Childhood obesity articles pdf

This is an area in need of attention as interventions are taken to scale. There are a number of directions for future research to improve outcomes and address the challenges of wide-scale implementation. More complex, individual child and family interventions need to be tailored both in terms of content and implementation strategy to best align with the personal needs of those involved.

Scaling out is a critical method for implementation research to address the health inequities and disparities of childhood obesity McNulty et al Economos and Hammond suggest that community-level research should employ novel techniques of systems mapping and causal loop diagramming, which can help stakeholders to visualize the interrelated processes and elements that are relevant to the intervention. They also suggest using agent-based modeling and other simulation methods to help encapsulate the complex dynamics involved in implementing successful community-based interventions.

Tailoring strategies to local communities and deepening engagement holds promise in enhancing sustainability and scalability of community-based interventions. Future directions should address the shortcomings of less rigorous study designs, which inherently increases the risk of confounding and presents challenges in attributing changes in the outcome to intervention effects, but as research translation moves toward scaling up after establishing effectiveness, this tradeoff is both expected and encouraged to increase external validity.

Additionally, research is needed to determine the appropriate length and dosage of interventions, along with clear reporting of outcomes, consistency of measures, and long-term follow ups Bleich et al , Ickes et al , St. Echoing Karacabeyli et al , we also recommend collecting process evaluation and outcome data in order to understand the complex causal chain and to help bolster inferences in regard to the effectiveness and implementation of the intervention using hybrid designs.

Large community trials in particular often suffer high attrition rates because of mobile populations who move to different residences, which can impact the ability to track and communicate with participants. And this relates to effectiveness. A way to attenuate attrition in research on community-level interventions could be through adjusting study intervention design. The majority of community-based interventions used a quasi-experimental design, which is often attributed to practicality and sustainability Bleich et al , Karacabeyli et al Interestingly, less rigorous study designs e.

RCTs demonstrated significant reductions in child weight Karacabeyli et al This participatory approach could potentially lead to lasting positive health changes that extend beyond the study period. In addition, Karacabeyli et al described the benefits of a quasi-experimental design which lends itself to selecting at-risk communities that could greatly benefit from intervention efforts.

There are signs that progress is being made in stemming the tide of childhood obesity and evidence-based interventions are available across development and for various contexts and systems that affected and at-risk children routinely encounter.

Tremendous challenges remain in connecting the dots between etiology, development, and intervention targets, as well as when and where to intervene. There needs to be a push to scale up effective interventions as even small changes in weight can yield significant impact on multiple cardiometabolic indices Lloyd-Jones et al that can improve quality and length of life.

Clinical health psychologists are ideally suited to conduct research on this complex problem but transdisciplinary teams will be needed to increasingly move the dial. Childhood obesity is a complex, multidetermined, preventable chronic disease that increases risk for premature death and psychological problems.

Evidence-based interventions for obesity are available for all stages of development from birth to 18 years. Specific interventions can be delivered in community, school, home, and healthcare settings depending on the type of strategy and risk level of the targeted population. Associated co-occurring medical and psychological conditions of childhood obesity present an opportunity for clinical and health psychology researchers and practitioners.

Future research ought to focus on translational considerations from the start and ways to scale up delivery of effective interventions. Research is needed on interventions and their implementation to more effectively reach minority and underserved populations at greatest risk for obesity.

Increasing engagement and retention in childhood obesity interventions is a promising focus for future research. The authors wish to thank Sara St. Hendricks Brown, in support of Justin Smith. Justin D. The authors are not aware of any other affiliations, memberships, funding, or financial holdings that might be perceived as affecting the objectivity of this review.

National Center for Biotechnology Information , U. Annu Rev Clin Psychol. Author manuscript; available in PMC May Phone: Find articles by Marissa Kobayashi.

Author information Copyright and License information Disclaimer. Email: ude. Copyright notice. The publisher's final edited version of this article is available at Annu Rev Clin Psychol. See other articles in PMC that cite the published article. Abstract Childhood obesity has become a global pandemic in developed countries, leading to a host of medical conditions that contribute to increased morbidity and premature death.

Keywords: adiposity, childhood obesity, health psychology, prevention, research translation. The developmental cascade model of pediatric obesity The model described in the Smith et al.

