Obesity as a Global Issue

Obesity has become a global epidemic over the last 30 years affecting 40 million children, below the age of five. The implications of obesity not only affect the health of an individual but also their social lives, the society around them and the overall economics of a country. Today, obesity affects 25% of Australian children, making it the biggest threat to Australia’s public health (Bronwyn, 2016).

Rates of obesity, over the last 25 years have risen globally(Overweight and Obesity,2019). This prevalence is most common in developed countries such as Australia and America having 25%(A picture of Overweight and Obesity in Australia,2017) and 30%(Bronwyn,2016) of their children having obesity, respectively. This trend is expected to increase.

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Childhood obesity sparks not only a wide array of physical distresses but also breeds a poor mental state for the individual. Children with obesity suffer from breathing difficulties, apnoea, hypertension and insulin resistance, fatty liver, high blood fats, low self-esteem and behavioural problems(Overweight and Obesity, 2019). These implications are carried into adulthood as 50% to 80% of obese children have obese parents, and following this trend, it is documented that many obese children become obese adults which harbours wider and more severe consequences(Bronwyn, 2016). The effects of obesity on an adult lead to an elevated risk of cardiovascular diseases, diabetes, cancer, musculoskeletal disorders and arthritic conditions (WHO,2018). Individuals also go through anxiety, depression, poor self-image and social stigma, and reduces happiness. All these factors produce an outcome of a shorter life expectancy (Bronwyn, 2016).

Similarly, with obese children becoming adults, close friends and family members are likely to also be affected with obesity spreading the risk of health problems associated with obesity(Friends and Family May Play a Role in Obesity, 2007). According to a study by Dr Nicholas Christakis of Harvard Medical School and Dr James Fowler of the University of California, San Diego, the likelihood of becoming obese increases by up to 57% when a close friend is obese. Same-sex friendships would increase the likelihood to 71%, with the highest percentage of increase being 171% with a close mutual friend being obese (The New England Journal of Medicine, 2007).

Outside of the individual and social issues, obesity also affects the countries economies. According to studies, obesity costs Australia around $58 billion a year with the addition of 7200 deaths(Obesity costs, The Australian,2013). In 2011 to 2012 it is documented by the AIHW that obesity equates to 7% of the total health budget, 63% of this cost lead to a fatal burden(AIHW, 2017). Obesity also produces indirect cost which is estimated to be 3.3 times greater than the direct cost (Childhood Obesity: An economic perspective,2010).

Cardiovascular disease (CVD) is an Australian National Health Priority due to its lead cause in mortality and morbidity in Australia, Childhood obesity contributes to this by elevating its cause. Not only does childhood obesity lead to adult obesity but also develops CVD risk factors which lead to cardiovascular disease in adulthood (Hallock, 2009). Childhood obesity is strongly associated with endothelial dysfunction, artery stiffness and Intima-media thickness which show early signs of CVD development in adulthood (Ayer, 2015). Additionally, cardiac structure specifically increased left ventricular mass is commonly found in obese children, as an independent risk factor in (CVD). A study was done with 1578 youth also shows the correlation between high blood pressure, cholesterol, diabetes and obesity all significantly contribute to the risk factors of CVD. Such principal components suggest that obesity is the strongest correlate for the determinants of CVD (Goodman, 2005).

In 2008, it is recorded that approximately 17% have a greater body mass index (BMI) greater than the 95th percentile, a level considered obese, while 4% of these children have a BMI above the 99th percentile, a level with an increase in CVD risk factors in individuals (Daniels,2008). These percentages have only gone up since then. A study in Denmark on a cohort of children identifies a link between higher BMI and coronary heart disease in Adulthood. Furthermore, a 55-year follow-up of the Harvard growth study leads to double the risk of coronary heart disease. A British study involves a 57-year follow-up also confirmed that all-cause and cardiovascular mortality were increased when the BMI of a child was greater than the 75th centile (Wang, Lai, Berenson, Chen, 2014). Even if the prevalence of obesity can be reduced, substantial young will grow to become obese adults (Ayer, Charakida, Deanfield, Celermajer, 2015).

It is evident that many childhood factors play a big role in shaping adulthood. The childhood obesity epidemic has erupted due to lifestyle life changes where an obesogenic environment is created early in an individual’s life where inactivity and overeating are promoted due to technological advances and the production of energy-dense foods. These lifestyle changes are a result of poor health education where eating sensibly and exercise is not favoured in raising the child. This is furthered in numerous studies where early infant/children feeding practices and television viewing are the biggest factors contributing to childhood obesity. (Wen, 2017). This reveals the importance of an infant's experience and how vital it is to reinforce healthy lifestyle choices during early life (Wilkinson, 2003).

A good food diet is essential for promoting good health and wellbeing. Low intake of healthy foods with excessive intake of fatty foods causes obesity which is strongly linked to a multitude of diseases. In 2011, 10% of the total burden of disease in Australia was due to dietary risk factors, with a diet low in fruit and vegetables accounting for 2.0% and 1.4% of the total disease burden, respectively (AIHW 2016c, 2017a). Excessive intake of energy dense-foods causes energy imbalance leading to obesity (NHMRC 2013a). Portion sizes have drastically increased over the past decade, where frequent snacking further contributes to the excessive caloric intake (Anderson, Butcher, 2006). Conversely, healthier foods and nutrients help weight control, an association is seen with the consumption vegetables and lower risk of weight gain (NHMRC 2013a).

Obesity is linked with socioeconomic disadvantage. Further down the social gradient childhood obesity increases due to higher unemployment, lower education level, and irregular meals (Wróblewska P, 2014). Many parents from a lower class often opt for fast food due to its convenience and the added benefit of favouring their children’s choices (Bhadoria, 2015), coupled with the lack of exercise due to the inability to afford sports equipment leading to a sedentary lifestyle. The experiences of a low socio-economic background also come with economic and social stress (Wilkinson,2003) where a sedentary lifestyle is employed to avoid street violence using fast food as a pleasure and escape. Children are often prohibited to play outside due to these dangers however, even without prohibition, poverty-dense areas often lack quality foods, parks and open spaces to facilitate physical activity (Levin, 2011). Children within these groups often inherit these lifestyle choices from their parents as result insecurity and fear of further disadvantage is built up thus the children grow up continuing these habits.

Prevention strategies used by the public and political, to combat the increasing rates of childhood obesity have been strongly targeted at the individuals. However although individuals are a factor in obesity, the choices people make stem from their environments.

Promoting healthy body weight in a population requires a response that includes upstream initiatives to tackle the obesogenic environments (rutter, 2017). This can be broken down to three components: government support, health-related initiatives and community-based interventions. The process of upstreaming begins with the government funding for health promotion, non-communicable disease monitoring systems, workforce capacity and support to enhance effectiveness in policy and community-based interventions. The second component helps to promote environments that enforce healthy diets and an active lifestyle. The third focus is on community-based activities where the local government seeks to implement strong community engagement and information for early childcare (WHO, 2012). These structural methods can alter an individual's decisions in order to prevent early development of Obesity as individuals with children are better informed. Nurses should inform parents of the importance of a healthier diet and an active lifestyle. They can also partake in school programs in areas lacking in health education to implement engagement for healthier lifestyle choices. These changes with the built environment should increase physical activity and reduce sedentary behaviours, overall impacting the influence of childhood obesity (Rutter, Rastrollo, Lissner, 2017).