Comprehensive Programs and Approaches to Obesity Essay

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Comprehensive Programs and Approaches to Obesity Essay

The behavioral approach to obesity

Obesity now ranges among the most pressing health problems of contemporary developed societies. There are a lot of approaches allowing the affected group to deal with the issue. Within the behavioral approach to weight loss, there are three major paths to deal with the problem. Comprehensive Programs and Approaches to Obesity Essay. These are Operant Conditioning (OC), Classical Conditioning (CC), and Social Learning Theory (SLT). Operant Conditioning presupposes reinforcement of the right behavior (either positive or negative). Classical conditioning deals with stimulus effect (which presupposes satisfaction from having a healthy and slim body). Social Learning Theory claims that the behavior of patients suffering from obesity can be modified by their social environment.

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Implementation plan

Thus, considering all these methods, a comprehensive weight loss plan featuring a reinforcement schedule and learning sequence may look as follows:

Goal-setting
1. the behavioral objectives leading to the achievement of the ultimate goal must be identified (diet plan, exercise program, ways to deal with hunger, etc.) Comprehensive Programs and Approaches to Obesity Essay.
Operant reinforcement
1. rating of objectives and goals
2. praising favorable behavior in eating and exercising
3. introducing a system of bonuses for each completed task (according to its complexity and results attained)
4. strictly adhering to the system of punishments for each violation of the rules (negative reinforcement), which should manifest itself in additional exercising, not in food deprivation
Stimulus control
1. starting learning from controlling conditioned stimulus: eating at a fixed time using the same tableware; keep products out of sight in-between the meals; serve the required amount of food without helpings; distracting from other activities during meals
2. controlling unconditioned stimuli through favorable behavior (the amount of gastric juice produced by the stomach and provoking hunger at the sight of food can be reduced gradually due to the right eating habits)
Response Prevention
1. learning to wait 5-15 minutes even if the urge to eat is hardly bearable
2. using vicarious reinforcement (replacing the activity with another one)
3. substituting high-calorie products with light ones (eating vegetables or fruit instead of sweets) Comprehensive Programs and Approaches to Obesity Essay.
Changing of eating behavior
1. learning to eat slowly, biting small pieces and chewing slowly; making pauses between bites
2. using the other hand to eat to slow down the process
Monitoring
1. recording eating habits (place, time, the quantity of food eaten, etc.)
2. monitoring weight changes
3. keeping track of the implementation of the program
Acquiring useful social skills
1. trying to refuse all the offers of food when it is not time to eat
2. introducing healthy habits in the family to support each other to increase self-efficacy
3. learning not to eat out of politeness
Cognitive transformation
1. learning to encourage yourself, especially in cases when you feel down and depressed and is about to quit the weight loss program because its effect seems questionable
2. learning to recognize and prevent situations in which you want to eat out of stress, boredom, excitements, and for other reasons not connected with real hunger
3. increasing self-esteem through constant improvement of your style, image, perception of the body, etc.; learning to love yourself and your achievements
4. forgetting how to compare yourself with others to avoid negative associations
Training to prevent future relapses
1. learning to predict risks associated with internal or external reason and learning to prevent or handle them
2. not quitting the weight loss program even if the weight starts fluctuating and some gains happen
3. learning to deal with stress with the help of exercising instead of eating more.

Overweight and obesity have instituted numerous health complications that has risen steadily over the last two decades. For example, recent data shows that adult overweight and obesity in most European countries has risen alarmingly, with 27% and 38% of men and women respectively considered to be obese (Sallis & Glanz 2009, p.128).

Even children are not spared, with statistics showing that 27% of UK children overweight and that there is increasing number of children with type 2 diabetes signifying obesity (NICE 2006, p.90).

Australian study found out that slightly more than a half Australians adults and a quarter of Australian children are either overweight or obese, resulting to numerous health and economic consequences such as diabetes, morbidity and mortality, and the estimated financial cost of $3.8 billion, with a further $ 17.2 billion in non-financial costs as a result of lost wellbeing (Wilson, Watts, Signal & Thomson 2006, p.2156). The paper outlines and critically analyses the population based strategy as a method of managing and preventing obesity used in United Kingdom.