Open in a separate window. Figure 1. Developmental cascade model of pediatric obesity Note. Psychosocial Contributors 3. Child mental health Poor self-regulation and related constructs such as reactivity and impulsivity, are prospective obesogenic risk factors Bergmeier et al , Smith et al d. Family-Based Interventions The home environment e. Primary Healthcare Primary care interventions are defined as health promotion or weight management programs conducted within or in close coordination with the primary healthcare system.

Pharmacologic Intervention Orlistat is the only FDA-approved medication for treating obesity for pediatric patients ages 12 years and older. Co-Occurring Medical Conditions The pro-inflammatory disease nature of obesity and contributing health behaviors affects normal physiology and metabolism, and can cause many associated diseases Gonzalez-Muniesa et al Type-2 diabetes Children with obesity are four times as likely to develop type-2 diabetes compared to children with a normal BMI Abbasi et al Asthma Asthma is one of the most common chronic diseases among children and adolescents: Hypertension Hypertension, like obesity, has been increasing among youth and is associated with increased cardiovascular disease risk throughout the lifetime May et al Nonalcoholic fatty liver disease NAFLD NAFLD is the leading cause of liver disease, leading to a shorter life expectancy due to associated comorbidities; one of which, non-alcoholic steatohepatitis, is projected to be the leading indication for pediatric liver transplant by Charlton et al Co-Occurring Psychological Conditions 6.

Implementation Science 12 : Asthma prevalence trends by weight status among US children aged 2—19 years, — Media and Young Minds. Pediatrics : e PLoS One 10 : e Self-regulation and household routines at age three and obesity at age eleven: longitudinal analysis of the UK Millennium Cohort Study.

International Journal Of Obesity 41 : Temperament and childhood obesity risk: A review of the literature. The role of emotion regulation in childhood obesity: implications for prevention and treatment. Emotional psychopathology and increased adiposity: Follow-up study in adolescents. Family-based childhood obesity prevention interventions: a systematic review and quantitative content analysis.

The international journal of behavioral nutrition and physical activity 14 : Prev Chronic Dis 16 : E Links between the organization of the family home environment and child obesity: A systematic review. Does maternal psychopathology increase the risk of pre-schooler obesity? A systematic review.

Child temperament and maternal predictors of preschool children's eating and body mass index. A prospective study. Recommendations from community partners to promote sustainable implementation of evidence-based programs in primary care. Prev Chronic Dis 14 : E Consequences of Obstructive Sleep Apnea in Children. Interventions to prevent global childhood overweight and obesity: a systematic review.

The lancet. Defining Childhood Obesity. The dynamic sustainability framework: addressing the paradox of sustainment amid ongoing change. The safety of pharmacologic treatment for pediatric obesity. Frequency and outcomes of liver transplantation for nonalcoholic steatohepatitis in the United States. Prevalence of hypertension in schoolchildren based on repeated measurements and association with overweight. Prev Chronic Dis 13 : E Diabetes Care 39 : Longitudinal analysis of risk of non-alcoholic fatty liver disease in adulthood.

Recommendations for prevention of childhood obesity. Childhood overweight: A contextual model and recommendations for future research. Designing for Diffusion of a Biomedical Intervention.

The Family Check-Up with high-risk indigent families: Preventing problem behavior by increasing parents' positive behavior support in early childhood. The obesity epidemic and nonalcoholic fatty liver disease in children. Designing effective and sustainable multifaceted interventions for obesity prevention and healthy communities. After the RCT: who comes to a family-based intervention for childhood overweight or obesity when it is implemented at scale in the community?

Journal of Epidemiology and Community Health 69 : The relationship of body mass index and blood pressure in primary care pediatric patients. Cardiovascular disease risk in healthy children and its association with body mass index: systematic review and meta-analysis.

Nature reviews. Predicting weight outcomes in preadolescence: the role of toddlers' self-regulation skills and the temperament dimension of pleasure. Screen time and sleep among school-aged children and adolescents: a systematic literature review. Trends in obesity and severe obesity prevalence in us youth and adults by sex and age, to The lifetime costs of overweight and obesity in childhood and adolescence: a systematic review.

Translational research: are community-based child obesity treatment programs scalable? BMC Public Health 15 : Toward a developmental conceptualization of contributors to overweight and obesity in childhood: The Six-Cs model.

Prevalence of binge and loss of control eating among children and adolescents with overweight and obesity: An exploratory meta-analysis. Associations between obesogenic risk factors and depression among adolescents: a systematic review. Maternal mental health at 5 years and childhood overweight or obesity at 11 years: evidence from the UK Millennium Cohort Study.

