The Life Of Obese Children Health And Social Care Essay

Introduction:

Childhood obesity is a complex metabolic disorder, which is increasing in both developed and developing countries reaching epidemic proportions (Hamiel, et al 2006). Obesity - a condition where fatty body mass accumulate to levels that can cause acute or chronic health problems, worsen quality of life and reduce life expectancy ( Swallen, et al 2005 ). Its prevalence associated with industrialization and lifestyle changes. About 30% children in the U.S. are overweight, 16-18% obese. Obesity is increasing across both sexes and various ethnic groups. The aetiology of this disorder involves a number of factors, including genetic, environmental, metabolic, lifestyle and eating habits. During childhood and adolescence, obesity is a complex disorder (Schwimmer, Burwinkle, Varni 2003 ). The most widely spread consequences related to the physical health is development of diabetes mellitus, cardiovascular disease and hypertension (Friedlandlander, et al 2003). The psychological consequences includes decreased self- esteem and self- image ( Hamiel at al. 2006), as well as increased behavioural problems and perceived cognitive ability(Friedlandlander, et al 2003). Researchers also show that obese girls have more psychological problems including higher rates of depression and lower self-esteem (Swallen, et al 2005). World health care organisation defines health as a physical, psychological and social wellbeing but quality of life is perceived individually and is directly related to the individual health. (Williams et al 2005). There have been few studies cared out about life of obese children. The most interesting thing which was found in previous researches was similarity between HRQQL of obese children and children diagnosed with cancer (Hamiel at al. 2006). In effort to find out more about impact of obesity on children’s life, the following research question guided this review: Health Related Quality of life of obese children.

Search Strategy

The following search engines were used to identify related research studies for this review: Google Scholar, DCU online library and Entrez. The following key search words were used to guide the research: obesity, quality of life, obese children. Six articles were identified as appropriate for this review. In an effort to answer the research question the key findings of these studies will now be presented.

Discussion of findings

The quantitative descriptive designs were used by Swallen et al. (2005) to measure Health related quality of life in adolescents and children. A cross section analysis was conducted using National Longitudinal Study of Adolescence Health. This type of method is widely used in medicine, to collect data at a definite time (Olsen and George 2004 ). Researchers used a random sampling of 4827 children. This type is considered as representative of population and fair (Marshall 1996). Response rate was 88.2%. Children were divided into five body mass categories. Underweight, normal BMI, overweight and obese. Socio-demographic variables were included in the study, such as age, gender, race, mother’s education, father’s education, family structure and income. All participants were measured by BMI (calculated weight and height).Four main concerns were measured in this study. General health, physical health, emotional functioning, social functioning and school functioning. SAS for windows, version 8.02 was used to interpret data. Researchers found relationship between general health and functional limitations, but not for anything else. Participants who were overweight and obese reported poor general health. Overweight and underweight participants reported 1 or more functional limitations. Researchers found that BMI was not related to the health related quality of life. Most significant factor was gender. Girls were more likely to report, depression and low self-esteems, which had implication of their quality of life in all categories. Whiles findings this study showed implications of obesity in quality of life, the number of limitations were identified. Researchers used cross section analysis which was conducted from National Longitudinal Study which was set up on 1996, during 1994-1995 school years. This study is too old as population demographic is changing every year. The perception of quality of life, medicine, and life style changing dramatically. Due to this findings is of research may not be accurate. Researchers in their study used school children, but did not set out age group. This may result in not accurate results as perception of life and health may vary with age. In interweaves they used questions such as "in general, how is your health?", this was separated into excellent , very good , good , fair. The meaning of these definitions was not clearly identified.

