Health Stressors: an in depth, critical discussion of a current issue and the implications for Environmental Health and the Public Health Agenda
Topic: Dr. John Reilly (Bristol University, Sept. 2002) stated “The growing number of obese children was likely to have serious implications for the general health and psychological welfare of the population.”
Introduction
The incidence of obesity coincides with the availability of food, obesity being conspicuously absent during famine. It is a serious condition in affluent cultures chiefly because of the abundance of food and the decreased amount of physical activity. During the past 10 to 15 years, there has been a rapid increase in the prevalence of obesity in many Western countries.
More and more children are faced with the problem of obesity. More likely, this is not only the problem of the children but of the parents and the community as well. Blame it to “coca-colonization” which entices the children to eat more junk food and “Nintendo-nization” which encourages the children to just sit in front of the television or computer instead of playing outdoors. With these kind of lifestyle, no wonder more and more children, and even adults, are becoming obese.
They say that accumulating too much fat is a slow and steady means to one’s grave. Self-image is unquestionably important. But there is a far more serious aspect of being overweight that we don’t talk about much, and that is how this condition can affect our health and longevity. To the entire society, the problem is more than that. According to Dr. John Reilly, the growing number of obese children was likely to have serious implications for the general health and psychological welfare of the population. This paper will attempt to discuss this issue and the implications for Environmental Health and the Public Health Agenda.
Set in context
The health problems dominating the early part of this century have been replaced by a new morbidity—diseases brought on by our living habits. Many industrialized countries now have high rates of heart disease, cancer, strokes, and obesity.
Obesity is a chronic condition—not an acute, urgent, and headline-grabbing disease like AIDS or meningitis—and is therefore likely to receive less attention. Its effects are insidious, its origins are complex and poorly understood, and its treatment is often discouraging. But obesity can be prevented if the people will that it be so (1999).
Obese people do not live as long as other people. Life insurance company studies done early in the 20th century showed that, as the weight of individuals increases above an optimal level, the probability of dying increases, too (1999).
There is a small, but growing literature on obesity in economics. Some of it addresses the underlying reasons for the increase in obesity and some examines the consequences of this increase. Children, in general, do not purchase their own food or determine what’s for dinner. (If they do purchase their own food, it is generally because an adult has given them the money to do so.) To a large extent, they do not determine how they spend their time.
In trying to understand the increase in childhood obesity, researchers have focused on both the physical activity and consumption sides of the equation. Television viewing is a perennial villain in this literature. And, indeed, there is evidence that children who engage in the least vigorous physical activity or the most television viewing tend to be the most overweight (1998). Television viewing is thought to affect weight through several insidious channels: first, obviously, children are typically sedentary while watching TV; second, eating is often a complementary activity to television viewing; and, third, while watching television children are exposed to many advertisements for foods that are thought to contribute disproportionately to weight problems (2003).
Establishing causations
As pointed out in the introduction of this paper, obesity can be blamed to the rapid “coca-colonization” and “Nintendo-nization” of our world today. These have made children lead more sedentary lifestyles, making them more prone to developing fats and ultimately get obese.
The scientific literature generally claims that overweight and obesity have exploded over the last twenty or thirty years, usually pointing to what would appear to be quite low levels of Western overweight and obesity during the 1960s and even 1970s. And yet, when it comes to demonstrating how ‘modern Western lifestyles’ have changed (and, therefore, caused rapid rises in body weight) scientists rarely look closely at Western life during the 1950s or any other period from the relatively recent past when, at least according to the contemporary scientific literature, overweight and obesity were not the catastrophic problems they are today (2004).
Quite apart from the unresolved nature of the biological processes that lead to overweight and obesity, research into how much people eat, how much recreational exercise they do and how many calories they use going about their average daily lives is beset with methodological problems. These problems multiply when attention turns to large populations or when the time-frame of interest is a number of days or longer. Needless to say, precise comparisons between entire populations are difficult and extremely scarce in the literature.
Stressors
Obesity negatively impacts virtually all body systems and increases patient risk for specific malignancies. In addition to physical comorbidities, multiple psychological pathologies and stressors stem from obesity – the most prevalent being depression and anxiety disorders.
Psychological stressors include prejudice and discrimination, limited access to public conveniences, and difficulty maintaining personal relationships. If left untreated, morbid obesity results in increased morbidity and mortality and a shorter life span (2004). The most frequently experienced psychological stressors related to obesity are: a. depression and anxiety disorders, b. panic and discrimination, c. drug dependence and difficulty with intimate relationships, and d. anger and coping disorders.
These stressors can produce negative outcomes on the children. Evidently these children will grow up with low self-esteem or with psychological and social problems. Obese children will feel that there is a stigma created by their being obese. Maybe they will see it by the looks some people throw at them or perhaps by how others treat them or by overhearing negative things about their body size.
The stressors mentioned can further make the children eat more, perhaps to cope up with the negative emotions they are feeling. This will somehow go on as a vicious cycle. The more the children feel depressed or discriminated, the more they will eat and the bigger they will become.
The role of Epidemiology
Studying the origin and spread of obesity is important if we are to cure this condition. Obesity as a disease should be considered an incurable yet manageable disease. The intake of food in excess of body requirements – overeating – is the principal cause of obesity. The capacity of the body to store protein and carbohydrate is limited, and excess food is converted into fat and stored (2000).
