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Adolescent Obesity

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  • If you would be so kind to hold all questions until the end of the presentation, we will have a brief Q&A session.
  • ALL TRUE!!
  • Here are a few of the goals I have set for our discussion today. We may cover some additional material along the way, but I would like to lay out the backbone of our session.
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  • Because these two terms are measured by the same means, they are sometimes used as interchangeable synonyms. However, being overweight does not necessarily mean that you are obese. Some of us here today would definitely qualify as being overweight, especially based on the recommended proportions. Nevertheless, obesity entails a more extreme set of values and it is often an indicator of many deleterious health conditions.
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  • The sad but true fact is that all of these pictures are of children. Their ages range from a few months to 17 years old. Decades ago, it was rare to see an overweight child. However, today we see children like these everyday. Obesity is an epidemic in America, but this epidemic can extreme deleterious conditions when it is introduced in the adolescent years.
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  • According to Barlow, obesity prevalence among younger black male adolescents was higher in affluent families than in poor families but prevalence among older black male adolescents was higher in poor families. In addition, it was found that higher family socioeconomic status is associated with lower obesity prevalence among white girls but this factor did not change the prevalence of obesity among black girls.
  • Comorbidities are the conditions, illnesses, and conditions that can and sometimes do accompany obesity. Any of these conditions can be controlled with medications but their outcomes are bleak at best when they strike someone of immature physical development. These can be lifelong conditions that may eventually lead to premature death.

    The Bogalusa Heart Study attempted to investigate the accuracy of different body mass index (BMI) cut points to identify children who have are excessively overweight (based on skinfold thicknesses). This was cross-sectional and longitudinal study that also examined adverse levels of insulin, lipids, and blood pressures, and a high risk for severe adult obesity.

    "Of children with a BMI > or =95th percentile (P) of the Centers for Disease Control (CDC) growth charts, 39% had at least two risk factors, 65% had excess adiposity, and 65% had an adult BMI of > or =35 kg/m(2). Of those with a BMI > or =99th P, 59% had at least two risk factors, 94% had excess adiposity, and 88% had an adult BMI of > or =35 kg/m(2). About 4% of children in the US now have a BMI > or =99th P” (Freedman, 2007)
  • The socioemotional aspects of obesity are alarming and predict a questionable social identity for those suffering from it.
  • The Chronic Care Model that takes fundamental aspects of health care and integrate them for higher quality outcomes to manage chronic disease. The core components of this model are community, the (actual) health system, self management, delivery design, decision support, and clinical info systems. Implementing this model allows for targeted,, highly specialized and cost effective care for the patient and their families(Improving Chronic Care, 2014).

    At this time I would like to break into groups of 3-4. Within your groups, please come up with a plan using the CCM that targets obesity.
  • Children with parent who are battling obesity are more likely to develop the condition themselves.
  • Participation in athletic extracurricular activities (football, cheerleading, track etc.), referrals to dietician and or nutrition specialists, joining fitness clubs (many offer free trial periods), buying video games that encourage physical activity.
    Sodas, chips, cookies, candies, and fried food options. Fast food should also be limited in all adolescent groups. See recommendations in comments.
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  • Preventing obesity is the best way to treat it; prevention is three fold and should incorporate the physical, psycho, and social aspects of obesity. Preventative measure include offering balanced meal options and encouraging physical activity. Family time options should encourage a future emphasis on maintaining an active lifestyle in lieu of a sedentary one.
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    For a final group activity, I would like for you to break into groups of 3-4 and set a treatment plan for an obese client and a prevention plan for a patient who is “at-risk” for obesity. Please choose one person to present each of these plans. You have 15 minutes to complete this task. Good Luck!!!
  • If you have questions that are specific to your site, you may email them to drsphil1980@gmail.com.
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  • Health beat presentation

