Childhood Obesity in the UK and Why it is a Major Health Issue

Childhood obesity is a significant health issue for their children and families because they cause implications for their health and mental status. Currently, obesity is associated with poor psychology and mental health. The majority of children who have obesity tend to experience bullying at school. Furthermore, in adulthood, these children are more likely to have high morbidity, disability, and premature mortality (Blanco et al., 2019, p. 753). Among children, there is an inherently substantial rise in nutritional deficiencies. Nutritional Deficiency related diseases such as diabetes and obesity. The distribution of these diseases can vary geographically based on the income disparities between countries and individuals. Developed nations tend to have many obesity cases, while least developed countries have nutritional diseases such as anemia and zinc deficiencies so prevalent. Recent trends show that developed nations are also experiencing a rise in deficiency diseases. 

Internationally, there has been a rise in nutrition-related diseases. In the last four decades, obesity in children has been on the rise, with the current number being at least four times more than in the past. The obesity prevalence has been different between genders. Among women, obesity has been more prevalent because of the differences in the hormonal structures of the body. Globally, according to Di Cesare et al. (2019, p. 134), in 2010, there were about 42 million cases of childhood obesity, with these cases being children below the age of five. Approximately 35 million children in developed and developing nations are experiencing childhood obesity.

At the national level, statistics indicate that childhood obesity in the United Kingdom is most prevalent among children from low-income families. Most cases are reported in the most deprived community areas. In England, about 9.9% of children below the age of three years were experiencing childhood obesity. Among children of six years, the figures between 2018 and 2022 rose from 10.3% to 30.6% in 2022, as acknowledged by Eskandari et al. (2022, p. 3695). 

At the local level, childhood obesity prevalence varied between 14% and 31.4% in local community levels, such as Coventry, across the country (Hsu et al., 2022, p. 205). Longford ward was seen to be the area with the highest cases of childhood obesity. Most children under six years in Longford account for the highest number of children with childhood obesity.

Definition of childhood obesity

Childhood obesity is the imbalance in child energy intake and expenditure, closely tied to dietary energy intake choices and the associated lifestyles adopted (Kenney et al., 2020, p. 1125). Research by Chourdakis (2020, p. 10) shows that causes of childhood obesity can be closely tied to factors such as dietary intake, sedentary behaviors, and the level of physical activity undertaken by the kids, and the risks posed by these factors are moderated by factors such as age and gender. However, other factors such as genetics, family parenting styles, and environmental factors such as school policies and parents' work-related demands are some of the major causes of changes in family eating behaviors. Notably, a study by Chourdakis (2020, p. 11) shows that while genetics is a cause of childhood obesity, with studies indicating that a body mass index of between 25% and 41% caused a bodily inheritance of childhood obesity, this case was more prevalent when the subject of childhood obesity was linked to other environmental factors.

Significantly studies indicate that parental factors are the leading cause of childhood obesity. Researchers such as (Kenney et al., 2020, p. 1127). note that children learn by observation and thus are more than willing to experiment with new food and eating styles based on what they see among adults. Developing meal preferences was seen as one way individuals could influence children's feeding behaviors and thus control their food intake. Mealtime structure by parents also contributes to determining childhood obesity status. Parents who consume food together have a higher likelihood of consuming healthy food, thus inversely contributing to health outcomes relating to childhood obesity.

Further research by Chourdakis (2020, p 9) indicated that parental control of food consumption directly correlates with childhood obesity. Parents who allowed their children to choose what to consume had lower chances of their children getting childhood obesity. On the contrary, children with strict dietary controls were more likely to consume junk food, thus acquiring childhood obesity. 

Apart from a medical perspective, government policies have affected dietary consumption. Therefore the government had a role in childhood obesity, as studies by Temme et al. (2020, p. 5930) indicate. Both adults and children associated junk food consumption with leisure, pleasure, and independence. Research into this topic provided recommendations stating that fixing fiscal policies and taxing unhealthy foods would help regulate the amount of harmful food consumption. Also, government investment into recreational facilities and the aesthetic quality of neighborhoods would help improve the quality of eating and physical activities to help manage childhood obesity. Family lifestyles and working conditions have been seen to contribute indirectly to childhood obesity. It appears that parents who are constantly working have no time to prepare healthy meals. As a result, they consume fast food, which they also provide to their children. Historically, research into fast food indicates that it contains high levels of calories.

Psychological factors have also been seen to contribute to childhood obesity. Kiefner and Hinman (2020, p. 20) note that Strained relationships within families caused children psychological traumas, which caused them to feed a lot, thus increasing their overall body BMI. These issues presented lifelong anxiety disorders, which caused feeding problems and, thus increase in childhood obesity. Childhood obesity also seemed to lower children's ability to exercise. The result is an unmanageable body mass index which resulted in adding weight among children. The role of gender is such that body dissatisfaction played a role in causing more girls to be obese than their male counterparts. In most UK cultures, ladies are perceived as attractive if they have lean bodies.

