The Overview of Childhood Obesity

Obesity is a current health epidemic that has dreadful consequences for America's health, particularly among low-income children and adolescents. The rising rate of obesity has reached epidemic proportions and is now one of the most grave public health challenges facing the US. However, underlying causes for this increase are unclear.

This literature studies several of the factors that place low-income children at risk for developing obesity; psychological, environmental, and biological. This investigation will show that none of these particular factors operate in isolation but are torturously intertwined, as suggested the Biopsychosocial model of Disease provided by Psychology. The findings indicated that participant's weight was most influenced by family lifestyle and school environment factors. More proper education and prevention methods are essential in creating a safer healthcare system that provides maximal quality of life.

The Overview of Childhood Obesity

Obesity is a critical health problem that is increasing worldwide, and in the United States in particular. In the US, the percentage of children and teens affected by obesity has more than tripled since 1970's ( Irimia R, Gottschling M 2016). According to a survey conducted and published in JAMA: The Journal of the American Medical Association, seven states have self-reported obesity rates surpassing 35%, according to new data from the CDC, up from the comparison in 2012 in which all states were lower than 35% (Bridget Kuehn, MSJ, 2018). Excess weight is not just a matter of physical appearance.

The concerns about the increasing prevalence of obesity are founded in the association between obesity and adverse health outcomes and increased health expenditures. Obesity has been linked to an increased risk of numerous comorbidities, including high blood pressure, high blood cholesterol, type 2 diabetes mellitus, coronary heart disease, osteoarthritis, asthma, and gallbladder disease.

An alarming fact of this epidemic is that children are increasingly becoming obese. Data collected from the CDC during the years 2015-2016 show that nearly 1 in 5 school age children and young people (6 to 19 years) in the United States has obesity ( Irimia R, Gottschling M 2016). Adolescents who are Black or Hispanic or live in poverty are at almost twice the risk for being overweight as non-Hispanic white youth. These children will become more susceptible to a poorer quality of life plagued by various illnesses, low energy and eventually low esteem.

There is a magnitude of factors that lead children to overeat, make innutritious diet choices, and not exercise consistently. Of great concern is that children who are overweight or obese are also more likely to be overweight or obese as adults (Freedman Et Al., 2005; Wang, 2008). Psychology, as a science of human behavior, offers a powerful perspective on the interwoven nature of these factors and can point the way towards the development of successful interventions to halt the march of this epidemic. However, this research has largely ignored the role of rising income. Studies that have examined the role of income on obesity within the United States have been unable to account for the potential endogeneity and reverse causality between income and weight and obesity prevalence.

Social and Enviromental Factors

With the numerous medical concerns obesity causes, childhood obesity affects children's social and emotional health. Obese adolescents are often bullied and/or teased because they are overweight. They face being exiled from activities, particularly sports. These negative social issues lead to low self esteem, low self confidence within themselves (Sahoo, K., Sahoo, B., 2015). The negative issues of childhood obesity presented can be life altering to children. The consequences of being an obese child tend to contribute to difficulty in weight management. Obese children shy away the public eye to protect themselves from negative comments and unwanted attention; retreating to safe places, such as their homes (Lobstein, T., Jackson-Leach, R., 2015).

The social factors intertwined with being apart of a low income family, the pressure on the child surmounts anything one could imagine. Low income families are faced with various obstacles that prevent them from obtaining a healthy lifestyle regimen, thus socioeconomic status tends to play a significant role in the obesity epidemic (Lobstein, T., Jackson-Leach, R., 2015). Environmental factors that include; low-income, lack of access to healthy food choices, and lack of resources within the confines of the community can definitely contribute to obesity. Approximately 23.5 million people within the United State live what the United State Department of Agriculture (USDA) labels a food desert; an urban area in which it is difficult to buy affordable or good-quality fresh food (United States Department of Agriculture, 2009).

