Childhood obesity is a health problem of global character. It began to demonstrate speedy growth several decades ago. As a result, over the last thirty years, the number of children suffering from obesity globally has doubled, and the number of obese adolescents has increased by four times (CDC 2015).
Previously, the focus of attention of the world’s scientists and medics targeted the problem of malnutrition in terms of lack of food, and necessary diet elements such as proteins and vitamins. Today, the priorities have shifted, and the excessive weight of the modern children has grasped the attention of the medical professionals as a threat to the future generations of our planet.
As obesity has a tendency to make significant impacts on the health and quality of life of the people suffering from it, this issue is a focus of multiple medical organisations and facilities. The extremely high rates of childhood obesity and the health issues it is associated with (such as heart disease, diabetes, and high blood pressure) have added to the list of diseases the contemporary health services have to fight.
Currently, hundreds of thousands of healthcare professionals are involved in working on the ways, programs, and policies that could help the society overcome this problem and decrease the number of affected individuals. The health services are overwhelmed by the number of burdens and challenges, and so is the population of our planet and the developing countries in particular.
This paper presents the problem of childhood obesity in the developing countries and discusses its severity and effects, its causes, contributing factors, and the main stakeholders. In addition, the essay provides the possible solutions and recommendations for the future policy and practice.
Description of the Problem or Childhood Obesity
Definition and Characteristics of Childhood Obesity and Overweight
As concepts, the terms “obesity” and “overweight” are used interchangeably. Both terms indicate the abnormal accumulation of fat in a human body that leads problems and complications of health (Ellulu et al. 2014). Obesity stands for the presence of excessive body fat in an individual, whereas the use of the word “overweight” assumes a correlation between a person’s weight and their height, bone structure, muscle, and amount of fat (CDC 2015).
Both obesity and overweight are associated with the imbalance of calorie intake and expenditure. In other words, an individual is likely to begin having issues with excessive body weight when the number of calories they consume significantly exceeds that of the expended energy (CDC 2015). To be more precise, World’s Health Organisation (WHO) uses the reference of growth of adolescents and children of school age to estimate obesity and overweight.
According to WHO (2016), overweight is registered in a case of one standard deviation of BMI (body mass index) for a particular age, and obesity is registered in case of two standard deviations. As a result, the problem of obesity in children and adolescents is tightly connected to the population’s diet and physical activity and the combination of these factors from the perspective of health.
Childhood obesity is one of the most important public health problems of the current century. The population it affects includes the individuals of school age and older teenagers; namely, those who are between 5 and 19 years old, also the infants aged 0 to 5 may be included. According to the data of the World’s Health Organisation (2016), by 2013, the number of children and adolescents suffering from obesity has exceeded 42 million, of whom, 31 million were the residents of the developing countries.
WHO (2016) also pointed out that the children living in urban areas are more vulnerable to this health problem. The issue of obesity in children is dangerous as their obesity tends to remain present later in life and lead to health issues in adulthood as well as during the earlier years of life.
Child obesity proves to serve as a powerful contributing factor to such health threats as diabetes, cardiovascular disease, and high blood pressure. Most importantly, the problem of obesity in children and adolescents is characterised as preventable, and the elimination of this issue is likely to improve the public health on the national and global levels.
Childhood Obesity and the Globe
As mentioned earlier, according to the data of WHO (2016), the number of obese children in the world today is more than 42 million, and the vast majority of them are the residents of the developing countries. The increase in the rates of childhood obesity happened rapidly within the last three decades. For instance, the number of obese children in the countries of Africa jumped from 4 to 9 million over this period of time (WHO 2016).
World’s Health Organisation (2016) also noted, the on average, the increase in the childhood obesity rates in the developing countries is 30% higher than that of the developed states. The problem requires immediate intervention because if the development of obesity rates continues at the same pace, the number of children affected by it may reach 70 million in just ten years.
Moreover, without an appropriate intervention program, childhood obesity is likely to continue throughout the adolescence and adult life of the individuals and cause multiple illnesses and disabilities some of which may have lethal consequences. Childhood obesity is a complex problem with multiple levels as it affects the internal organs of the children, their blood flow, lifestyle, as well as their self-esteem and overall quality of life. In other words, the issue has physical and psychological dimensions and needs to be treated as soon as possible.