Global school-based childhood obesity interventions: a review. The role of sleep hygiene in promoting public health: A review of empirical evidence. Systematic review and meta-analysis of comprehensive behavioral family lifestyle interventions addressing pediatric obesity. Budget impact analysis of preparing to implement the Family Check-Up 4 Health in primary care to reduce pediatric obesity.

Meeting fruit and vegetable consumption and physical activity recommendations among adolescents intending to lose weight. Evaluation of complex community-based childhood obesity prevention interventions. Freemark MS, pp. A synthesis of existing systematic reviews and meta-analyses of school-based behavioural interventions for controlling and preventing obesity. School based interventions versus family based interventions in the treatment of childhood obesity- a systematic review.

Design and analysis in dissemination and implementation research In Dissemination and implementation research in health: Translating research to practice , ed.

Journal of Allergy and Clinical Immunology : — Overweight children report qualitatively distinct asthma symptoms: analysis of validated symptom measures. The Journal of allergy and clinical immunology : — BMC Public Health 18 : Interventions to prevent and manage overweight or obesity in preschool children: A systematic review. Parents have both implicit and explicit biases against children with obesity.

Relationship between maternal depression symptoms and child weight outcomes in Latino farmworker families. Prevalence of cardiovascular disease risk factors among us adolescents, — Scaling-up evidence-based obesity interventions: A systematic review assessing intervention adaptations and effectiveness and quantifying the scale-up penalty. ASMBS pediatric committee best practice guidelines.

Depression and obesity: evidence of shared biological mechanisms. Sleep patterns and obesity in childhood. Are bidirectional associations of obesity and depression already apparent in childhood and adolescence as based on high-quality studies?

Childhood obesity and obstructive sleep apnea. Global, regional, and national prevalence of overweight and obesity in children and adults during — a systematic analysis for the Global Burden of Disease Study Nonalcoholic fatty liver disease: A challenge for pediatricians.

Associations of maternal stress with children's weight-related behaviours: a systematic literature review. Prevalence of obesity among youths by household income and education level of head of household—United States — Morbidity and Mortality Weekly Report 67 : Prevention of overweight and obesity in children and youth: a systematic review and meta-analysis.

Treatment of overweight and obesity in children and youth: a systematic review and meta-analysis. Implementation strategies: recommendations for specifying and reporting. Obesity and type 2 diabetes in children: epidemiology and treatment. Current diabetes reports 14 : A biopsychosocial approach to processes and pathways in the development of overweight and obesity in childhood: Insights from developmental theory and research.

WIC mothers' depressive symptoms are associated with greater use of feeding to soothe, regardless of perceived child negativity. Preschoolers' delay of gratification predicts their body mass 30 years later.

Parental stress increases body mass index trajectory in pre-adolescents. Editorial: Pediatric Hypertension: Update. Factors associated with depression and anxiety symptoms among children seeking treatment for obesity: A social-ecological approach. Pediatr Obes : e Predicting adult obesity from childhood obesity: a systematic review and meta-analysis. Obesity prevention and obesogenic behavior interventions in child care: A systematic review.

General parenting, childhood overweight and obesity-inducing behaviors: A review. An individually tailored family-centered intervention for pediatric obesity in primary care: Study protocol of a randomized type II hybrid implementation-effectiveness trial Raising Healthy Children study. The Family Check-Up 4 Health FCU4Health : Applying implementation science frameworks to the process of adapting an evidence-based parenting program for prevention of pediatric obesity and excess weight gain in primary care.

Frontiers in public health 6 : George SM, et al. Preventing weight gain and obesity: Indirect effects of a family-based intervention in early childhood. George SM, Prado G. Family-centered positive behavior support interventions in early childhood to prevent obesity. Curr Diab Rep 18 : Prospective association between overvaluation of weight and binge eating among overweight adolescent girls.

A developmental cascade perspective of pediatric obesity: A systematic review of preventive interventions from infancy through late adolescence.

Adult and childhood weight influence body image and depression through weight stigmatization. Fetal programming of children's obesity risk. Family-based models for childhood-obesity intervention: A systematic review of randomized controlled trials.

Do stressed mothers have heavier children? A meta-analysis on the relationship between maternal stress and child body mass index. Chronic Sleep Curtailment and Adiposity. Psychosocial predictors and moderators of weight management programme outcomes in ethnically diverse obese youth. Pediatrics : Weight bias in versus Contradictory attitudes among obesity researchers and health professionals.