Another study cared out by Schwimmer, Burwinkle and Varni ( 2003) looked at the quality of life of children and adolescence. Researchers used cross sectional method, same method as a previous study of 106 children and adolescence, age range from 5 till 18 years who had been referred to the Children’s Hospital. All participants mass index was 34.7. They defined obesity as BMI in the 95th percentile higher then age. Researchers used a generic core scale to measure quality of life. All participants were assessed for any underlying conditions and which could implicate their weight. Interviews and questionnaires were set out for children 8 to 18, and for children aged of 5 to 7 parents were asked to fill out the questioners. Socioeconomic statuses were taken into consideration and calculated using Hollingshead index. Researches divided quality of life into the physical functioning, emotional functioning, social and school functioning. This division is same as in previous study. 5 point response scale was used, as 0 never and 4 almost always a problem. Researchers used sample t test to compare scores. They also used t test for investigating difference of quality of life between genders. This study concentrates mostly on the physical effects on the children and their quality of life relating to it. Study highlights most common comorbidities present in obese children such as hypertension, diabetes. However, very little emphasis has put on psychological effects and life experiences. This study interestingly highlights similarity between the quality of life in children with diabetes and those who had been diagnosed with cancer. This particular research highlights very important issues that children experiencing, but it is too narrow and don’t provide the reading with overall quality of life. Sample sizes were big but it was from only one hospital which did not represent overall population. From 106 participants only 57 were boys, which also put the question on reliability of the results.

The next study which was done by Williams et al (2005), highlights the fact that all previous studies were carried out in the clinical settings but had little or no concentration on community based children. There were only two studies cared out previously about health and well- being to child of BMI , both suggesting a less striking with weight status than reported by Schwimmer et al.2003. Same as other studies researchers used cross sectional sample of 2000 people, which is much bigger sample. Researches used random sampling design which is common method used and gives greater quality of results. ( ) Survey was completed by both parents and children. Participants were classifies into 3 categories, not overweight, overweight and obese. Researchers used PedsQL4.0 questionnaire, which assessed physical, emotional, social and school functioning. Results of research found that quality of life is decreasing with increasing weight status. The difference in physical activity between children was low; however the difference in social functioning across each weight category was noted. Results showed that parents did not notice any significant psychosocial effects while in children it significantly decreased between overweight and obese children. This study also included result from the Schwimmer et al. 2003 research. Researchers noted that health related quality of life decreased across overweight children. This study found that parents and their children perceptions were strikingly similar. While parents completed questionnaire at home, children completed same questionnaire independently at school. By separating parents from children decreased buest and increased quality of results. Study showed that in contrast to other health related concerns, children’s own personal response to obesity is not more negative than that of their parents. Also to ensure quality of results researchers analysed findings using ‘Centers for Disease Control and Preventions age and sex specific cut points’. To ensure that definition’s did not affect any of the results. This study confirms that physical and social functioning of obese and overweight children is strongly effected; however emotional and school functioning does not differ from non-overweight children. Researchers also suggests given that relationship between teenagers and their parents is not that close, future research’s would be beneficial to see whether agreement dissipates as children age.

Friedlander et al (2003) also looked at decreased quality of life in obese school age children. He used cross sectional analysis of 371 children from 8 to 11 years old. Children were considered overweight BMI Of >95th percentile. The main purpose of this research was to see association between health related quality of life and obesity in pre-adolescent children. All children were gathered by randomised sampling. Health related quality of life was assessed by CHQ PF50, a parent report tool. All information was divided to sections of social roles, emotional health, physical health and family life. Researchers obtained a formal consent from the parents and hospitals. This is the only one research that provided this information. Interestingly this researcher paper makes a comparison of quality of life of obese children and underweight children. Research showed high similarity between them . Both group children had a decreased physical health as well low self-esteem. Similarly to the previous studies parents also are effected and having emotional distress. There few limitations noted for this study, including small age range , inability to evaluate causality and using one informant concerning the child’s health related quality of life. Also results of this research might not be accurate as distress could bias parents to over report problems. Researchers also noted that parents who them selves are suffering from obesity might report quality of life differently. They also suggested future study relating obese parents and their children.

The impact of obesity on Health related quality of life was also researched by Singer et. all 2006. They used cross sectional sample in two settings .