Child Obesity Treatment Programs
Child Obesity Studies
A number of studies have reported that the prevalence of child obesity
is continuing to increase at an alarming rate. Recent studies from Leeds
show that by the age of eleven, as many as 30 percent are overweight and
17 percent are obese (<85th and >95th BMI centiles respectively)
(Rudolf et al. 2002). Many studies have also shown that BMI tracks from
childhood to adulthood, which has major implications for adult morbidity
in the coming decades. Other studies have shown that obese teenagers already
have the cardiovascular, glycemic and lipid changes associated with increased
adult disease risk (Freedman, 1999). Perhaps of even more importance to
the children is the social and emotional morbidity that is associated
with being overweight or obese.
Child Obesity & Intervention
Given the increasing prevalence of childhood overweight and obesity and
associated morbidities, it is important to establish appropriate and successful
interventions to tackle the problem of obesity in the pediatric population.
It is worth noting that at this time there is no program of health care
currently available for this group. There is also a lack of research evidence
on successful intervention programs. However, the need for appropriate
interventions for overweight and obese children is well acknowledged and
there are a number of groups in the UK that are engaged in intervention
work with overweight and obese children. Examples of the work of some
of these groups will be discussed in the presentation, highlighting where
appropriate the similarities and differences in the approaches used by
the different groups.
Child Obesity Support
Some common elements are the use of a multidisciplinary approach to intervention,
combining expertise from psychology to support the behaviour change element,
exercise science to support the physical activity element and nutrition
to support the dietary element. Some of the interventions are based on
the important work of Epstein from the USA. One important requirement
used by some of the UK groups is the child centred focus of the intervention,
placing emphasis on understanding the specific needs and lifestyle of
the individual children. The framework of principles and practices that
underpin the intervention are then contextualised to the individual requirements
of the participant, in terms of factors such as likes and dislikes, choices
and opportunities that are related to successfully changing their current
eating and activity behaviour.
Child Obesity & Intervention Programs
There is not only a need for the development of successful intervention
programs, but also for the sharing of good practice based on evidence
of effective intervention programs. Such evidence is not currently available
from randomised controlled trials conducted in the UK, but it will not
necessarily accumulate from such an approach, given the limitations of
this form of design for evaluating interventions for obesity where weight
loss is the treatment (Lean, 2000). Evidence of what works for different
children in different contexts in facilitating behaviour change associated
with an evaluation of change in eating and activity behaviour, fitness
and body composition are all ideally required to evaluate intervention
programs for overweight and obese children.
Source: Professor C B Cooke, School of
Leisure & Sport, Leeds Metropolitan University, Leeds, LS6 3QS, UK
(2002)
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