity, today's pediatricians are witness to an onslaught of pediatric patients with adult-like physical and mental health problems.

Obesity in children and adolescents is associated with multiple comorbidities, including metabolic, cardiovascular, gastrointestinal, pulmonary, orthopedic, and psychological disorders. In fact, cardiovascular and metabolic impairments in childhood and adolescence constitute major risk factors for developing cardiovascular disease in adulthood. An obese children are more likely to become obese adults. Also, if children are overweight, obesity in adulthood is likely to be more severe. Obesity"s financial toll is staggering. Treating obesity and obesity-related conditions costs billions each year. One estimate suggests the United States spent $190 billion on Obesity-related health care expenses in 2005, which is twice previous estimates. Pediatricians who spend their days treating these patients say the old paradigm of dictating to kids and their parents that they need to eat less and exercise more doesn't work in this new age.

FACTS OF CHILDHOOD OBESITY

Only about 8% of adolescents aged 12 to 15 years get 60 minutes of daily physical activity (Troiano RP, et al. Med Sci Sports Exerc. 2008;[1]:181-188).In some communities children "account for almost half of new cases of type 2 diabetes which had previously been adult onset" (Frieden TR, et al. Health Aff [Millwood]. 2010;29[3]:357-363).Hospitalizations of obese children and adolescents aged 2 to 19 years nearly doubled between 1999 and 2005 for obesity-related conditions such as asthma, diabetes, gallbladder disease, pneumonia, skin infections, pregnancy complications, depression and other mental disorders (Trasande L, et al. Health Aff [Millwood]. 2009;28[4]:W751-W760).Defined as body mass index (BMI) >1.2 times the 95th percentile or an absolute BMI >35 kg/m, severe obesity is estimated to affect about 5% of the US pediatric population (Kelly AS. J Pediatr. 2013;163[1]:6-8).About 1 in 3 kids and teenagers is overweight or obese, nearly triple the rate in 1963 (American Heart Association; 2013).In 2007, the average person consumed 400 more calories a day than in 1985, and 600 calories more a day than in 1970 (Wallinga D. Health Aff [Millwood]. 2010;29[3]:405-410). Recent data show that Hispanic and black high school children have obesity rates of 16.6% and 18.3%, respectively, which is significantly higher than their white counterparts (10.8%) (Trust for America's Health; 2009). The same disparities exist for younger children ( Bethell C, et al. Health Aff [Millwood]. 2010;29[3]:345-356).Almost 17% of children were obese in 2009 - 2010 (Ogden CL, et al. NCHS Data Brief. 2010;[82]:1-8).Percentage of adolescents aged 12-19 years who are obese: 18.4% (2009-2-10) (Ogden CL, et al. NCHS Data Brief. 2012;[82]1-8)Percentage of children aged 2-5 years who are obese: 12.1% (2009-2010) (Ogden CL, et al. NCHS Data Brief. 2012;[82]:1-8)Most obese children and adolescents are not low income (below 130% of the poverty level). Childhood Obesity prevalence decreases as the education of the head of household increases, but the relationship is not consistent across race and ethnicity groups (Ogden Cl, et al. NCHS Data Brief. 2010;[[51]:1-8).

PROBLEM

Childhood Obesity has both immediate and long-term effects on health and well-being. There are lots of treatment that can cure Childhood Obesity. According to www.aacap.org (2014), the problem of Childhood Obesity in the World has grown considerably in recent years, between 16 and 33 percent of children and adolescents are obese. Obesity is among the easiest medical conditions to recognize but most difficult to treat. Unhealthy weight gain due to poor diet and lack of exercise is responsible for over 300,000 deaths each year. The annual cost to society for obesity is estimated at nearly $100 billion. Overweight children are much more likely to become overweight adults unless they adopt and maintain healthier patterns of eating and exercise. Overweight and Obesity are the result of "Caloric Imbalance" - too few calories expended for the amount of calories consumed and are affected by various genetic, behavioral and environmental factors.

STATEMENT OF THE PROBLEM

Obesity frequently becomes a lifelong issue. The reason most obese adolescents gain back their lost pounds is that they tend to go back to their old habits of eating. An obese adolescent must therefore learn to eat and enjoy healthy foods in moderate amounts and to exercise regularly to maintain a desired weight. Parents of an obese child can improve their child's self-esteem by emphasizing their strengths and positive qualities rather than just focusing on their weight problem.

SIGNIFICANCE OF THE STUDY The purpose of this study was to give an insight into the providers who care for children, the children themselves, and the communities in which they live. By monitoring children's growth more effectively we can identify children who are at risk for becoming an obese. This research also determine the effects of Obesity and its interaction with age, specially during childhood level. This study will help you be aware of this type of disease and it will widen your knowledge about this topic. In order for you to avoid this kind of disease you should have a proper diet and always consult your dietitian to get more information about this disease. The study was guided by following questions.