Conversely, males are accepted to have wells structured or lean bodies. Therefore, males may be forced to take in more food to retain their muscular structure, which may result in obesity. In females, lean body requirements may cause self-esteem issues, resulting in girls developing anxiety, eventually leading to weight gain.

Approaches that the nurse would implement when addressing childhood obesity

Nursing interventions aimed at reducing childhood obesity are dedicated to impacting Child's eating and exercise behaviors because improper diet and lack of exercise are the leading causes of childhood obesity. One can perform several multifactorial interventions to arrest these changes to stem the problem. First, these interventions involve behavioral, dietary, and physical interventions. In addressing these multifactorial interventions, nurses can adopt several interventions, including motivational interviews, behavioral interventions, child growth monitoring, and family-based interventions. These interventions are education focused; however, it is crucial to focus on parental involvement to achieve better outcomes.

Motivational interviews

Motivational interview is a behavioral nursing change technique used in the nursing field to change the addictive behavior of people over time (Beckwith & Beckwith, 2020, p. 339). Unlike adults who understand their choices, children do not have that level of awareness, and therefore subjecting them to this method might not have the desired outcomes. However, when parents cannot provide the best diet to children, they can be subjected to this method and thus will eventually change their way of addressing diet shortcomings in their homes. The result is an improvement in the diet level of children, thus offering obesity therapy. Parental willingness may effectively influence children's desire to change; therefore, this strategy becomes a success among pediatrician patients.

Besides influencing their willingness through the emotional side approach, nurses can influence the changes in several ways. One practical way is to understand how much the parents want to change the situation. This need is reflective of their concern levels. A nurse will employ reflective listening to understand and identify the reason for employing behavioral change. Quaye et al. (2020, p. 650) note that the nurse will document what the parents want or want to achieve during this period. Furthermore, the nurse gives the parents an open space to employ nonjudgmental and empathetic listening. During this period, the nurse will help them make specific and achievable behavioral goals that imply selecting measurable goals that contribute to overall weight management, not just weight loss.

Family-based interventions

In this intervention, pediatrician nurses encourage parents to focus on providing their children with nutritious food and spend more time on physical activities and less on screen-based activities. Parents who neglect the issue of obesity always think that their children's obesity cannot be changed and, therefore, may ignore nutrition details. In these cases where the parents are not involved in designing solutions, the nurses may develop a nutrition program on behalf of the family. Other than nutrition, the program may affect aspects such as pediatrician-patient and parent education, exercise, and behavioral modification, as Enright et al. (2020, p. 4099) note. Family involvement is crucial when a child is the only obese kid. Family therapy is essential to avoid any form of stigma in the nutrition routine that may impact the Child. Research shows that targeting the parent with or without a child is effective in delivering a change of behaviors, and it is more effective than targeting a child.

Child growth monitoring

Parents should consider participating in antenatal clinics since it helps monitor a child's weight progress. During these visits, weight progress is continuously recorded by the nurses, and during this period, they can get personalized advice based on the weight progress of the Child. Also, during these clinics, nurses can measure and document children's body mass index (BMI) and offer personalized care and weight monitoring based on this metric. Furthermore, they can recommend the Child's nutrition (Pearl, 2018, p. 150). Through the BMI, parents can be able to understand the nutritional requirements as well as exercise requirements of their children, thus enabling them to make healthy progress. As a health records requirement, nurses must complete the annual analysis of the BMI records made in the year to review and emphasize to parents the need to watch a child's weight to avoid cases such as obesity in children.

Behavioral interventions

Behavioral interventions typically involve targeting behavior modification to influence changes in nutrition and exercise behaviors. Among the activities that nurses conduct is behavioral training that encourages a reduction in sedimentary behavior while encouraging an increase in physical behaviors. Behavior modification also involves counseling the family to support the weight loss goals. To avoid sudden changes that may not be sustainable, Smith et al. (2020, p. 360) note, it will be essential to consider lowering sedimentary to two hours a day or a maximum of fourteen hours a week. This programmed transition is manageable for the Child since they can program themselves and slowly adapt.

Children have a limited ability to understand the long-term consequences of their feeding behaviors as well as their level of exercise. If the Child does not want to change their diet, a parent may successfully force the change. Also, parental involvement may help nurses understand unfamiliar changes in other cases. This collaboration creates a healthier environment that is great for social support and is limited to barriers to success. Modifiable behaviors include parenting style and early feeding experience of a child. Smith et al. (2020, p. 3025) note that since sedentary behaviors can begin, early nurses are encouraged to start training parents early about the importance of proper feeding to avoid obesity. Family members or caregivers of the Child should also be involved in the Child's treatment program. Also, given that these changes are long-term and hard to achieve in the short term, the family must be psychologically prepared to participate in the change process.

