Evidence to Guide Best Practice with Overweight School Age Children

Paper

Friday, 21 July 2006

This presentation is part of : Evidence to Guide Best Practice with Overweight Children & Adolescents

Diana L. Jacobson, MS, RN, CPNP, College of Nursing, Arizona State University, Tempe, AZ, USA

Childhood overweight and at-risk for overweight has increased dramatically in the last decade. While the physical health consequences of childhood overweight often do not manifest until adolescence, adulthood or decades later, the negative psychosocial consequences of childhood overweight unfortunately begin to occur during the school-age years. Overweight children demonstrate lowered self-esteem (feelings of self-worth), depressive symptoms, and decreased social competence (peer acceptance and interaction). Preventing and treating overweight in children and adolescents is a complex challenge for health care providers. In order to address the psychosocial ramifications of childhood overweight, intervention programs for the school-age child must address more than the intake of excessive calories and not expending enough energy through physical activity. Emotions and social adjustment are equally important.

The National Institutes for Health has recommended that intervention research focus on developing interventions that consider the child’s developmental age, childhood susceptibility to obesity, and the complications of childhood obesity, such as psychosocial and mental health problems. Initiating overweight interventions at a younger age is recommended because younger children have had a shorter time to develop poor eating habits. The child may be more open to cognitive skill building, and early intervention will take advantage of the rapid growth and increasing lean body mass that are an ongoing growth process in the younger child.A summary of the best practice recommendations, based on the evidence, of the effects of overweight intervention programs on the school-age child’s psychosocial health will be presented. The most successful of these programs for children, have demonstrated modest improvements in physical and psychosocial health and behavior. Specifically, the most comprehensive of those intervention programs have emphasized building cognitive behavioral skills (problem solving, goal setting, self-monitoring, behavior modification, and knowledge attainment), collaboration with a parent, diet modification, and an increase in physical activity.

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