Childhood overweight is one of the most serious problems currently affecting individual and public health. Schools represent a logical site for prevention because children spend 6-8 hours a day there during most of the year. Although reports of school-based overweight or obesity prevention programs exist, there are no summaries specifying which interventions are effective in preventing weight gain in the school environment. Researchers generally consider randomized controlled trials to be the most reliable and valid findings; so, naturally they are the best for providing evidence on which to base curriculum and policy guidelines. Consequently, the purpose of this paper is to provide an overview of school-based randomized controlled studies intended to prevent increases in schoolchildren's body weight or body mass index. This paper addresses the successes and other positive health outcomes, as well as the limitations of the school-based research. The goal of this paper is to assist school health administrators with curriculum decisions related to overweight or obesity prevention in schools. Following the critique, the challenges of childhood overweight or obesity prevention are discussed, and recommendations for further research, school activities, and policy changes are made.
Negative attitudes toward obesity by healthcare professionals can act as a barrier to diabetes management. Primary care providers including NPs must begin through self-reflection to recognize their own attitudes regarding weight-stigma and how these attitudes may affect their patients. By implementing effective strategies to reduce weight bias, an environment conducive to diabetes and lifestyle modification management may prevent patients from forgoing care.
The prevalence of childhood obesity is increasing in the United States and globally. Associated with numerous comorbid conditions, childhood obesity is also recognized as a risk factor for multiple chronic conditions and premature mortality in adult life. Children and adolescents, particularly those from ethnic minorities and rural low income populations, bear an excess burden of obesity and its attendant comorbidities. A major contributor to childhood obesity is a physical and social environment that promotes foods high in fat and calories and minimizes the opportunities for physical activity. Despite the strong environmental influences that encourage overeating and sedentary behavior, weight maintenance is viewed as a personal responsibility. Addressing the obesity crisis requires a paradigm shift away from blaming individuals for the lack of will power to control their eating and physical activity to one of recognizing the "toxic" or "obesigenic" environment as a primary determinant. This article addresses the obesity crisis from individual, family, local community, and public policy perspectives. Emphasis is placed on the role of nurses and nursing, acting to promote change with individuals and families and acting as advocates for multilevel policy initiatives, in reversing the epidemic and improving the health of future generations.
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