The Role of Social Work in the Childhood Obesity Epidemic

Childhood obesity is growing at alarming rates in the United States. According to the American Obesity Association (AOA), the prevalence of obese children and adolescents has greatly increased in the past three decades. From 1976 to 1980 the prevalence of obesity in children between ages 6 and 11 was 7 percent, and the prevalence of obesity in adolescents between ages 12 and 19 was 5 percent. Between 1999 and 2000, 15.3 percent of children in the United States were considered obese, and 15.5 percent of adolescents were considered obese (AOA, 2002). It is astonishing that obesity has doubled in children and has tripled in adolescents between 1976 and 2000. So how is obesity determined? The medical community formulates a person's body mass index (BMI), which takes into account the person's weight and height. The BMI is then charted on standardized growth chart from the Centers for Disease and Control and Prevention (CDC) to determine the percentile of that person's BMI. The AOA (2002) declared that a child or adolescent at the 85th percentile of BMI is considered overweight and a child or adolescent at the 95th percentile of BMI is obese. It should be noted that the CDC refrains from using the word "obese" for children and adolescents. Rather, the CDC suggests two levels of overweight: the 85th percentile is "at-risk" level and the 95th percentile is "severe." (See http://www.cdc.gov/ nccdphp/dnpa/growthcharts/training/modules/ modulel/text/modulelprint.pdf for more information on the BMI and growth charts.) Deckelbaum and Williams (2001) investigated the health risks associated with childhood obesity. They found that comorbidities associated with obesity and excessive weight in adult populations, including hypertension and dyslipidemia and the higher prevalence of factors associated with insulin resistance and type 2 diabetes, can also be found in children. In fact, type 2 diabetes is now the dominant form of diabetes in certain populations of children and adolescents because of obesity (Deckelbaum &Williams). The causes of this surge in the prevalence of childhood obesity can stem from a variety of reasons. Children are consuming more calories and decreasing their level of physical activity. It is becoming a cultural issue in the United States regarding family lifestyles that cater to obesity. Families are busier, and there is less time for parents to make their children healthy, scheduled meals. Children are running out the door without breakfast. Lunches consist of high-fat food items from the school cafeteria. Often, dinner is served in the car, in front of the television, or at a restaurant. High-calorie, high-fat foods such as chips, sweets, fast food, and other "junk foods" are staples in U.S. homes. Instead of playing outside with friends after school or on the weekends, more children are resorting to watching television, playing on the computer, or playing video games. These types of lifestyle choices are some of the major contributors to the childhood obesity epidemic. Some might say that with the medical health risks associated with childhood obesity and the known methods to combat it, treatment and prevention should be left to physicians, dieticians, and others in the medical field, right? Wrong! Treating childhood obesity needs to be a much more comprehensive intervention than strictly nutritional counseling and treatment of comorbidities. It is crucial to address the behavioral and lifestyle changes of the child and the family. Many fundamental principles of social work are essential when working to treat childhood obesity, including family systems theory, advocacy, cultural competence, and strengths-based perspective. SYSTEMS THEORY Systems theory is an important part of trying to understand how to deal with childhood obesity. When working with an obese or overweight child, it is important to remember that the child is part of a family system. Consideration of this system is essential for successful, healthy lifestyle intervention. …