In addition, the issue of obesity is complicated by a multitude of contributing factors of different characters (such as the economic development of a country, urban planning, diet, food processing and marketing, income distribution, environment, and education to name a few (Ellulu et al. 2014). As a result, the obesity rates among adults as well as children tend to be higher in the developing countries where the population is to cut their daily expenditures at the cost of healthy nutrition.
Prevalence and Rates of Obesity in Various Countries
As pointed out by Gupta et al. (2010), the combination of the increased amount of processed food consumption and sedentary lifestyle has led to the significant increase in the childhood obesity rates in the developing countries of Africa, Middle East, Asia, and Latin America.
The prevalence of childhood obesity has demonstrated fast growth in the developing countries over the last several decades. Namely, it increased by over 19% in Argentina, and over 22% in India and Brazil, as for Mexico, the prevalence of obesity rates there grew by over 40% (Gupta et al. 2010). Besides, in the country of Thailand, the prevalence growth increased from 12 to over 15.5% over just two years between 1991 and 1993 (Gupta et al. 2010).
Moreover, the rates of obesity have shown a threefold increase in such regions as the Middles East, Pacific Islands, and China (Ellulu et al. 2014). The countries that used to suffer from the problem of malnutrition today have to fight obesity and overweight. In fact, the number of children diagnosed with obesity in the developing countries is higher and that of the children suffering from underweight and undernutrition (Ellulu et al. 2014).
The rates of obesity prevalence differ from one developing country to another; however, even the data from the countries with slower growth shows a rapid development of obesity in children. The major increase in the childhood obesity rates in the countries of the Middle East, West Africa, the Caribbean, and Latin America became visible in the 1980s, whereas the countries of Asia as well as some East African states have demonstrated the similar growth in the obesity rates during the 1990s and 2000s (Ellulu et al. 2014).
It is important to notice that regardless of the fact that the rates of childhood obesity in the developing countries have skyrocketed over the last few decades and continue to grow, the overall percentage of obese children and adolescents there is still lower. In other words, the leading ranks in the list of the countries with the largest number of overweight and obese children still belong to the highly developed countries such as the United Kingdom and the United States.
To be more precise, while the average number of children affected by obesity in the developing countries estimates 5-10%, that of the developed countries may reach 20% or more (Cameron 2005). This tendency is related to the fact that the industrialisation and consumerism have occurred much earlier in the developed states, and that is why the public health issues brought about by them have been persisting in these countries for much longer.
Dimensions of the Problem
Socio-Economic Dimension
The factors that contribute to the prevalence of the rates of childhood obesity in the developing countries are multiple. In addition to the physiological factors such as genetic predisposition, gender, and body type, there are a number of socio-economic determinants of obesity in children and adolescents.
Among the most significant contributors there are the state of the local economy and income distribution in particular, the geographical position of the area (rural or urban), level of industrialisation, lifestyles of children and their mothers, literacy and education, climatic conditions and diets of the regions (Ellulu et al. 2014).
The researchers have noticed that the childhood obesity rates are much higher in the urban areas of the developing countries (Ellulu et al. 2014; Gupta et al. 2010). This tendency is explained by the fact that the diets of the rural regions are rather lean and do not include many processed foods, whereas those of the industrialised and urbanised areas have changed over the last several decades and began to include foods rich in fat and sugar.
As a result, the rural areas are mainly associated with undernutrition and growth stunt while the urban children suffer from excessive body weight and obesity (Cameron 2005; Ellulu et al. 2014; Gupta et al. 2010).
The income of the families where the children grow up is another powerful factor that impacts the possibilities of obesity. The households with lower income are forced to save funds and purchase cheaper food. As a result, their diet mainly consists of meals rich in calories due to fat and sugar.
The passive lifestyle of the modern urban children dictated by the popularity of the internet and computer games creates an imbalance between the calories the children consume and the energy they expend during the day. In addition, not only the food children have at home contributes to obesity rates. Privately funded urban schools are known to serve fast food and fizzy drinks at the canteens sharing the daily diets of the school-aged population as highly unhealthy.