Introduction

The global health complications associated with overweight and obesity problems has risen steadily over the last two decades, a significant justification that the global obesity has risen exponentially over this period. For example, recent data show that adult overweight and obesity in most European countries has risen alarmingly, with 27% and 38% of men and women respectively considered to be obese (Sallis & Glanz, 2009, p.128). Comprehensive Programs and Approaches to Obesity Essay.

Approximately 46% of men and 32% of women in England have a body mass index between 25 and 30 kg/m2, therefore considered overweight, and further 17% of men and 21% of women have body mass index of more than 30 kg/m2 implying obesity (House of Commons Health Committee, 2004, p.78).

Underestimated as a serious cause of ill-health, obesity’s steady rise in prevalence has caused many problems in England, where the overweight prevalence has risen by over 50% in the past two decades and obesity incidences has even trebled (National Audit Office 2006, p.65).

Even children are not spared, with statistics showing that 27% of UK children overweight and that there is increasing number of children with type 2 diabetes signifying obesity (NICE 2006, p.90). Between 1995 and 2002 alone, there was a double increase in obesity between boys aged 2 and 15, representing a rise from 3% to 6%, and obese girls increased from 5% to 9% (Penny Gibson et al. 2003, p. 88).

A survey conducted in Hong Kong was even more astonishing, indicating that 38% and 57% of boys and girls respectively between the age of 9 and 12 were obese, with body mass index exceeding 95^th percentile (Grundy 2004, p.557). Comprehensive Programs and Approaches to Obesity Essay.

More research revealing that obesity is highly associated with diabetes is even more worrying to the health professionals and the society as a whole, with the Hong Kong findings revealing that both obese children showed higher systolic blood pressure, triglyceride, and insulin and lower HDL cholesterol more than the average weight (Grundy 2004, p.557).

Another recent data in Australia showed that slightly more than a half Australians adults and a quarter of Australian children are either overweight or obese, resulting to numerous health and economic consequences such as diabetes, morbidity and mortality, and the estimated financial cost of $3.8 billion, with a further $ 17.2 billion in non-financial costs as a result of lost wellbeing (Wilson, Watts, Signal & Thomson 2006, p.2156). These global statistics indicate that obesity is ha no physical boundary and what happens in one country can happen in another country.

What causes obesity?

Although experts agree that there is the connection between genetics as well as biological factors in the obesity prevalence, it is universally acknowledged that there are some behavioral risk factors such as diet and physical activity, which nonetheless are the major causes for obesity (Sigal et al. 2006, p. 43).

The environmental factors such as lack of access to grocery stores, increasing cost of healthy foods, and inadequate play grounds limit the possibility of healthy lifestyle among the people in modern society (Hill & Peters 1998, p.280; Minkler 1989, p.59).

Furthermore, the more sedentary lifestyles prompted by the modern working conditions have pushed the possibility of good exercise at the periphery of the work programs, thereby aggravating the obesity epidemic in the UK major cities(Story et al. 2005, p.231).

Strategies for controlling obesity

Considering the consequences of obesity, efforts to understand the best ways to prevent it are still the priority number one for health experts and government of UK. There have been numerous separate strategies designed to control obesity based on parameters associated with medical, scientific, social, and economical criteria (Tones & Tilford 2001, p.159).

The strategies have been separate because of the cultural and linguistic diversity that exist among the communities of the world.

There is published evidence showing that the intensity of the chronic disease as well as exposure to attendant risk factors is unevenly distributed among the ethic groups in the United States (Trayhurn & Beattie 2001, p.657).Comprehensive Programs and Approaches to Obesity Essay. This paper critically analyses the population based strategy for obesity control and management in the UK, considering the past and present studies related to the epidemic.

Population-based promotional strategies

The population- based promotion control is a common strategy to control obesity (Leddy 2006, p.676). In this section of the paper, I will critically look at the population-approach strategy in relation to childhood obesity. As early stated, children and adolescent obesity has dramatically increased exponentially over the last years.

However, the definition for childhood obesity has posed a great challenge to medical fraternity, with some experts simply referring to it just as “an excess of body fats” (Wilson et al. 2006, p.137). But all the frequently used definitions use body mass index as a point of reference to make the variations.

Pi-Sunyer (1993, p.31) states that although BMI is a useful and feasible parameter outside the realm of scientific research for identifying overweight children and adolescent, it is not an accurate measurement for excess depository, normally referred to as the excess accumulation of lipids in a body site or organ.

