Childhood Obesity And Abuse
Main Category: Obesity / Weight Loss / FitnessAlso Included In: Pediatrics / Children's Health
Article Date: 02 Feb 2009 - 5:00 PDT
email to a friend 
printer friendly 
opinions
| Patient / Public: |  |
4.4 (5 votes) |
| Healthcare Prof: |  |
4.67 (3 votes) |
| Article Opinions: | 1 posts |
When does severe childhood obesity become a child protection issue? This is just one of the ethical, medical and legal questions confronting doctors as they deal with increasing rates of childhood obesity, according to a series of articles in the latest Medical Journal of Australia.
Dr Shirley Alexander from Westmead Children's Hospital and her colleagues say severe childhood obesity is a common problem that can result in acute and chronic life-threatening complications. Their article examines the case of a severely obese child whose parents were unwilling or unable to adhere to management programs aimed at helping her lose weight.
"We argue that in a sufficiently extreme case, notification of child protection services may be an appropriate professional response," the report says.
According to the report, parental neglect can be a causative factor in ongoing obesity and related medical problems including sleep apnoea.
The case described in the article, an amalgamation of real issues from a number of actual cases, described a four-year-old girl who was 110cm tall and weighed in at a hefty 40kg. The child watched TV for six hours a day and had temper tantrums when denied food. A family-focused multidisciplinary approach failed to stop or reverse the child's weight gain. Child protection authorities were finally notified when the child's health continued to deteriorate. She was introduced to a program of physical activity and reduced dietary intake that soon had her losing weight.
The report concludes that a doctor is duty bound to report severe cases of inadequately managed paediatric obesity to the authorities.
A related article by Joanne Stubbs and Helen Achat says that collecting accurate data is essential in the fight against obesity. The article says monitoring and reporting on childhood obesity provide information on which to base, and subsequently evaluate, our efforts and are dependent on 'opt out' consent to minimise problems of inadequate participation.
"Ongoing population-based anthropometric measurement is fundamental to such efforts (early intervention in weight problems). We argue this is only possible with 'opt out' consent."
'Opt out' consent facilitates the recruitment of a representative sample of the population for valid and meaningful anthropometric information and, at the same time, leaves the individual with the right to decline participation. The article calls on ethics committees to support endeavours to confront the challenges of childhood obesity by allowing opt-out consent for anthropometric measurement studies.
The final article in the series written by nutritionalist Dr Tim Gill and a diverse group of experts in paediatrics, public health, nutrition and endocrinology from the University of Sydney, refutes recent commentary downplaying the prevalence of childhood obesity saying it remains a widespread health concern that warrants population-wide prevention programs.
The statements or opinions that are expressed in the MJA reflect the views of the authors and do not represent the official policy of the AMA unless that is so stated.
Medical Journal of Australia
Visit our obesity / weight loss / fitness section for the latest news on this subject.
MLA
12 Feb. 2012. <http://www.medicalnewstoday.com/releases/137504.php>
APA
http://www.medicalnewstoday.com/releases/137504.php.
Please note: If no author information is provided, the source is cited instead.
|
Rate this article: (Hover over the stars then click to rate) |
Patient / Public: |
or |
Health Professional: |
Visitor Opinions In Chronological Order (1)
Obesity
posted by Dan on 2 Feb 2009 at 11:21 amThoughts about Obesity Aside From Social Problems
Obesity has been defined as when excess body fat accumulates in one to where their physical overgrowth makes the person unhealthy to varying degrees. Obesity is different than being just overweight, as it is of a more serious concern.
As measured by one’s body mass index (BMI), one’s BMI of 25 to 30 kg/m is considered overweight. If their BMI is 30 to 35 kg/m, they are class I obese, 35 to 40 BMI would be class II obese, and any BMI above 40 is class III obesity. Presently, with obesity affecting children progressively more, the issue of obesity has become a serious public health concern.
Approximately half of all children under the age of 12 are either obese are overweight. About twenty percent of children ages 2 to 5 years old are either obese are overweight. The consequences of these stats on our children are very concerning, considering the health issues they may or likely experience as they get older.
Worldwide, nearly one and a half billion people are either obese or overweight. In the United States, about one third of adults are either obese or overweight. Women of low socioeconomic status are likely to be twice as obese compared with those who are not at this status. It is now predicted that, for the first time in about 150 years, our life expectancy is suppose to decline because primarily of this obesity problem.
Morbid obesity is defined as one who has a body mass index of 30 kg/m or greater, and this surgery, along with the three other types of surgery for morbid obesity, should be considered a last resort after all other methods to reduce the patient’s weight have chronically failed. Morbid obesity greatly affects the health of the patient in a very negative way. It has about 10 co-morbidities that can develop if the situation is not corrected. Some if not most of these co-morbidities are life-threatening.
One solution beneficial in many cases of morbid obesity if one’s obesity is not eventually controlled or corrected is what is known as gastric bypass surgery. This is a type of bariatric surgery that essentially reduces the volume of the human stomach in order to correct and treat morbid obesity by surgical re-construction of the stomach and small intestine.
Patients for such surgeries are those with a BMI of greater than 40, or a BMI greater than 35 if the patient has co-morbidities aside from obesity. This surgery should be considered for the severely obese when other treatment options have failed. The standard of care illustrating as to whether this surgery is reasonable and necessary should be clarified.
There are three surgical variations of gastric bypass surgery, and one is chosen by the surgeon based on their experience and success from the variation they will utilize. Generally, these surgeries are procedures related to gastric restrictive operations or mal-absorptive operations.
Over 200,000 gastric bypass surgeries are performed each year, and this surgery being performed continues to progress as a suitable option for the morbidly obese. There is evidence that this surgery is particularly beneficial for those obese patients that have non-insulin dependent Diabetes Mellitus as well.
It is believed that the results of this surgery to correct morbid obesity greatly limits or prevents such co-morbidities associated with those who are obese. Yet about two percent of those who undergo this surgery die as a result from about a half a dozen complications that could occur. However, the surgery reduces the overall mortality of the patient by 40 percent or so, yet this percentage is debatable due to conflicting clinical studies at times.
Age of the patient should be taken into consideration, as to whether or not the risks of this surgery outweigh any potential benefits for the patient who may have existing co-morbidities that have already caused physiological damage to the patient. Also what should be determined by the surgeon is the amount of safety, effectiveness, and rationale for a particular patient regarding those patients who are elderly, for example.
Many feel bariatric surgery such as this should be considered as a last resort when exercise and diet have failed for a great length of time.
If a person or a doctor is considering this type of surgery, there is a website dedicated to bariatric surgery, which is: http://www.asmbs.org,
Dan Abshear
Add Your Opinion
Please note that we publish your name, but we do not publish your email address. It is only used to let you know when your message is published. We do not use it for any other purpose. Please see our privacy policy for more information.
If you write about specific medications or operations, please do not name health care professionals by name.
All opinions are moderated before being included (to stop spam)
Contact Our News Editors
For any corrections of factual information, or to contact the editors please use our feedback form.
Please send any medical news or health news press releases to:
Note: Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care professional. For more information, please read our terms and conditions.
Privacy Policy |
Terms and Conditions
MediLexicon International Ltd
Bexhill-on-Sea, United Kingdom
MediLexicon International Ltd © 2004-2012 All rights reserved.