Ethical dilemmas within the childhood obesity issue

Parental and nurses' responsibility

Weight management in childhood obesity cases presents ethical dilemmas for nurses and parents. While parents and nurses are supposed to uphold decision-making rights, they face a relatively unfamiliar situation that forces them to take drastic actions to manage a Childs's weight; otherwise, the Child will be predisposed to future weight-related health complications that impact his physical but also their mental well-being. Within the human rights domain, parents have the right to decide on behalf of their children. However, when it comes to weight gain treatment in children, parents face the ethical dilemma of the best choice since every choice has consequences that may have unknown results in the future. Their choice today may affect the kid's physiological and psychological state in the future. Reiter et al. (2023, p. 100) note that specifics go through a child's mind versus a parent's. In a particular focus on pediatric bariatric surgery as a solution to child obesity, parents consider this the most appropriate form of weight loss; however, most children prefer the usual way of weight loss through exercise and dieting. Parents select the fast method since they feel it will protect the kind from weight-associated diseases that would otherwise be unmanageable. These sharp contrast in opinions like Tolvanen et al. (2020, p. 1260) presents an example of the first but many ethical dilemmas that exist when addressing weight loss in children. Nurses, too, are responsible for informing parents about the other forms of weight loss, such as dieting; however, they opt for fast ways of managing weight, such as surgeries, instead of giving children the time to try other weight loss strategies.

Autonomy of children versus nurses as professionals

Nursing professionals are responsible for ensuring that they do not cause harm to their patients, be it physical or emotional. This is the duty of care. However, when recommending the best treatment to reduce weight, several options might come on board: pharmacotherapy, family-based therapy, and bariatric surgery. While bariatric surgery is fast, Rogge et al. (2019, p. 480) noted that it is not the best due to the physical injury the surgery might have on the patient. Owing to this fact, the nurse will recommend the option of family-based treatment; however, this option has its challenges. Home-based therapy encourages the parent to use motivation as a treatment factor. However, this motivation can create an atmosphere of competition and antagonism. These outcomes can be hurtful to the Child and have consequences that are risky to the Child. 

Truthfulness is another essential aspect between the nurse, doctors, and the patient's family. While it is impossible to relate why a medical practitioner would not be truthful to their patients, specific incidents undermine this trust, first, if there is an economic gain, like in the case where more surgeries lead to more medication. In this case, Martinelli et al. (2023, p. 1232) note that obesity becomes profitable and rewarding; therefore, most practitioners ignore their duty of care for monetary gains. As such, it is crucial to consider remedies that not only provide solutions to the Child who wants to conform but also provide the remedy to financial exploitation that occurs when a patient is subjected to costly solutions 

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Obesity as neglect

According to Clay et al. (2020, p. 8), in the child abuse prevention and treatment act of 2010, abuse constitutes any act or failure to act that results in serious harm, either physical, emotional, or risk, that would present any damage or harm to a person. In light of this provision, any failure to act is a form of harm done to a child. Given these underlying definitions, it is possible to define obesity as a form of abuse by the parent. Given this form of abuse, the nurses are presented with the dilemma of either considering the parent as the abuser and giving recommendations based on the doctor's assessment or respecting that the parent has the right of determination over the Child and allowing them to choose what is the proper form of weight reduction treatment to the Child. Therefore, to think that a parent will be committed to contributing emotional and psychological support to the Child will ultimately be violating the Child's duty of care, given their earlier abuse.

Selecting best treatment

When selecting the best treatment for the Child, the parent must ensure they have the Child's interests since they cannot make decisions alone. Decisions made for the Child must be in consultation with health practitioners, especially nurses who design the best weight loss program (Roebroek et al., 2018, p. 1178). However, while developing these programs, it is the parent's responsibility to ensure that aspects such as motivation are factored in, and the ability of the Child to understand what is required of them is brought to their attention for the program's success. However, the ethical dilemma arising from this program is that it does not always work for the Child, and at one point in their life, they could decide to sue for the emotional or physical damages caused. Therefore, the ethical dilemma question is how well nurses feel they can trust the parent to make a decision that does not cause consequences later in life.

Conclusion

Childhood obesity is a significant healthcare issue in the United Kingdom owing to the rising number of children with the condition. Despite these challenges, healthcare has devised methods for nurses to treat this condition and involve parents. Motivational interviews, family intervention, and behavioral interventions have helped nurses to involve parents since they can make decisions on behalf of their children. However, despite this progress, ethical dilemmas have rocked the intervention methods, thus forcing nurses to focus more on long-term family interventions than short-term ones, such as pharmacology and bariatric surgery.

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