Another method of identifying and monitoring obesity in children and adolescent is through the measurement of skin-fold thickness (Grundy, Brewer, Cleeman, Smith & Lenfant 2004, p.436)

5^th– 85^th percentile BMI is taken normal, 85^th to 95^th percentile BMI is at risk of obesity, and more than 95^th BMI percentile is considered obese (Trayhurn & Beattie 2001, p.12). What actually causes obesity in children? Even its causes are said to be complex, obesity is associated with imbalance in the intake of energy and body expenditure (WHO 2002, p.51). Comprehensive Programs and Approaches to Obesity Essay.

One study found out that children’s BMI is related to adiposity in adulthood and that “overweight children had a greatly increased risk of becoming obese adults” (Freedman, Khan, Serdula, Dietz, Srinivasan, Berenson, 2005, p.412).

Childhood school interventions

To respond to the alarming rise in obesity, the UK government proposed several intervention strategies, setting the public service agreement targets in the year 2004. According to National Audit Office (2006, p.3), with the main objective being to halt the obesity cases in children under the age of 11, several government departments comprising of health, culture, Media and sport, and education departments were outlined as the key stakeholders.

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This was after identifying key problem in obesity management among the children population in the UK that is diverse socially, ethnically and economically, and thus the need for a “multi-agency coordination” together with partnership for success.

This intervention focused on the diet improvement and addition of more physical activities among the population’s schedule, thus the inclusion of parental participation that was considered to be very important (NICE 2006, p. 7)

According to Seidell, Kahn, Williamson, Lissner & Valdez (2001, p.675) schools in England and any other country provide opportunity to offer a proactive approach to obesity management in a positively proactive, broader, and more cost effective. They highlight that schools provide critical intervention base since the disadvantaged group can be reached at ease (p. 676).

Furthermore, schools have a great influence on the children in terms of promoting a healthy diet, physical activity and other healthy behaviors (WHO 2002, p.12).Comprehensive Programs and Approaches to Obesity Essay. However, there is little evidence that supports such multifaceted approaches like the school- based intervention strategy according to the meta-analysis of the applied strategies (Campbell et al. 2002, p. 2).

The analysis revealed that the approach that targeted both parents and their children had “mixed reviews in terms of success and evidence” that was rather inconclusive in relation to the strategy effectiveness (p. 8).

Furthermore, Bracht (1999, p.2786) and Teague (1987, p.123) had earlier refuted the claim of success of such strategies by stating that even a Cochrane review produced no supporting evidence to the child obesity management strategies, citing limited data on BMI reporting, lack of process indicators, and lack of sustainability and ability to generalize results as the main barrier to the success of the strategy.

For the success of this process, the design should be made with some specific information about the target audience, children and adolescents in this case (Sim & Mackie 2009, p.49). They state that this process should identify some specific issues considered to be critically important for children and adolescents, considering their “social and cultural values, incentives and disincentives” (p.58).

It’s therefore advisable to identify and emphasize on factors that will increase their attention, motivation and participation, and most importantly, when making decisions.Comprehensive Programs and Approaches to Obesity Essay. “Obesity intervention education in schools should discuss the environmental and socio-cultural factors that contribute to obesity, such as levels of physical activity, the selection of healthy food options at home and school, the impact of television fast-food advertisements, attitudes, perceptions, beliefs around food, intake of energy-dense nutrition and sedentary child entertainment activities” (Cheung 2007, p.453).

Another controlled evaluation study on the impact of nutritional education to reduce the consumption of carbonated drinks among school children between the ages of 7 and 11 in England (James, Thomas, Cavan & Kerr 2004, p.459). The component of the intervention entailed one-hour lesson, conducted three times a week by a trained personnel assisted by teachers, who would reiterate the same message in their later lessons in class.

The sessions dwelled on promoting drinking water or diluted fruit juice and tasting fruit to establish natural sweetness, music competition, and quiz (James et al., 2004, p. 1237). The students were encouraged to compose songs with positive message and were exposed to all information from the project website (Lucas & Lloyd 2005, p.876).

The evaluation team assessed the situation after twelve months and there were no significant difference in the interventions and the control classes. However, the intervention group reported the reduction in soft drink consumption after just three days, in contrast to the controlled group who never participated in the program (Lucas & Lloyd 2005, p.877). Comprehensive Programs and Approaches to Obesity Essay.