Addressing Childhood Obesity

Addressing Childhood Obesity
Dr. Dawn-Elise Snipes PhD, LPC-MHSP, LMHC
Executive Director: AllCEUs Counselor Education
Host: Counselor Toolbox Podcast

CEUs are available at allceus.com and Australia.allceus.com

Objectives
– Learn about the effects of obesity on health
– Identify best practices for addressing obesity in childhood
Clinician Functions
– Engage
– Children
– Caregivers
– Communities (task forces, county commission committees)
– Assess
– Risk factors
– Barriers
– Motivations
– Set SMART Goals at the individual, family and community level
Clinician Functions
– Implementation of goals
– Monitoring
– Risk factors
– Protective factors
– Evaluation
– Engagement
– Goal achievement
Why do We Care- Impact of Obesity
– Physical Health
– Increased risk of becoming an adult with obesity
– Glucose intolerance and insulin resistance
– Type 2 Diabetes
– Multiple cancers
– High blood pressure
– High cholesterol
– Adult heart disease
– Low testosterone (males)
– Polycystic Ovarian Syndrome
– Endometriosis
– Asthma
– Sleep apnea
– Joint problems
– Gastric Reflux
– Non-Alcoholic Hepatitis
– Back pain
– Mental Health
– Anxiety and depression
– Low self-esteem
– Lower perceived quality of life
– Being bullied
– Stigma
– Discrimination
Assess
– Use established guidelines to routinely assess children’s
– Health literacy
– Nutrition
– Sleep
– Physical activity/Sedentary behavior
– Mental Health
– Coping Skills
– Self-Esteem
– Pediatrician, school counselor/social worker, school nurse/health teacher, preschool teacher, caregiver

Assess
– Assess the risk factors in the environment
– Parenting/primary caregiver influences
– Conditions that promote sedentary or less active lifestyles—Reliance on cars, increased time watching t.v. or on computers
– Time and financial constraints that can adversely affect caregivers’ ability to provide healthy food options
– Overconsumption of high-fat, high-calorie foods
– Biology and genetics
– Breastfeeding for less than 6 months
– Lack of sufficient sleep

Assess
– Assess the risk factors in the environment
– Parenting/primary caregiver influences
– Caregiver mental illness, especially depression
– Lack of modeling positive nutrition and movement
– Lack of knowledge about nutrition or cooking
– Coercive clean your plate rules
– Mindless eating (with television on etc.)
– Over-normalizing growth-related weight gain
– Caffeine consumption during pregnancy

Assess
– Assess the risk factors
– Individual influences
– Rewarded behaviors
– How can good nutrition be made rewarding: Cooking tasty foods, making palatable snacks available
– How can exercise be made rewarding: Play with the dog, parks, trampolines
– Interests
– Geocaching, Pokémon go, martial arts, X-box/wii etc.
– Unsupervised time
– Peer values

Assess
– Assess the risk factors
– Individual influences
– Health
– Genetics
– Hypothyroid
– Diabetes
– Yo-yo dieting
– 80% of 10 year olds have been on at least 1 diet
– Insufficient sleep

Assess
– Assess the risk factors in the environment
– Sociocultural factors
– Income and social status
– Social support network to reduce stress, increase supervision, activities and availability of healthy food
– Affordability of healthy foods—Connect with sources of healthy food, community gardening
– Food marketing (media) and distribution (portions)

Engage
– Collaborate with school leaders to address risk factors that influence childhood obesity, including:
– Student demographics
– Increase availability of healthy food, afterschool care availability for lower income families
– School policies
– Food environment
– Healthy snacks available
– Options for packed lunch refrigeration
– Affordability and palatability of school lunches
Engage
– Collaborate with school leaders to address risk factors that influence childhood obesity, including:
– Physical activity—
– No or poorly enforced physical activity requirements (1 hour per day)
– Education
– Health literacy
– Coping skills