FIVE (5) QUESTIONS

Why is it important to tackle the issue of Childhood Obesity ?What are the causes of the Obesity disease ?What are the common methods to treat obesity ?What is the impact of food television advertisements on Childhood Obesity ?What are some home strategies that can overcome obesity ?

SCOPE AND LIMITATION

This topic, the researchers will be focusing on discussing the causes of childhood obesity, the effects of fats in our body, the six different kinds of Obesity, What are the proper diet to overcome Obesity, common treatment of Obesity, the effects of Obesity to people and ways to avoid this kind of disease. Childhood weight involves cultural norms and expectations as well as personal beliefs and characteristics of both patient and provider into the disease process, treatment and prevention.

CHAPER II

TACKLING CHILDHOOD OBESITYChildhood obesity has become a public health crisis, not just in the Philippines but all over the world. Childhood obesity problem can be reduced by educating children and parents about healthy nutrition and encouraging them to be physically active. Behaviors are shaped in childhood. With increases in technology leaving many children adopting sedentary lifestyles and the abundance of high-caloric foods available in schools, restaurants, and convenience stores, children are heavier now than never before. For children, those extra pounds can add up to health problems, often for life. Type 2 diabetes was once rare in American children - now it accounts for up to 46 percent of newly diagnosed diabetes cases in children and adolescents. In addition to physical health, being overweight or obese also has a significant impact on children's social and emotional health, as overweight children are also more likely to become overweight or obese as adults. If not addressed, we are at risk of raising the first generation of children who will not outlive their parents.

CAUSES OF THE DISEASE OBESITY

Obesity is a term that means they weigh at least 20% more than what is considered a normal weight for their height. It makes them more likely to have conditions including: Heart disease and stroke, Hypertension, Diabetes, some Cancers, Gallbladder disease and Gallstones, Osteoarthritis, gout, breathing problems, such as sleep Apnea (When a person stops breathing for short episodes during sleep) and asthma. Not everyone who is obese has all of those problems. The risk rises if they have a family history of one of those conditions. Also, where their weight is may matter. If it's mostly around the stomach (the "apple" shape), that may be riskier than if they have a "pear" shape, meaning that their extra weight is mostly around there hips and buttocks. Obesity comes to be in one of three ways; it can be inherited through genetics from one's parents, it can be developed by shock of the body by the person in question, or it can be due to chemicals in our food. Substances like high fructose corn syrup, Magic Sugar (MSG), and other laboratory made organisms cannot break down in one's body in the same way that chemically unaltered materials can. This lack of proper digestion causes one's body to become damaged and lack a maintained balanced. tho result is a fairly new phenomenon that occurs with the continuance of laboratories producing food as opposed to food being naturally grown and processed with as few chemicals as possible.

The Centers for Disease Control (the U.S government health organization) report that this country has been struggling with obesity for well over 20 years now and regarding childhood obesity, it is no less daunting. Data from their surveys comparing the 1970s to the 2000s show that the prevalence of obesity has increased for children of all ages at least 3 times over to about 20% of our population less than 19 years old (adult obesity trends by state and race/ethnicity over the past 4 years). Obesity appears to be most commonly seen in the African American, hispanic and Native American populations and in lower income families (although this differences is diminishing and it seems to be affecting all classes, at least to some degree).

It is important to note that increasing awareness over the past several years as well as effective interventions have seemed to perhaps start making a small difference in that, in some populations, we are starting to see evidence of some stabilization of the increase in obesity. There is not a decrease, but it seems that it is not rising at a rate as quickly as it used to be. Lifestyle issues - too little activity and too many calories from food and drinks, remain a significant contributor to childhood obesity. but there are also some genetic and hormonal factors that likely play a role as well. Recent research has found that changes in digestive hormones can affect the signals that let them know they are full.

COMMON METHODS TO TREAT OBESITY

Treatment for childhood obesity is based on the child's age and if he or she has other medical conditions. Treatment usually includes changes in the child's diet and level of physical activity. In certain circumstances, treatment may include medications or weight-loss surgery. For children and teens who are overweight or mildly obese with no other health concerns, the goal of treatment may be weight maintenance rather than weight loss. This strategy allows the child to add inches in height but not pounds, causing BMI-for-age to drop over time into a healthier range. however, for an obese child, maintaining weight while waiting to grow taller may be as difficult as losing weight is for older people. Weight loss is typically recommended for obese children and teens and for children younger than 6 who have obesity-related health concerns. The method for maintaining the child's current weight or losing weight are the same. The child needs to eat a healthy diet and increase his or her physical activity. Success depends largely on the commitment to helping the child make these changes.