What childhood obesity prevention programmes work? A systematic review and meta-analysis. Strength of obesity prevention interventions in early care and education settings: A systematic review. Family functioning and obesity risk behaviors: Implications for early obesity intervention. Hypertension in childhood obesity. Intervention for childhood obesity based on parents only or parents and child compared with follow-up alone.

Support Center Support Center. External link. Please review our privacy policy. Research which indicates the number of hours children spend watching TV correlates with their consumption of the most advertised goods, including sweetened cereals, sweets, sweetened beverages, and salty snacks.

Media effects have been found for adolescent aggression and smoking and formation of unrealistic body ideals. Regulation of marketing for unhealthy foods is recommended, as is media advocacy to promote healthy eating. While extensive television viewing and the use of other electronic media has contributed to the sedentary lifestyles, other environmental factors have reduced the opportunities for physical activity.

Opportunities to be physically active and safe environments to be active in have decreased in the recent years. The majority of children in the past walked or rode their bike to school. Other reasons parents gave for driving their children to school included no safe walking route, fear of child predators, and out of convenience for the child.

Socio-cultural factors have also been found to influence the development of obesity. Our society tends to use food as a reward, as a means to control others, and as part of socializing. Family factors have also been associated with the increase of cases of obesity. The types of food available in the house and the food preferences of family members can influence the foods that children eat. In addition, family mealtimes can influence the type of food consumed and the amount thereof.

Lastly, family habits, whether they are sedentary or physically active, influence the child. A recent review concluded that the majority of studies find a prospective relationship between eating disturbances and depression.

Research has consistently found that body satisfaction is higher in males than females at all ages. Thus, there is a linear relationship between body dissatisfaction and increasing BMI for girls; while for boys a U-shaped relationship suggests that boys with BMIs at the low and high extremes experience high levels of body dissatisfaction. Traits associated with eating disorders appear to be common in adolescent obese populations, particularly for girls. These potential consequences are further examined in the following sections.

Childhood obesity has been linked to numerous medical conditions. These conditions include, but are not limited to, fatty liver disease, sleep apnea, Type 2 diabetes, asthma, hepatic steatosis fatty liver disease , cardiovascular disease, high cholesterol, cholelithiasis gallstones , glucose intolerance and insulin resistance, skin conditions, menstrual abnormalities, impaired balance, and orthopedic problems.

Although most of the physical health conditions associated with childhood obesity are preventable and can disappear when a child or adolescent reaches a healthy weight, some continue to have negative consequences throughout adulthood. Below, three of the more common health problems associated with childhood obesity are discussed, diabetes, sleep apnea, and cardiovascular disease. In addition to being implicated in numerous medical concerns, childhood obesity affects children's and adolescent's social and emotional health.

They also face numerous other hardships including negative stereotypes, discrimination, and social marginalization. It is often difficult for overweight children to participate in physical activities as they tend to be slower than their peers and contend with shortness of breath.

The social consequences of obesity may contribute to continuing difficulty in weight management. Overweight children tend to protect themselves from negative comments and attitudes by retreating to safe places, such as their homes, where they may seek food as a comfort. In addition, children who are overweight tend to have fewer friends than normal weight children, which results in less social interaction and play, and more time spent in sedentary activities. This in turn inevitably results in weight gain, as the amount of calories consumed exceeds the amount of energy burned.

Childhood obesity has also been found to negatively affect school performance. A research study concluded that overweight and obese children were four times more likely to report having problems at school than their normal weight peers. The growing issue of childhood obesity can be slowed, if society focuses on the causes.

There are many components that play into childhood obesity, some being more crucial than others. A combined diet and physical activity intervention conducted in the community with a school component is more effective at preventing obesity or overweight. Moreover, if parents enforce a healthier lifestyle at home, many obesity problems could be avoided. What children learn at home about eating healthy, exercising and making the right nutritional choices will eventually spill over into other aspects of their life.

This will have the biggest influence on the choices kids make when selecting foods to consume at school and fast-food restaurants and choosing to be active. Focusing on these causes may, over time, decrease childhood obesity and lead to a healthier society as a whole. Source of Support: Nil. Conflict of Interest: None declared. National Center for Biotechnology Information , U. J Family Med Prim Care. Author information Copyright and License information Disclaimer.

