Earlier in 2019, UK health officials declared obesity a chronic national health issue, with childhood obesity a potential ‘timebomb’ that could have significant societal impacts and devastate the National Health Service (NHS). It is a concerning public health threat as “younger generations are becoming obese at earlier ages and staying obese for longer” (Higgins 2019, para. 9). This report will seek to address the concept of childhood obesity, analyze impacts on society and the individual, as well as present viable recommendations and interventions to reverse the trend in the context of public health.
Medical Definition of Obesity and Causes
Childhood obesity is one of the most critical challenges of the 21st century. Obesity is defined by an excess of body fat present in an individual. One of the most accepted medical measures of obesity to differentiate the level of excess body fat is known as Body Mass Index (BMI) which inputs weight and height into a formula devised to determine underweight, healthy, overweight, and obese categories for average human beings. Other techniques such as multi-frequency bioelectrical impedance analysis (BIA) and skin-fold thickness tests are more accurate in determining body fat percentage (Sahoo et al. 2015). Children are a critical category since they are rapidly developing, which makes it more difficult to standardize measurements. However, they are also the most at-risk since obese children are more likely to continue leading such lifestyles and develop noncommunicable diseases such as diabetes and cardiovascular conditions at younger ages (World Health Organization 2019).
The cause of obesity is attributed to an imbalance between energy intake and expenditure, directly associated with dietary intake and chosen lifestyle and in some relation to genetic background. Based on an ecological model, child obesity risk factors include diet, physical activity, and sedentary behavior (Sahoo et al. 2015). Childhood obesity is particularly worrisome since health behaviors and dietary preferences get formed early on. Modern social and marketing trends have significantly popularized the consumption of fast food, sugary beverages, and snack foods, especially in adolescents. In combination with larger portion sizes, availability, and intake incidence, such trends contribute to metabolic disorders or caloric surplus leading to obesity. Furthermore, environmental factors of extensive media consumption on television and online, the transition of social communication unto digital devices, and general changes in routine (parents driving kids to school instead of them walking) have significantly shifted in the last 15-20 years (Gurnani et al. 2015). This results in the prevalence of sedentary lifestyles and psychological factors leading to overeating.
Statistics in the UK
In the past years, statistics show unchanging trends across the UK. Upon Reception, at the age of 4-5, the approximate prevalence of childhood obesity is 9.5%. By Year 6, the prevalence rises to approximately 20% (Secretary of State for Health and Social Care 2019). Over the years, data shows that the prevalence of obesity doubled in that time. Furthermore, childhood obesity is disproportionately present in certain parts of English society. Low-income households, as well as children from Black and minority ethnic groups, are more likely to be overweight or obese, with the gap increasing rapidly. The difference in obesity prevalence between least and most deprived areas ranges in the 6 to 13.5% range depending on the year. It is also important to note a correlation between parental and children’s obesity as 24-28% of children whose either parent was obese also showed such tendencies, in comparison to 8% where neither parent is obese (NHS Digital 2019).
Impact on Individual
The impacts on the individual are largely based on the medical concepts discussed earlier. Early-onset obesity has been proven to have profound and harmful effects on the developing body of a child and further health risks. Obesity causes high blood pressure and cholesterol which increases the risk of cardiovascular disease as well as impaired glucose tolerance and insulin resistance leading to type 2 diabetes. Other conditions include asthma, musculoskeletal issues, and problems with internal organs. While a young organism of a child may be able to avoid significant health issues, once entering adulthood, the risks increase exponentially, especially obesity continues into adulthood as it often does, resulting in early illness, detrimental quality of life, and death (CDC 2016).
In addition, a child with obesity will likely face psychological problems and social pressures. It is a cycle that begins with social stigmas and bullying, leading to lowered self-esteem and self-reported quality of life, causing anxiety and depression in the long term. Obesity is one of the most stigmatizing conditions in adolescence, leading to numerous consequences to social and emotional health. Children face hardships such as discrimination, marginalization, and negative stereotyping, which continue into adulthood, reflecting on self-esteem and personality (Rankin et al. 2016). Social consequences can include difficulty in weight management throughout life and social seclusion, resulting in potentially unhealthy relationships, poor communication skills, and, in some cases, self-harm. As a combination of the above factors, children with obesity are statistically more likely to experience academic problems due to absenteeism in the context of health and social pressures, resulting in limited academic and professional success further in life (Sahoo et al. 2015).
Impact on Society
In the context of societal impacts, financial and economic consequences must be considered. Currently, obesity costs the NHS £6.1 billion annually, with a wider impact on the economy at £27 billion a year. It is expected the number of obesity-related health cases will increase to 7.6 million annually by 2035 (BDA 2019). This can be attributed to the generation of children currently experiencing a significant prevalence of obesity in a population, growing up into adulthood. Extensive health issues will further overburden the health system, creating much greater costs for the NHS and the national economy. The childhood obesity epidemic impacts social development, socio-economic activity, and the length and quality of life. In combination with other demographic factors, the younger generation is predicted to be the first that is unable to support the aging generation above, both on a familial and societal level (Sârbu 2017).
Impact on society when discussing childhood obesity is difficult to pinpoint and limited research exists from this perspective. Beyond individual impacts, society begins to experience these on a greater scale in terms of population health, healthcare utilization, social adaptation and health, and overall culture that is not sustainable for a healthy demographic or economic development. As medical costs increase, it becomes inherently challenging to maintain the health of an obese population with all consequential comorbidities, especially in a government-funded healthcare system as existent in the UK. Furthermore, there are extensive indirect impacts of obesity such as productivity loss and absenteeism, costs for accommodation requirements and change in social environments, and general quality of life decrease. As productivity and employment falter, the national economy will suffer from decreased output and innovation (Spieker & Pyzocha 2016). While these aspects are not directly associated with childhood obesity, as mentioned, the high probability of the condition persisting into adulthood, makes this a relevant consideration.
Recommendations to Reverse Trend
The complexity and multifactorial causes of childhood obesity require a comprehensive ‘whole systems’ approach which encompasses collaboration between government agencies, private organizations, educational institutions, and parents. Some methods that the government can impact childhood obesity, with many of these aspects in the discussion, include limiting marketing for fast food, imposing higher VAT taxes on unhealthy products, implementing healthy eating options in schools, and developing public health education programs through the NHS (Secretary of State for Health and Social Care 2019). Policy-driven initiatives which are meant to create barriers to access for fast food while increasing transparency and education regarding nutrition (such as mandatory calorie labeling and improved school lunch standards) are effective and have been systematically proven to save more in long-term than the cost of implementation (Gortmaker et al. 2015).
Many health interventions have been designed to address childhood obesity at various levels including behavioral, familial, school, and community. Behavioral strategies focus on psychological help and motivation strategies. Family-focused interventions seek to improve family bonding and create positive role models at home where a child is supported in healthy nutritional and activity choices. School interventions can be effective due to the consistency of contact and influence with the child, with various education-based programs that support increased physical activity as well as social skills to establish a support system. Finally, communities are environments that impact disparities that often cause unhealthy behaviors. These should be addressed, creating a safe neighborhood that promotes healthy lifestyles (Karnik & Kanekar 2012). All the interventions are supportive and can be implemented into various public health programs by the NHS.
It is evident that childhood obesity is a critical public health issue in the UK and worldwide. It is affecting significant segments of the population and is caused by modern societal and environmental factors. Childhood obesity can have profound effects on the individual in terms of health and prospects, while negatively impacting society by creating devastating financial and demographical losses to the economy and national health care. The trend can be reversed through a competent and comprehensive approach to health policy and public education.
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