Healthy Eating. Parents are the ones who buy the food, cook the food and decide where the food is eaten. Even small changes can make a big difference in the child's health. Physical Activity. A critical part of weight loss, especially for children, is physical activity. it not only burns calories but also builds strong bones and muscles and helps children sleep well at night and stay alert during the day. Such habits established in childhood help adolescents maintain healthy weight despite the hormonal changes, rapid growth wand social influences that often lead to aver eating. And active children are more likely to become fit adults.Medications. Only one prescription weight-loss drug is available in the United States of adolescents: Orlistat or Xenical (a synthetic drug which blocks pancreatic enzymes involved in the digestion of fats, used to treat obesity). Orlistat, which is approved for adolescents older than 12, prevents the absorption of fat in the intestines. Prescription medication is not often recommended for adolescents. The risks of taking a prescription medication long term are unknown and the medications effect on weight loss and weight maintenance for adolescents is still questioned and weight loss drugs do not replace the need to adopt a healthy diet and exercise regimen.Weight-loss Surgery. Can be a safe and effect option for some severely obese adolescents who have been unable to lose weight using conventional weight loss methods. however, was with any type of surgery, there are potential risks and long-term complications. Also, the long term effects of weight loss surgery on a child's future growth and development are largely unknown. Weight loss in adolescents is uncommon, but the doctor may recommend this surgery if the child's weight poses a greater health threat than do the potential risks of surgery. It is important that a child being considered for weight-loss surgery meet with a team of pediatric specialists, including a pediatric endocrinologist (concerned with endocrine glands and hormones). Weight-loss surgery limits the amount of food they are able to comfortably eat or decreases the absorption of food and calories or both. Weight-loss surgery can often help lose as much as 35% or more of the excess body weight. But weight-loss surgery is not a miracle obesity cure. It does not guarantee that will lose all the excess fats. Weight-loss success after surgery depends on the commitment to making lifelong changes in eating and exercise habits.

IMPACT OF FOOD TELEVISION ADVERTISEMENTS

A study of 8,234 children reveals factors that are statistically significantly associated with childhood obesity including sedentary behavior and dietary patterns among others. The odds ratio of developing obesity has a positive linear correlation with the number of hours of television viewing (Reilly, et al., 2005). Children who spend more time watching television are less likely to participate in physical activity (Lindsay, et al., 2006). in addition, junk for consumption pattern at age 3 was significantly associated with obesity at age 7. Television viewing may ask induce poor eating habits by exposing children to commercials for non-nutritious foods that greatly influence their preferences for foods. In 12985, Dietz and Gortmaker found that an additional hour of television viewing is associated with 23 percent of increase in the prevalence of obesity. Built environment such as proximity to school, recreational activities, green space and the safety to neighborhood have also been identified as factors influencing the development of childhood obesity (Reilly, et al., 2005).

The impact of television advertisements on children's eating behavior and health is of critical interest. In a preliminary study of Jason C.G Halford, Jane Gillespie, Victoria Brown, Eleanor E Pontin, Terence M Dovey (2004 - 2005) they examined lean, overweight and obese children's ability to recognize eight food and eight non-food related adverts in a repeated measures design. Their consumption of sweet and savory, high and low fat snack foods were measured after both sessions. While there was no significant difference in the number of non-food adverts recognized between the lean and obese children, the obese children did recognize significantly more of the food adverts. The ability to recognize the food adverts significantly correlated with the amount of food eaten after exposure to them. The overall snack food intake of the obese and overweight children was a significantly higher than the lean children in the control (non-food advert) condition. The consumption of all the food offered increased post food advert with the exception of the low-fat savory snack. These data demonstrate obese children's heightened alertness to food related cues. Moreover, exposure to such cues induce increased food intake in all children. As suggested the relationship between television viewing and childhood obesity appears not merely a matter of excessive sedentary activity. Exposure to food adverts promotes consumption.

LIFESTYLE AND HOME REMEDIES

overcoming obesity is more likely to be successful if they follow some home strategies in addition to their formal treatment plan.

Learning about your condition. education about obesity can help to learn more about why they become obese and what can they do about it. It may feel more empowered to take control and stick to the treatment plan. Read reputable self-help books and consider talking about them with the doctor and therapist.Setting realistic goals. When having to lose a significant a punt of weight, it may set goals that re unrealistic such as trying to lose too much too fast. Do not set yourself up for failure. Set daily or weekly goals for exercise and weight loss. Make small changes in diet instead of attempting drastic changes that are not likely to stick with for the long haul.Sticking to your treatment plan. Changing a lifestyle that may have lived with for many years can be difficult. Be honest with the doctor, therapist or other health care providers if they find the activity or eating goals slipping, The doctor and the patient can work together to come up with new ideas and new approaches.Identifying and Avoiding food triggers. Distract yourself from the desire to eat with something positive, such was calling a friend. Practice saying no to unhealthy foods and big portions.Keeping a record. Keep a food and activity log. This record can help remain accountable for the eating and exercise habits. It can discover behavior that may be holding them back and conversely, what works well for them. They can also use the log to tract other important health parameters such as hypertension and cholesterol levels and overall fitness.Taking your medications as directed. If taking a weight-loss medications or medications to treat obesity-related conditions, such as hypertensions or diabetes, take them exactly as prescribed. If having a problem sticking with medication regimen or have unpleasant side effects, talk to the doctor or specialist.