Moreover, the level of health literacy and education in the area is another determinant of obesity as the individuals’ idea as to what comprises a good and healthy diet may not be correct. For instance, many developing countries are known to appreciate fried and deep fried foods, and consume a large amount of grains poor in proteins and rich in calories.
Without the knowledge about the effects fatty foods produce on the human body, the population is likely to stick with unhealthy nutrition choices for decades and fail to connect the diet to the emerging health threats.
In addition, health literacy and education concerning proper nutrition are required to help the population of the developing countries to find substitutes for the fatty foods without damage to their household budgets. Otherwise, the areas that used to be challenged by insufficient nutrition and health risks related to it may shift to the problem of obesity as a result of an improperly addressed primary threat.
Political Dimension
In the contemporary world, the process of globalisation is one of the main and most powerful causes of a variety of global effects. Globalisation has economic and political outcomes that result in social trends. The political strengthening of the Western countries has led to the economic and social impacts on the other parts of the world. One of the best examples of this influence is the change in lifestyle and diets all around the world.
Sugar and fat induced products of the Western technologies and economies have quickly spread all around the world. For instance, while the popularity of fast food in the United Kingdom and the USA have been gaining popularity since the middle of the first half of the 20th century. However, their arrival to the developing countries occurred only in the 1990s or 2000s.
The rapid pace of the child obesity prevalence is the outcome of the popularity of the processed and fast foods in the regions that previously used to suffer from undernutrition. On the large scale, the shift of diet is the effect of the Western political and economic domination over the developing countries.
The change in lifestyle and its transition from active to sedentary can be analysed in the same way based on the fast spread of the technologies to the developing countries and the resulting shift in the lifestyle quality. Consequently, the rates of obesity in the United States and the United Kingdom are much higher than those of the developing countries, and the situation had reached more severe stages that required the addition of the term of extreme obesity.
Today, obesity is not just a public health issue; it is political as well. In the United States, the politicians are actively participating in the development of anti-obesity campaigns promoting health literacy, responsible consumption and active lifestyle. Namely, the American First Lady Michelle Obama is involved in the promotion of her “Let’s Move” campaign.
However, while the parents, the teachers, and schools are regarded as the ones responsible for the problem of childhood obesity, little attention is paid the contribution of the food industry, fast food chains, and the ubiquitous advertisement of unhealthy meals (Rosen 2011).
Stakeholders of the Issue
As mentioned above, the policy makers and the authors of the programs designed to address the problem of childhood obesity tend to target only a few of its stakeholders failing to take into consideration the others who are just as powerful.
Parents
Parents and caretakers are the individuals who are in constant communication with the children and who have a very strong impact on them. The practices and points of view of the parents are often repeated by the children later in life. The lifestyles witnessed by the children while growing up in most cases become habitual for them. As a result, the quality of diet the children have since the first years of life is known to determine their future health.
Moreover, the nutrition the infants receive at the fetal stages also has been proved to impact their likeliness of developing obesity during school age (Gupta et al. 2010). In short, WHO (2016) maintains that “every aspect of the environment in which children are conceived, born and raised can contribute to their risk of becoming overweight or obese”.
Besides, the breastfeeding patterns and the maternal weight during pregnancy and birth are recognised as the contributors to the growth stunts and obesity of the children. Moreover, the stunts, undernutrition, and obesity tend to coexist in the same families in the developing countries (Hoffman n.d.). That way, the lack of education concerning healthy nutrition in parents is directly connected to the calorie imbalance and abnormal accumulation of body fat in children.
Schools
The modern children spend a large amount of time at schools. As a result, schools and their policies as to health practices become very influential in the development and wellbeing of the adolescents and children. Facing a common problem of insufficient funding and the need to save costs, the school administrations often tend to adopt cheaper resources. Among other aspects, this tendency concerns the school meals that are known for low quality.
Today, the schools in developing countries, just like those in the USA or the United Kingdom, choose to serve fast food and place machines selling soft drinks in the school areas. As a result, the children and adolescents of school age are surrounded with unhealthy and processed foods on the daily basis.
This practice contributes to the development of unhealthy diet choices and a habit to consume excessive amounts of sugar and fat. One may say that adopting unhealthy nutritional practices, the school administrations force the unsafe diet choices on the children and make a significant contribution to the growth of the childhood obesity rates.
