Introduction
Over the last 30 years, it was infrequent to find adolescents experiencing complications related to overweight and obesity. However, in the last two decades, the prevalence rates of overweight and obese adolescents have increased significantly in both the developed and developing countries [1, 2]. However, the rates are notably higher in the developed countries compared to the developing countries. These insidious rates of overweight and obesity among the adolescents all the world call for the active involvement of clinicians, patients, and their family members in fighting the epidemic [1].
According to the BMI-based measurements of body weight, overweight individuals are referred to as those persons with a BMI of 25-30kg/m2 while obese individuals are those with a BMI exceeding 30kg/m2 [3]. Conventionally, obesity is also defined as the occurrence of excessive body fat in the adipose layer of an individual. Obesity holds a variety of complications, which affect both the physical and the psychosocial health of adolescents [2]. Moreover, the obesity-related complications may extend into adulthood whereby they lower the quality of life, give rise to other dangerous diseases, and lead to incapacitation and death [3].
However, a number of preventive and management strategies are in place, which aids the clinicians, patients and their family members in managing obesity and influencing positive dietary in-takes and lifestyles among the populations with the highest risk of obesity [2]. The obesity-related management strategies include lessening of high energy dietary in-takes, increased physical activity, avoiding sedentary lifestyles in addition to other pharmacological and surgical procedures aimed at reducing excessive body fats.
This essay presents an in-depth analysis of the current literature concerning the issue of overweight and obesity in adolescents. In this age-group, the prevalence rates of overweight and obesity have increased significantly in the last two decades due to the increased number of individuals leading sedentary lifestyles, lack of physical activity, and increased intake of high-energy foods and drinks among others. In addition, a thorough examination of the etiology of overweight and obesity in adolescents is provided. Finally, the essay analyzes the treatment modalities aimed at encouraging weight-loss, lifestyle changes and physical activity among the obese adolescents.
Overweight and Obesity in Adolescent
The Prevalence rates of Overweight and Obesity
The importance of measuring the prevalence rates for overweight and obesity among the adolescents is that it provides a clear picture of the prevailing conditions and influences the medical care and intervention measures. In addition, the intervention measures taken at the adolescent stage are helpful in combating the major illnesses associated with obesity and the death rates at adulthood [4]. As indicated earlier, the prevalence rates of overweight and obesity in adolescents is increasing in both the developed and developing worlds [1]. Research studies indicate that over 10% of adolescents aged 11-17 years are overweight in the world. Moreover, approximately 2-3% of adolescents in the world are obese [2, 5]. Globally, the prevalence rates of obesity range from 10% in Africa to more than 20% in most western countries such as USA and other European countries [6]. For instance, in 1999, the prevalence rate for obesity in adolescents aged 11-19 years old was 14% in the United States. However, recent studies indicate that the rates tripled by the year 2007 [7]. Additionally, the incidence rate of overweight adolescents aged 11-18 years in Australia was 11.6-20.0% and 14.7-17.2% for boys and girls respectively in the year 1995. In the same year, the rate of obese adolescents (11-18years) was 3.7-6.8% and 4.4-6.3% for boys and girls respectively in Australia. By the year 2007, the prevalence rates for overweight and obesity had increased considerably for both boys and girls [7, 8].
From the above statistical data, it is notable that the number of overweight adolescents is higher than that of obese adolescents. Moreover, the number of overweight and obese adolescent boys is greater than that of adolescent girls. Considering that overweight individuals have a 70% probability of experiencing obesity, it is worth noting that the higher number of overweight adolescents indicated above will probably become obese with time. Besides, there is a probability of 80% for adolescents of obese parents becoming obese themselves [7, 9]. Furthermore, research studies indicate that obesity persists systematically from childhood and adolescence to adulthood. Unsurprisingly, these studies indicate that there is a direct relationship between high body mass indices (BMI) in adolescents and the increased tendencies of developing obesity at adulthood. For instance, adolescent girls aged 11-20 years with a BMI that falls within the 95th percentile have a 40-60% probability of becoming obese in their adulthood. On the other hand, adolescent boys aged 11.5-17 years have a 40-60% probability of becoming obese in adulthood. However, the rates are much lower in adolescents with BMIs lying within the 85th percentile [10].