Within these low-income communities, the only places residents are able to buy food are fast-food restaurants and gas stations that offer sugary, fatty, and processed products according to the Food Research and Action Center (FRAC). These restaurants serve many energy-dense, nutrient-poor foods at relatively low prices. Fast food consumption is associated with a diet high in calories and low in nutrients, and frequent consumption may lead to weight gain (Powell & Nguyen, 2013). According to researchers at the Rudd Center suggest that despite the addition of some healthy kids' meal options, less than 1% of all kids' meal combinations - 33 out of 5,427 possible meals -- met recommended nutrition standards (Yale, Rudd Center 2013).

These hyperpalatable foods served at Burger King, and or McDonald's, for instance, are much higher in fats, sugar and sodium than healthier foods choice (i.e. vegetables and fruits). In addition to the lack of access to healthy food options, parents within these communities work long hours outside of the household. Which leaves the parent(s) not having the adequate time to prepare healthy meals at home, making it harder to set up a routine of eating quality food.

A child's environment and mind is also flooded with the presence of media. Typically children spend 44.5 hours a week in front of electronic screens. Watching television has been directly linked to obesity in childhood, with a rate of obesity that is 8.3-times greater in children who watch more than 5 hours of television per day compared with those who watch up to 2 hours of television per day (Proctor MH et al. (2003). Adolescents aged 9-14 spend over 20 percent of waking hours watching television, compared to 9 percent on hobbies and 3.5 percent on homework. The average American teen spends about 20 hours a week watching television, with the heaviest viewers coming from low-income households (Irimia R, Gottschling M 2016).

Electronic use time amounts to nine hours a day for children of minorities, more than the six hours a day watched by Caucasian children. Not only are adolescents moving less when they watch television, but they are also more exposed to the media's message. Low-income children are exposed to disproportionately more marketing and advertising for obesity-promoted products that encourage the consumption of unhealthful foods (fast food, sugar infested beverages) and discourage physical activity (television shows, video games) according to a report issued by the Institute of Medicine (2013).

Approximately 0% of the commercials broadcast on children's networks are for fruit or vegetables, while about 34% of the commercials are for candy and snacks. Such advertising has a particularly strong influence on the preferences, diets, and of children, who are the targets of these marketing efforts (Institute of Medicine, 2013). Media outlets are not the only culprits; children exposed to marketing by advertising on billboards, on buses, and at school in vending machines. The marketing is very exploitative, for adolescents under the age of 10 do not comprehend the sole intent behind these ads. Simply viewing a commercial once can create a preference for a child, impacting what the child will begin to ask their parents to buy (Harris, Bargh, Brownell, 2009).

Psychological Risk Factors

Psychological factors affecting other medical conditions is diagnosed when attitudes or behaviors have a negative effect on a medical disorder that the person has. People's attitudes or behavior can negatively affect any disorder (such as obesity, heart disease and or diabetes).
An enormous number of studies have revealed that the initial food environment of obese children differs distinctly from other children. Adolescents who are obese frequently eat a bigger portion of food and the quality of food is often high in calories. These individuals often have raised food portion sizes, increased calorie intake and eat less fruits and vegetables from an early age compared to normal weight children of the same age (Bammann, K., 2014).

Obese children tend to have less hours of physical activity and spend more time using electronics. This inactive lifestyle combined with high caloric intake contributes to obesity. It is well documented that a large number of children with pediatric obesity have parents and or family who are obese as well. Parents who are obese contribute to specific food environments, that are created at a young age.
The underlying basis of obesity and eating disorders tend to lie in some grouping of psychosocial, environmental, and genetic attributes. Individuals who suffer from mental disorder (e.g. eating disorder, depression, and anxiety) may have more trouble controlling their food intake, obtaining the adequate amount of exercise and maintaining a healthy weight.