Food and Drink Companies
The contemporary world is highly industrialised and can be referred to as the world of commerce. As a result, the food industry is one of the most powerful and rich industries in the world. The fast food segment is one of the largest parts of the modern food and drinks field.
Each country of the world has a number of domestic fast food producers and also welcomes some of the influential chains of the world that mainly originate in the West (among them there are such fast food giants as McDonalds, KFC, Pizza Hut, Taco Bell, and Subway, to name a few).
The location and ubiquity of these fast food restaurants are designed to cover large segments of the population and serve huge customer base promoting excessive portions and encouraging the consumers to buy and eat more than they need. For instance, all the discount menus of the largest fast food chains include double-sized portions mainly, whereas small portions are either excluded from the menu or are made unattractively small forcing the customers to prefer large ones.
Advertisers
In the modern world of commerce, advertising plays an important role in the consumption patterns. The public opinion is impacted and the perception is altered in a way that fast food seems like a pleasurable and highly beneficial choice of meal. As a result, busy parents who do not have time to cook homemade meals tend to order fast food and introduce their children to unhealthy diets since very young age.
The tendency is similar with the parents who have low income because fast and processed foods are cheaper compared to the organic and healthy products. Besides, advertising designed to impact the beliefs of people is especially effective among children.
The producers of fast food are aware of their advantage, and that is why multiple fast food advertising campaigns target children offering them toys and colourful experiences as rewards for choosing fast food as a meal. This system may be compared to operant conditioning that trains children to make particular diet choices since the early age.
Technologies
The sedentary lifestyle contributes to childhood obesity just as much as diets rich in fat and sugar. The ubiquitous popularity of computers, smartphones, and other digital devices makes children forget about the activities requiring movement and energy.
In fact, the contribution of the modern technologies to the childhood obesity rates can be easily observed when the prevalence of excessive weight in children of rural and urban areas is compared. The lifestyles of the urban children are much more passive due to the easy access to the internet and technologies combined with the larger amount of processed foods in the diet.
Peers
Overweight and obese school children suffer physically as their health in threatened by multiple risk factors for diabetes mellitus, cardiovascular disease, hypertension, and various muscle and bone impairments (WHO 2016). At the same time, they are exposed to psychological pressure due to the lack of popularity among peers.
Obese and overweight children and adolescents are often mocked for their appearances, their social and love life is heavily affected by the way the look, and so is their self-esteem and confidence level. These patterns are similar throughout the world regardless of the levels of economic development of the countries.
The contemporary mass media promotes slim figures as beautiful and attractive while obesity is generally possessed as unpleasant looking. Negative relationships with peers may harm the children suffering from obesity making them depressed, anxious, and generally unhappy. However, they may also serve as the important catalyst in the process of realisation that an intervention is necessary and a powerful motivation for the obese adolescents and children to change their lifestyles.
Politicians
One of the main powers that enable the change is constituted of the policy makers and politicians who put into practice the policies and programs targeting childhood obesity. As mentioned by Rosen (2011), the politicians mainly focus on the development of programs improving health literacy and educating parents and children about the causes and effects of obesity, as well as the ways to plan family budget in order to buy healthy food without the damage to the household income.
However, they overlook the other stakeholders of this health problem – the food and drinks companies. It is possible that the rates of obesity could decrease significantly if the politicians could regulate the amount of processed foods produced. The issue is that the developing countries and their economies are dependent on the generation of domestic income and such profitable and cost-effective industries as fast food. As a result, they are reluctant to limit these organisations.
Healthcare Organisations and Medical Professionals
Healthcare organisations, medical professionals, and researchers are actively working on the development of strategies to intervene childhood obesity. Unfortunately, in the developing countries where the funding of medical facilities is limited, the medical facilities and practitioners have to concentrate on more dangerous issues (such as infectious diseases, for example).
The same tendency can be observed among the politicians. The developing states have a long list of crises that require an immediate attention of the policy makers, and that is why the problem of childhood obesity is often skipped or neglected.
Overall, each of the stakeholders mentioned above is able to make both positive and negative contributions. However, the majority of them seem to make the problem worse instead of addressing and minimising the damage. A powerful and effective intervention would have to combine the positive influence of all or several of the stakeholders and rely on their agreement and collaboration.