Consequently, overweight and obese adolescents have an increased probability of developing a number of deleterious complications such as type 2 diabetes mellitus, heart diseases, hypertension, and a variety of cancers. Moreover, adolescents who are overweight or obese experience a number of consequences such as social discrimination, depression, anxiety, and low self-esteem among other psycho-social problems. Additionally, the increased amount of body fats leads to major changes in the physiological functions of the body of an obese individual and predisposes this person to a variety of health complications such as cardiovascular diseases, asthma, orthopedic complications, and liver problems. In addition, the long-term consequences of obesity in adolescence have varied financial implications on public health services [11].
Measurement and Assessment of Overweight and Obesity in Adolescents
Accurate assessment of obesity in adolescents entails measurement of the body mass index and the use of the CDC 2000 charts for growth, which rely on percentile distribution patterns. Many healthcare professionals prefer the BMI measurement method in determining obesity in children and adolescents aged 2-19 years [12]. Under this method, the weight to height ratio is determined in order to give the body mass index of an individual in kg/m2. This method is the easiest and most appropriate in determining the percentage body fats particularly at the upper extremes such as the 85th and 95th BMI percentiles [13]. Thus, adolescents with a BMI of 30kg/m2 or ≥ 95th percentile are referred to as being overweight. Meanwhile, individuals with BMIs above this level are obese. On the other hand, adolescents whose BMI values lies between the 85th -95th percentiles are referred to as being at an increased risk of becoming overweight. Moreover, other methods for measuring BMI apart from direct calculations include determination of the BMI values from nomograms and automated BMI calculator programs available online [14].
Besides the BMI measurements, obesity in adolescents is assessed using other alternative methods such as measurement of the skin-fold thickness, which utilizes standardized calipers for measuring fats under the skin in the subscapular, triceps, and suprailiac regions. This method is very effective in determining the total fats in the body of adolescents. Moreover, integration of this method with certain standardized regression models provides a wide range of information that cannot be provided by the weight and height measurements. Additionally, determination of body fatness and the potential health risks of obesity can be determined by measuring the waist circumference in adolescents. This is because; accumulation of the dense adipose tissue around the waist is associated with increased incidence rates of cardiovascular diseases and other metabolic disorders [15].
Etiology of Overweight and obesity in adolescents
From the discussions above, obesity is defined as the excessive accumulation of body fats as a result of unbalanced energy intake and expenditure over a long period of time [2]. The ever-increasing rates of overweight and obesity can be attributed to a number of causative factors as discussed below:
Limited or Lack of Energy Balance
Energy balance entails striking a balance between energy in-take and energy expenditure, that is, the two should be equal. Energy intake comprises of the total calories an individual obtains from food and drinks [16]. On the other hand, energy expenditure consists of the amount of energy the body utilizes in the process of being physically active, digesting, thinking, and breathing among other activities. Balancing energy intake and expenditure occurs over an extended period of time and it enables the body weight to be constant. However, many overweight and obese adolescents consume large quantities of calories than their body can utilize [16].
Lack of physical activity
Besides consuming large amounts of calories than the body can handle, many adolescents especially those in developed countries such as USA and Australia lead sedentary lifestyles characterized by limited physical activities [16]. Studies indicate that in Australia, over 96.9% of Adolescents watch TV and an additional 68.9% play computer games as part of their leisure activities. In addition, most adolescents especially girls experience high levels of inactivity as they develop into adulthood [17]. Additionally, overweight and obesity arises as a result of using cars regularly rather than walking, lowered energy demands while working due to technological changes, and lack of physical education curricular for school-going adolescents. Consequently, lack of physical activity leads to weight gain and increased risk of hypertension, colon cancer, coronary heart diseases, and diabetes among other health complications [17].
Environmental factors
These are factors that occur in the immediate surrounding of adolescents such as overpopulated neighborhoods lacking sidewalks, recreational facilities and recreational spaces, which makes hard for individuals to be involved in physically activity. Besides, availability of numerous eateries in the neighborhoods implies that the adolescents are accessible to large quantities of food rations. Some of these food rations include snacks and fast foods, which are high in fats and energy [18]. Thus, consumption of these foods leads to weight gain supported by lack of physical activity. Furthermore, many restaurants and supermarkets selling healthy foods are expensive thereby denying most individuals the opportunity to access them. These individuals opt to consume junk food to save on cost.
