3. The U.S. is in the midst of an epidemic of obesity involving more than one third of the adult population, which is approx. 60 millionpeople.
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5. Obesity Defined BMI = [Lbs./ (Height in inches)2] x703 Or… BMI ≠ accurate predictor of risk
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7. In 2008, only one state (Colorado) had a prevalence of obesity less than 20%. Thirty-two states had a prevalence equal to or greater than 25%; six of these states (Alabama, Mississippi, Oklahoma, South Carolina, Tennessee, and West Virginia ) had a prevalence of obesity equal to or greater than 30%.http://www.youtube.com/watch?v=7iBHm5zji_Y
8. Obesity Trends* Among U.S. AdultsBRFSS,1990, 1999, 2008 (*BMI 30, or about 30 lbs. overweight for 5’4” person) 1999 1990 2008 No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
9. Obesity Trends* Among U.S. AdultsBRFSS, 1985 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14%
10. Obesity Trends* Among U.S. AdultsBRFSS, 1986 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14%
11. Obesity Trends* Among U.S. AdultsBRFSS, 1987 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14%
12. Obesity Trends* Among U.S. AdultsBRFSS, 1988 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14%
13. Obesity Trends* Among U.S. AdultsBRFSS, 1989 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14%
14. Obesity Trends* Among U.S. AdultsBRFSS, 1990 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14%
15. Obesity Trends* Among U.S. AdultsBRFSS, 1991 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%
16. Obesity Trends* Among U.S. AdultsBRFSS, 1992 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%
17. Obesity Trends* Among U.S. AdultsBRFSS, 1993 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%
18. Obesity Trends* Among U.S. AdultsBRFSS, 1994 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%
19. Obesity Trends* Among U.S. AdultsBRFSS, 1995 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%
20. Obesity Trends* Among U.S. AdultsBRFSS, 1996 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%
21. Obesity Trends* Among U.S. AdultsBRFSS, 1997 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20%
22. Obesity Trends* Among U.S. AdultsBRFSS, 1998 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20%
23. Obesity Trends* Among U.S. AdultsBRFSS, 1999 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20%
24. Obesity Trends* Among U.S. AdultsBRFSS, 2000 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20%
25. Obesity Trends* Among U.S. AdultsBRFSS, 2001 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
26. Obesity Trends* Among U.S. AdultsBRFSS, 2002 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
27. Obesity Trends* Among U.S. AdultsBRFSS, 2003 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
28. Obesity Trends* Among U.S. AdultsBRFSS, 2004 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
29. Obesity Trends* Among U.S. AdultsBRFSS, 2005 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
30. Obesity Trends* Among U.S. AdultsBRFSS, 2006 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
31. Obesity Trends* Among U.S. AdultsBRFSS, 2007 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
32. Obesity Trends* Among U.S. AdultsBRFSS, 2008 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
42. Health Implications Also linked with mental health conditions such as : Depression Low self-esteem Feelings of shame Many obese people are discriminated against and the targets of insults and verbal abuse
50. Emotional Effects of Childhood Obesity Obese White and Hispanic girls 13-14 years old Significantly diminished self-esteem levels than non-obese girls Increased loneliness, sadness, nervousness More likely to engage in unhealthy activities (smoking and drinking) -Richard S. Strauss, M.D. (Jan 2000).
53. Federal Policies on Obesity “(A) a physical or mental impairment that substantially limits one or more of the major life activities of such individual [such as walking, or working]; (B) a record of such an impairment; or (C) being regarded as having such an impairment.” -Americans with Disabilities Act
54. Federal Policies on Obesity “…temporary, non-chronic impairments of short duration, with little or no long term or permanent impact, are usually not disabilities…Similarly, except in rare circumstances, obesity is not considered a disabling condition.” ADAObesityprotection
55. Court Decisions Cook v. Rhode Island Department of Mental health, Retardation and Hospitals Francis v. City of Meriden EEOC v. Watkins
56. Obesity Legislation Up For Reauthorization in 2009 Child Nutrition and Special Supplemental Nutrition Program for Women, Infants and Children Act Elementary and Secondary Education Act
57. Obesity Legislation Up For Reauthorization in 2009 Safe, Accountable, Flexible, Efficient Transportation Equity Act Supports transportation by “bike, foot, or other non-motorized means” Number of children walking to/from school: 48% in 1969 vs. 16% in 2001
62. Interventions Community programs of health promotion through lifestyle change Education programs Facilitating the development of new habits and routines Lifestyle Redesign® programs; recommendation of home modifications Adaptations/equipment Compensatory training in ADL and IADL Wellness programs for children, teens, and adults; play and physical education in the schools Safe patient-handling programs in hospitals and skilled-nursing facilities; and post-surgical acute-care interventions
63. Equipment Expandable support surface bariatric beds, Weight-rated portable bedside hoyer lifts, Weight-rated wheelchairs, Bariatric bedside commodes and shower chairs, HoverMat Bariatric tilt tables Bariatric rolling and standard walkers, Bariatric sliding boards, etc.