Genetic factors may also be involved, since some persons do not gain any appreciable amount of weight regardless of their food intake. A slim body habitus in these individuals appears to be a part of their genotype. Other factors are sometimes involved when obesity develops. By putting a stop to that which leads to the development of obesity, hopefully the disease can be cured.
Implications for Environmental Health and Public Health Agenda
Obesity during childhood and adolescence can cause psychological and social problems, and may predispose young people to obesity and its health consequences as adults. Obese children tend to grow more quickly, and may be mistaken for older children and expected to behave accordingly. Children develop negative attitudes about overweight as young as 6 years old, and may exclude fat children from play. Obese youth can be at risk for diabetes, fatty liver, high blood pressure, and sleep apnea. Development of a negative body image in youth may lead to eating disorders, especially in girls ( 1998).
The most widespread consequences of childhood obesity are psychosocial. Obese children become targets of early and systematic discrimination. As they mature, the effects of discrimination become more culture-bound and insidious. An important sequel of the widespread discrimination and cultural preoccupation with thinness is concern about weight expressed at young ages. The concern becomes part of the culture and is most pronounced among female dancers and gymnasts ( 1998).
Public health agenda on obesity as can be seen by the NHS’ actions calls for help in fighting obesity. The UK government published a national service framework for coronary heart disease years ago. It includes targets for reducing obesity.
What strategies are in place and how effective are they
Strategies in fighting childhood obesity includes programs especially those at school which teaches and encourages children to eat healthy food and exercise regularly. These are very effective in making the children aware of the negative consequences of eating too much or having too little exercise.
The downside though is that even though these schools educate and make the children aware about obesity, they still sell foods that can promote obesity. For instance, at the school canteen, they sell soda and junk foods. They leave it to the children to choose what to eat. This is not good since as children, although they are aware, they still cannot exert much control, especially when it comes to food.
Obstacles to health
Body fat is a living tissue. It doesn’t just sit there and do nothing! It has to obtain oxygen and to get rid of waste material, and therefore has to have a blood supply. As we put on extra fat, we develop extra blood vessels, red blood cells, and plasma to carry oxygen and nutrition to it. The amount of blood in our circulatory system increases, and, since the heart has to pump all the blood that comes into it, the two pumping chambers of the heart (ventricles) may dilate to handle the extra volume, with their walls becoming thicker (hypertrophic) to pump the blood out with extra force (1999).
Obesity is strongly associated with diseases of the heart and blood vessels in several ways. Obese people appear to be more likely to develop disease of the coronary arteries, which are the vessels that supply the heart muscle with blood. Blood flow in those arteries can be blocked due to a complex process called atherosclerosis, which is more common in obese than in non-obese adults (2000).
Obesity presents numerous health problems for children. It is the leading cause of pediatric hypertension and Type II diabetes, increases the risk of coronary heart disease, increases stress on weight-bearing joints, lowers self-esteem and affects relationships with peers, and increases the risk for chronic health problems in adulthood. One of the most severe problems is sleep apnea (interrupted breathing while sleeping), which, in some cases, can lead to problems with learning and memory. Many authorities believe that social discrimination associated with obesity presents the most devastating consequences for children. Children who are teased a lot can develop low self-esteem and depression, which often has implications for long-term happiness and success in life (2003).
Health promotion
The increased rates of obesity could probably have been prevented during childhood if excessive food, especially fatty food, had not been available and consumed, and if the majority of individuals had been more, rather than less, physically active (1999).
The hope for health promotion and obesity prevention is that as more individuals get the message that eating excessive amounts of foods, especially fatty foods, can result in obesity for many of us, people’s buying habits will reflect less responsiveness to advertising of foods with unacceptably high fat and calorie content.
As detailed in the above paragraphs, children’s junk food and soda consumption and television watching have increased, while at the same time more active physical activity has decreased. Health promotion should start from these areas.
Schools for a start should educate the children about obesity – especially its complications in the long run. Many schools have probably provided nutrition education to students in courses such as those linked to physical education classes. But other approaches may be more likely to result in changes in health behaviors.
Conclusion
More and more children are affected by obesity. This can be attributed to the increasing consumption of children of unhealthy foods like soda and junk foods. Along with these are the decreasing physical activities which the children engage in. With so many other things that can be done by children while sitting – like playing games on the computer – the children of today are deprived of the exercise they needed. This epidemic of childhood obesity is indeed undoubtedly due to the increasing abundance of high-energy foods especially fatty foods and sedentary lifestyles.
Environmental and cultural factors, genetic factors, and physiologic control systems all influence food intake, energy expenditure, and energy stores in the body. Added to these are also powerful physiologic control systems that control food intake.
Children who are obese are more likely to suffer from low self esteem once they get older. The child would sometimes be more prone to being ridiculed by his or her peers because of the body size. Added to this are the serious health problems that can complicate in people with obesity. Obese individuals would be more prone to developing diabetes and heart diseases.
These are problems that are on a national scale. Obese individuals would be experiencing psychological problems especially with their dealings in the society. Obese individuals would also be posing serious problems to the environment.
The UK government has already made programs in the local and national levels in order to solve this increasing problem of childhood obesity. The NHS in particular calls for help from all other organizations – public and private – in the country to help in the fight against childhood obesity.
But despite of all these efforts, these programs geared towards eliminating or decreasing childhood obesity still needs further guidance. Some organizations may be teaching and making the children aware of obesity, but at the same time they still let them eat unhealthy foods. There is still the need for unity in the country in order to solve the problem of childhood obesity.
Credit:ivythesis.typepad.com
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