Engage
– Engage neighborhoods to improve community-level risk factors that influence childhood obesity
– Lack of safe places to exercise
– Modeling of unhealthy behaviors (lots of fried food/take out, alcohol consumption, smoking)
– Improve health literacy
– Provide effective smoking cessation
– Encourage family-focused exercise
– Lack of health literacy (only 12% of adults are health literate)
– Fliers
– Local newspapers (columns) and media (daily segment)
– Library sections and presentations

Engage
– Engage and collaborate with community stakeholders to develop, promote, and implement comprehensive primary-prevention interventions for childhood obesity
– County commission—Build parks, add sidewalks
– Law enforcement—Community oriented policing
– Schools—
– Activity and nutrition policies and resources
– Counselors and health class teach healthy coping strategies and health literacy
– Community centers/libraries/parks—Offer education and activities
– Physicians—Health education

Engage
– Engage community stakeholders when planning primary-prevention interventions for childhood obesity
– Vendors—Healthier options in machines
– Grocery Stores—Promote healthy food choices (recipes, visibility)
– Restaurants– Portion sizes and food options
– Malls—Open early for walking and kids play areas
– Health Insurance Providers– Cover RDs, get discounts on gym memberships, reduce premiums for proof of participation in wellness programs and or maintain a healthy body fat percentage (not BMI)

Engage
– Incentivize for Adults
– Money
– Time/Time Off
– Movie Tickets
– Business promotion for participation and/or model programs
– Childcare (Monthly caregiver’s night out)
– Clothing discounts (consignment shops etc.)
– Other—

Engage
– Incentivize for Kids
– Days off from school
– More nutritious meals are palatable (food substitutions—i.e. French bread pizza with pineapple and diced tomatoes; salad bars)
– Options for active study hall– recumbent bikes, recorded lectures students can listen to on a treadmill
– Walking desks
– Token economy to earn video game time
– —

Planning
– Develop interventions that are:
– Universally applied, as early as possible in multiple settings
– Infancy—Pediatrician, mommy and me clubs, daycares, videos, fitness centers*
– School age– School, afterschool care, fitness centers, home
– Targeted toward multiple behaviors
– Stress management
– Eating habits and choices
– Exercise and activity choices
– Sleep and health-related behaviors

Planning
– Develop interventions that are:
– Implemented using multiple approaches
– Handouts
– Festivals and activities
– Workplace wellness fairs
– Videos
– Homework that requires caregiver participation
– Create a healthy menu for a week, cook it and report back
– Inclusive of caregivers and the child

Monitoring
– Advocate for the establishment of a comprehensive population-level surveillance system to monitor risk and protective conditions for childhood obesity, including:
– Prevalence of healthy weights
– Physical activity and healthy eating
– Adequate, quality sleep
– Mood disorders
– Adverse Childhood Experiences
– Socio-economic factors such poverty
– Prevalence and duration of breastfeeding
Evaluate
– Evaluate the effectiveness and sustainability of school- and community-based primary-prevention initiatives on a community and individual organizational basis (schools, pediatricians, daycares, vendors etc.)
– Participation
– Cost
– Outcomes

Summary
– Obesity prevention involves
– Educating the public as well as community stakeholders about nutrition, exercise, stress management and sleep hygiene
– Motivating healthy eating and exercise behaviors (modeling, media, opportunities)
– Reducing stress and improving coping in children and their caregivers
– Making healthy food more accessible, affordable and appealing
– Creating environments that are conducive to healthy eating and activity (parks, community centers, malls, schools, vending, sidewalks, community policing)

Summary
– Adults can make their own decisions regarding maintaining an unhealthy weight and health behaviors
– Children are cognitively unable to make informed decisions, so it is up to caregivers, schools, medical personnel and the media to help them make decisions that will enhance their health and self esteem.
– Children who are obese are at an increased risk of pediatric health problems, stigma and bullying as well as becoming an adult who is obese