Address for correspondence: Dr. E-mail: moc. This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.

This article has been cited by other articles in PMC. Abstract Childhood obesity has reached epidemic levels in developed as well as in developing countries. Keywords: Childhood obesity, consequences, epidemiology, lifestyle, non-communicable disease, overweight. Introduction The world is undergoing a rapid epidemiological and nutritional transition characterized by persistent nutritional deficiencies, as evidenced by the prevalence of stunting, anemia, and iron and zinc deficiencies.

Definition of Childhood Obesity Although definition of obesity and overweight has changed over time, it can be defined as an excess of body fat BF. Causes of Childhood Obesity It is widely accepted that increase in obesity results from an imbalance between energy intake and expenditure, with an increase in positive energy balance being closely associated with the lifestyle adopted and the dietary intake preferences.

Sugary beverages A study examining children aged 9—14 from —, found that consumption of sugary beverages increased BMI by small amounts over the years. Snack foods Another factor that has been studied as a possible contributing factor of childhood obesity is the consumption of snack foods. Portion size Portion sizes have increased drastically in the past decade.

Activity level One of the factors that is most significantly linked to obesity is a sedentary lifestyle. Environmental factors While extensive television viewing and the use of other electronic media has contributed to the sedentary lifestyles, other environmental factors have reduced the opportunities for physical activity.

Socio-cultural factors Socio-cultural factors have also been found to influence the development of obesity. Family factors Family factors have also been associated with the increase of cases of obesity. Psychological factors Depression and anxiety A recent review concluded that the majority of studies find a prospective relationship between eating disturbances and depression.

Body dissatisfaction Research has consistently found that body satisfaction is higher in males than females at all ages. Eating disorder symptoms Traits associated with eating disorders appear to be common in adolescent obese populations, particularly for girls. Consequences of childhood obesity Childhood obesity can profoundly affect children's physical health, social, and emotional well-being, and self esteem.

Medical consequences Childhood obesity has been linked to numerous medical conditions. Socio-emotional consequences In addition to being implicated in numerous medical concerns, childhood obesity affects children's and adolescent's social and emotional health. Academic consequences Childhood obesity has also been found to negatively affect school performance.

Conclusion The growing issue of childhood obesity can be slowed, if society focuses on the causes. Footnotes Source of Support: Nil. References 1. The obesity epidemic is a worldwide phenomenon. Nutr Rev. Gupta RK. Nutrition and the Diseases of Lifestyle. In: Bhalwar RJ, editor. Text Book of Public health and Community Medicine. Indian Pediatr. Obesity in Indian children: Time trends and relationship with hypertension.

Natl Med J India. Factors affecting prevalence of overweight among 12 to 17 year old urban adolescents in Hyderabad, India. Obesity Silver Spring ; 15 — Prevalence of overweight and obesity in affluent adolescent girls in Chennai in and Prevalence of obesity in affluent school boys in Pune.

Panjikkaran ST, Kumari K. Indian J Community Med. Body fatness and risk for elevated blood-pressure, total cholesterol, and serum-lipoprotein ratios in children and adolescents. Am J Public Health. Weight-for-stature compared with body mass index-for-age growth charts for the United States from the Centers for Disease Control and Prevention.

Am J Clin Nutr. Guidelines for overweight in adolescent preventive services - Recommendations from an Expert Committee. Ghosh A. Explaining overweight and obesity in children and adolescents of Asian Indian origin: The Calcutta childhood obesity study. Indian J Public Health. Influence of behavioral determinants on the prevalence of overweight and obesity among school going adolescents of Aligarh. Body mass index in screening for adiposity in children and adolescents: Systematic evaluation using receiver operating characteristic curves.

Childhood overweight: A contextual model and recommendations for future research. Obes Rev. Childhood obesity: Trends and potential causes. Future Child. Center for Disease Control and Prevention. Contributing factors. Patrick H, Nicklas T.

A review of family and social determinants of children's eating patterns and diet quality. J Am Coll Nutr. Development of eating behaviours among children and adolescents. Individual and environmental influences on adolescent eating behaviours.

J Am Diet Assoc. Chapman G, Maclean H. J Nutr Educ Behav. Dublin: Department of Health and Children; Department of Health and Children. Obesity: The policy challenges: The report of the national taskforce on obesity. Niehoff V. Childhood obesity: A call to action. Bariatric Nursing and Surgical Patient.