Those who suffer from obesity, tend to use food as a coping mechanism, particularly when they are stressed, feeling isolated, sad and or anxious. Many of these individuals there seems to be a perpetual cycle of mood swings, gluttony and weight gain. When in a mood of distress, these individuals turn to food to cope, and to comfort them which may result in temporary attenuation of their current mood. The weight gain that results may cause a dysphoric mood due to their inability to control their stress. The guilt they accumulate tends to reactivate the cycle, leading to a ongoing pattern of using food to cope with their emotions.

Mental factors also play a real role in increasing the risk for childhood obesity by influencing dietary choices. Due to the fact children are very dependent on their parents for providing food, their parents' choices largely determine their diets. The development of children's food preferences involves a complex interplay of genetic, familial, and psychological factors. There is evidence of a strong genetic influence on appetite traits in children, but environment plays an important role in modeling children's eating behaviors.

Parents use a variety of strategies to influence children's eating habits, some of which are counterproductive. Overcontrol, restriction, pressure to eat, and a promise of rewards have negative effects on children's food acceptance. Parents' food preferences and eating behaviors give an opportunity to model good eating habits. Satiety is closely related to diet composition, and foods with low energy density contribute to prevent overeating. Parents should be informed about the consequences of an unhealthy diet and lifestyle and motivated to change their nutritional habits (Scaglioni, S., De Cosmi, V., 2018).

Biological Risk Factors

Biological factors, such as exercise activity and sleep amount, also play a significant role in maintaining health. Physical activity controls weight by stimulating the metabolic, endocrine, and hormone processes of the body. Regrettably, adolescents have become increasingly lazy over recent years. Children who live in low-income neighborhoods have even fewer opportunities to safely exercise partly due to the fewer parks, green spaces, bike paths, and recreational facilities than are found in high-income communities, making it problematic to live a physically active lifestyle (FRAC, 2013). Due to high crime rate, and other safety concerns, children and adults, alike, are more likely to stay indoors and engage in inactive activities, such as watching television or playing video games.

This lack of physical activity is established by the fact that less than 20% of ethnic minority adolescents participate in youth sports (Wijtzes, A. I., Jansen, W., 2014). Along with parents who do not participate in any physical activity themselves, adolescents aren't given many examples of what being active looks like.

Another biological risk factor for obesity is the quality and measure of one's sleep. Research has shown that interrupted sleep interferes with the body's ability to effectively process fats and calories by altering hormone production (Myers, D. 2011). When a person is suffering from sleep deprivation, there is an increase in ghrelin in the intestines, which creates an appetite and creates the hunger feeling. Also, proteins, and leptin, which creates a feeling of being full, decreases; and, the stress-related hormone, cortisol, which leads to fat storage, increases. A person who does not sleep well will obviously feel tired and have less energy to exercise and carry out their daily routine.

Conclusion

This study was conducted to gain an understanding of how social-environmental, psychological and biological factors including family lifestyle, culture, neighborhood environment, and social environment that were present during participants' childhood, impact obesity. The tangled nature of the risk factors for childhood obesity may seem impossible to overcome and leave doctors, researchers, and policy makers feeling hopeless about putting a halt to this epidemic. However, the biopsychosocial model of disease used by psychologists demonstrates that it is within this very interplay of biological, environmental and psychological factors that we can find optimism. The biopsychosocial model advocates that by creating even a slight change in a child's behavior, a well-designed intervention program has the potential to decrease obesity by creating a ripple effect that will be felt within the system.

As a captive audience, children ages eight through twelve years experience the most exposure to these ads that infiltrate their minds with negative notions for healthy eating, exercising and caring about your health. It is perfect the age(s) to approach adolescents with new and convincing ideas that allow for the beginning of new, empowering thoughts about developing a healthy body. Numerous of American children have become fixed on a malicious biological, psychological/mental, and social cycle that is directing them towards a sustained future suffering from obesity. Yet, psychology permits us to recognize that due to the linked nature of the factors causing obesity, this cycle also has a solution.

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