66. People and Perspectives Arguments supporting occupational therapists play a role in childhood obesity. Arguments against occupational therapists playing a role in childhood obesity.
67. OT Practice “AOTA endorsed occupational therapy intervention as a way to meet the needs of children and adolescents who are at risk for overweight status or obesity caused by controllable lifestyle factors.” AOTA adopted a statement -2006.
70. Interventions Working with families Changing habits Working with school systems Environment modification ADLs/IADLs
71. Ots = imperative in changing policy to fix the issue that is derived from factors both on a macro and micro level.
Editor's Notes
CutoffsMale: BMI> 25.0Female: BMI> 30.0Extreme obesity BMI> 40.0Childhood obesity = at or above the 95th percentiles of a specified reference population.
The prevalence of obesity in the U.S. has increased SUBSTANTIALLY over the past 30 years.1980-2004: Prevalence in adults increased from 15% to 33% Prevalence in children increased from 6%- 19%The highest BMIs (> 50) are increasing exponentially in all age groups and sexes in the U.S. and worldwideThe largest increase has been in women and younger children
The prevalence of obesity in the U.S. has increased SUBSTANTIALLY over the past 30 years.1980-2004: Prevalence in adults increased from 15% to 33% Prevalence in children increased from 6%- 19%The highest BMIs (> 50) are increasing exponentially in all age groups and sexes in the U.S. and worldwideThe largest increase has been in women and younger children
Comorbidities
Enacted by Congress in 1990Defines Disability as:
Child Nutrition and Special Supplemental Nutrition Program for Women, Infants and Children ActFocuses on nutrition programsElementary and Secondary Education ActAKA No Child Left BehindReauthorized/Edited version to include “report cards” on physical fitness and education in schools promoting healthy eating and activity in school and at home
To insure low-income children not covered by Medicaid Includes obesity benefitsEstablishes healthy lifestyle programsHOWEVER, state-by-state coverage of obesity treatment for adults and children is vague and varies
“To establish the Office of Childhood Overweight and Obesity Prevention and Treatment within the Office of Public Health and Science of the Department of Health and Human Services”Control advertisement of unhealthy foods and beverages during child programming Evaluate, Expand, Implement policies on childhood obesity
School meal nutrition (CLICK) Dietary Guidelines for Americans (DGAs) USDA and Institute of Medicine Out of date guidelinesCompetitive foods (CLICK) Competitive Foods- vending machines, a la carte linesFederalLaws regulate where and when food is soldRevenue for schoolsPhysical and Health Education (CLICK) Every state has some form of a requirement for physical education Quality Enforcement
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OT approach can help design and implement interventions that maximize potential benefits from relationship btw child, family, and surrounding environment. (meso, micro, etc.)Pediatric OTs- in unique position to support children in increasing activity levels and developing healthy habits.
Ots can push off responsibility to someone elseWe are advocates!
Chau and Rach
Things people sent me:Occupational therapists have a role in prevention of obesity in children though education and advocacy. They work within the community to allow access to healthy foods and promote active lifestyles. Occupational therapists take part in the intervention process with children who are obese by working with families and schools to introduce healthier habits and work on environment modification that enable children to live more active lifestyles. While there currently are some practices set in place by school systems, they are not working. The unique role of the occupational therapist can devise effective implementations to reduce childhood obesity. Occupational therapists are not strictly clinical professionals; as occupational therapists, we have the power to be huge advocates for public policy makers. With this powerful role, occupational therapists can help develop and implement programs and policies that effectively reduce obesity.