    1. 1. Dr. Shari L. Harvey-Philpot M.D. Health Beat Adolescent Obesity
    2. 2. About the Facilitator Dr. Shari L. Harvey-Philpot • Director and CEO of NBHC • Graduated ASU in 2007 with a Bachelor’s Degree in Sociology and Psychology. • Over 10 years experience working with Developmentally Disabled Individuals. • Licensed by the state of Georgia as a QMRP. • Supervised a full research team and conducted research for St. James School of Medicine. Measured and compared active mercury amounts obtained from samples of fish in the Atlantic and Caribbean Ocean. • Earned a Master Degree in Education /Kinesiology from UGA in 2008. • Earned a Masters Degree in Public Health from ASU in 2011. • Earned a PhD and MD at Saint James School of Medicine in 2010. • Currently pursuing another Master’s Degree with NCU. • The CEO of Philmo Professional Partnership LLC., and NewU International. • Member of Phi Theta Kappa American Medical Association American Psychological Association United Way of CSRA Board of Directors and the NAACP.
    3. 3. Objectives • Terminology review • Discuss the prevalence of adolescent obesity • Discuss the demographics of corpulence • Identify comorbidities of obese conditions in children • Identify risk factors for adolescent obesity • Suggest possible preventative measures and treatment strategies for obese children and teens (Chronic Care Model)
    4. 4. First Things First… Useful Definitions According to the Centers for Disease Control (CDC), there is a difference between the terms overweight and obesity. •Overweight is defined as a BMI at or above the 85th percentile and lower than the 95th percentile for children of the same age and sex. •Obesity is defined as a BMI at or above the 95th percentile for children of the same age and sex. http://www.cdc.gov/obesity/childhood/basics.html
    5. 5. The Prevalence of Corpulence • Nationally, the prevalence of obesity in children has increased from ∼5% in 1963 to 1970 to 17% in 2003 to 2004. • Childhood obesity has more than doubled in children and quadrupled in adolescents in the past 30 years. ... • The percentage of children aged 6–11 years in the United States who were obese increased from 7% in 1980 to nearly 18% in 2012. • More than one-third of adults and 17% of youth in the United States are obese (Ogden, 2014) http://www.cdc.gov/healthyyouth/obesity/facts.htm
    6. 6. The Demographics of Obesity • In a study in 2003–2004, the prevalence rates of obesity were alarmingly high among black girls (24%) and Mexican American boys (22%). • The same study showed that rates have also increased among Native American and Asian American youths. • Poverty has also been associated with greater obesity prevalence among adolescents. (Barlow, 2007)
    7. 7. Comorbidity • Type 2 Diabetes and Metabolic Syndromes • Arthritis • Cardiovascular Disease • Hypertension (Stroke) • Arteriosclerosis (High Cholesterol) • Sleep Apnea • Asthma • Early Pubescence or Menstruation
    8. 8. Comorbidity Continued… • Depression • Low Self-Esteem • Victimization • Behavior and learning problems
    9. 9. What are the RISKS? • Immediate Risks  High blood pressure and high cholesterol, which are risk factors for cardiovascular disease (CVD). In one study, 70% of obese children had at least one CVD risk factor, and 39% had two or more.  Increased risk of impaired glucose tolerance, insulin resistance and type 2 diabetes.  Breathing problems, such as sleep apnea, and asthma.  Joint problems and musculoskeletal discomfort.  Fatty liver disease, gallstones, and gastro-esophageal reflux.  Obese children and adolescents have a greater risk of social and psychological problems, such as discrimination and poor self-esteem, which can continue into adulthood.  Children and adolescents who are obese are at greater risk for bone and joint problems, sleep apnea, and social and psychological problems such as stigmatization and poor self-esteem. • Future Risks  Obese children are more likely to become obese adults. Adult obesity is associated with a number of serious health conditions including heart disease, diabetes, and some cancers.  If children are overweight, obesity in adulthood is likely to be more severe.
    10. 10. Recognizing Risk Factors for Obesity • Ethnicity • Socioeconomic Status • Obese or Overweight Parents • Poor Self Image • Decreased or No involvement in Physical Extracurricular Activities • Conditions that Perpetuate Obesity
    11. 11. Aspects of a Healthy Lifestyle
    12. 12. Prevention • Diet and Exercise: Healthy eating and physical activity, can lower the risk of becoming obese and developing obesity related illnesses. • Psychsocial: Health associated behaviors of kids and adolescents are influenced by many aspects of society. This includes their families, communities, schools, child care settings, health care providers, religious affiliations, government agencies, influence of the media, and the food and beverage industries and entertainment industries. • Education: Schools play a crucial role in the establishment of a safety net by offering a supportive environment with policies and practices that support healthy praxis. Schools also provide an opportunities for kids to learn practice healthy activities.
    13. 13. Community Health Starts with Individual Care Nora Blackmon Health Center THANK YOU
    14. 14. Questions????
    15. 15. ReferencesOgden, C., Carroll, M.D., Kit B., Flegal, K. (2014). Prevalence of childhood and adult obesity in the United States, 2011-2012. JAMA: 311(8):806-14. doi: 10.1001/jama.2014.732. Ogden, C., Carroll, M.D., Flegal, K. (2004). Prevalence and trends in overweight in Mexican-American adults and children. Nutrition Review: 62(7 Pt 2):S144-8. Freedman, D., Mei, Z., Srinivasan, S.R, Berenson G.S., Dietz W.H. (2007). Cardiovascular risk factors and excess adiposity among overweight children and adolescents: the Bogalusa Heart Study. Journal of Pediatrics: 150(1):12-17. Centers for Disease Control Website. (2014). Childhood obesity facts. [Data File]. Retrieved from http://www.cdc.gov/obesity/childhood/basics.html. Barlow, S. E. (2007). Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: Summary report. Pediatrics: 120(4) S164 -S192. doi: 10.1542/peds.2007-2329C. Mayo Clinic Website. (2014). Childhood obesity. [Data File]. Retrieved from http://www.mayoclinic.org/diseases-conditions/childhood- obesity/basics/complications/con-20027428.
    16. 16. References Continued Improving Chronic Care Website. (2014). The chronic care model. Retrieved from: http://www.improvingchroniccare.org.

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