Genes and family History
Overweight and obesity runs down the family lines and studies have shown that genes can strongly influence weight changes. For instance, if one or both parents are obese, the probability of their children being obese is 70-80%. The genes also influence the pattern of fat deposition in an individual’s body. Moreover, because most families share the same foods and influence each other’s physical activity, there is a strong relationship between environmental factors and genes [19]. Finally, other risk factors in overweight and obesity include health conditions such as Cushing’s syndrome and hypothyroidism. Some medicines, smoking, emotional stress, age, lack of sleep and pregnancy can lead to weight gains [19, 20].
Overweight and Obesity Treatment Modalities
The first step towards achieving successful treatment of overweight and obesity entails devising specific goals and objectives that aim at weight-loss and lifestyle changes [21]. This also entails consumption of low energy food rations and implementation of increased physical exercises. The key aspects of these strategies are as outlined below:
Weight-loss Strategies
Weight-loss among overweight and obese adolescents is highly dependent on active familial involvement in instilling behavioral change in the teens. For overweight or at-risk of overweight adolescents, the major treatment strategy entails maintaining the current weight of an individual alongside encouraging physical activity and healthy eating in this person. Otherwise, for those adolescents with health complications associated with overweight and obesity, it is imperative to seek proper medical attention [22].
Lifestyle Changes
This entails weight-loss strategies that will last for an extended period of time and requires that the family and the patients be actively involved in activities aiming at cutting weight and healthy living. This includes striking a balance between energy in-takes through controlling the quantity of food and drinks consumed and energy expenditure through active involvement in physical activities. Furthermore, obese individuals should be encouraged to follow a healthy eating program. At last, continuous adoption of a healthy eating and living plan will translate into a daily routine that can guide weight-loss [20, 23].
Low Energy In-take
This entails cutting down on the amount of daily calories that an individual consumes. For obese adolescent girls, consumption of 1000-1200 calories per day is sufficient to guarantee weight-loss. On the other hand, adolescent boys suffering from obesity should consume 1200-1600 calories per day in order to safely lose weight. Furthermore, obese individuals should develop a healthy eating plan, which ensures that the body gets the nutrients it requires per day while avoiding excessive consumption of large quantities of food [24].
Physical Activity
Physical activity coupled with low-energy intake enables an individual to lose weight besides lowering the risk of heart attack, cardiovascular diseases, diabetes and certain types of cancers. Additionally, physical activities enable obese individuals to lower the degree of bone loss and strengthen the heart and lungs. The most basic physical activity recommended for obese individuals include aerobics, stretching, bone strengthening, and muscle strengthening [20, 21].
Other Treatment Interventions
Besides weight-loss and lifestyle changes, obesity can be treated using weight-loss medicines such as Sibutramine and Orlistat. Other medicines used include those treating depression, seizures, and diabetes. Furthermore, under certain circumstances, obese patients may require weight-loss surgery particularly for extreme cases where treatment and other interventions have failed [20].
Conclusions
This essay presents an in-depth account on the issue of overweight and obesity in adolescents. Furthermore, it discusses the prevalence rates of the condition among the adolescent age-groups in the world relative to their significance in influencing other health-related complications in the adulthood stage. Moreover, the essay explores the etiology and the treatment modalities for overweight and obesity in adolescents.
From the above discussions, it is notable that the prevalence rates of overweight and obesity are increasing considerably in both the developing and the developed worlds. This is attributable to the ever-increasing technological and improved transport systems that require less energy in accomplishing tasks that otherwise consume large amounts of energy under normal circumstances. Furthermore, the increased rates are associated with the sedentary lifestyles and consumption of large amounts of foods and drinks, which are high in saturated fatty acids and energy. Other factors influencing the rates include the genes and family history, which play a major role in influencing the lifestyle and eating habits of adolescents.
However, a variety of treatment modalities are in place which entail encouragement of weight-loss, consumption of low-energy foods and drinks, lifestyle changes, physical activity, and pharmacological interventions, which guarantee weight-loss among the obese adolescents. Besides, individuals experiencing extreme cases of obesity have the opportunity of undergoing weight-loss surgical procedures to lose the additional fats. Obesity is a serious health condition that leads to other health complications such as cardiovascular diseases, certain types of cancers, and diabetes among others. Besides, the condition leads to both physical and psycho-social complications, which can have far-reaching implications on the patient’s body and health. Therefore, it is imperative to encourage the adolescents to practice healthy eating and living strategies coupled with physical activities in order to avoid the deleterious implications associated with overweight and obesity.
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