Recommendations for Solutions and Interventions of Childhood Obesity
Despite the adverse effects consequences of childhood obesity, this public health problem is highly preventable. As the children and their parents are the main active agents of the issue, they are the main targets of the policies and programs addressing this challenge. The policies are to provide the necessary support to the actors through the cooperative actions of various organisations and communities.
Infants and Toddlers
World’s Health Organisation recommends that the problem of obesity should be addressed ever since the first days of the infants’ lives (WHO 2016). To be more precise, the parents of infants are to make sure that the feeding patterns are steady and organised. For instance, the breastfeeding of babies has to be initiated during the first hour of birth, and the overall period of breastfeeding is to continue for at least six months (WHO 2016).
Besides, according to WHO (2016), the safe and healthy way to introduce the babies to solid foods is based on the gradual addition of the safe and age-appropriate solid foods to the infants’ diets in combination with the on-going breastfeeding. This transition is recommended to go on for at least two years starting from the sixth month of a child’s life. Besides, the portions of the infants are to have an adequate size.
The parents are recommended to begin introducing solid and complimentary foods in smaller amounts and the gradually to increase them as the children grow. Moreover, the ingredients of the meals given to young children are to be organic and safe with the inclusion of all necessary nutrients, minerals, and vitamins. Most importantly, the diets of young children are to be diverse and contain a variety of foods with different origins – meat, fish and poultry, fruits, herbs, and vegetables, eggs, bread, and dairy.
The introduction to a diverse diet will teach children about the importance of variety, and also, train their bodies and digestion systems to process different foods and obtain a wide range of microelements. At the same time, infants are not to be given foods that contain large amounts of sugar, salt, and fat.
School Children
Healthy diets are just as important for the children of school age as they are for babies. For the children of 6 years and older WHO (2016) recommends to reduce the consumption of fatty foods and those rich in sugar, especially in case if the children do not have a very active lifestyle. Due to the developmental needs, the children are to have sufficient diets while their bodies are growing.
At the same time, the coexistence of childhood obesity and growth stunt demonstrates that the sufficiency of a diet is not determined by the amount of food they consume but by the presence of nutrients necessary for the healthy growth (Hoffman n.d.). In addition, WHO (2016) recommends that the parents and teachers promote and encourage physical activities for the children that should occupy no less than one hour a day.
Finally, the government and policy makers can address the problem of childhood obesity by regulating the ingredients and contents of the complimentary foods designed specifically for young children. The producers of such foods can be obliged to stick to the imitations requiring a strictly outlined percentage of sugar and fat.
Conclusion
To sum up, childhood obesity is an issue of global character. It affects the majority of the world’s countries both developing and developed. However, while the developed countries have been facing this challenge for quite some time, the developing states have just begun dealing with this issue.
Childhood obesity is a public health concern that endangers the wellbeing of the future generations exposing infants, children, and adolescents to the risk factors of such serous conditions as diabetes, CVD, high blood pressure, muscular and bone impairments. Childhood obesity maximises the rates of mortality and morbidity and without intervention is likely to become worse as the children grow up. The problem has many stakeholders.
The most important actors are the children and their parents. The issue is preventable and requires the focus of political leaders and healthcare organisations. In the developing countries, this problem is overlooked due to the presence of a multitude of other severe crises and demand attention.
Food and drink industries are interested in selling large amounts of cheap and processed food advertised as a clever choice of a diet doe to its low cost. That is why the best and most effective way to intervene childhood obesity is to educate parents and children about healthy nutrition and oblige schools and the producers of complimentary foods for infants to limit the content of fat and sugar in the meals.
References
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Ellulu, M, Abed, Y, Rahmat, A, Ranneh, Y & Ali, F 2014, ‘Epidemiology of obesity in developing countries: challenges and prevention’, Global Epidemic Obesity, vol. 2, no. 1, p. 2.
Gupta, N, Goel, K, Shah, P & Misra A 2012, ‘Childhood Obesity in Developing Countries: Epidemiology, Determinants, and Prevention’, Endocrine Reviews, vol. 33, no.1, pp. 48-70.
Hoffman, J D n.d., Obesity in developing countries: causes and implications. Web.
Rosen, D 2011, The Politics of Obesity. Web.
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