Michael A. Pizzi; Promoting Health, Well-Being, and Quality of Life for Children Who Are Overweight or Obese and Their Families. Am J Occup Ther 2016;70(5):7005170010p1-7005170010p6. doi: 10.5014/ajot.2016.705001.
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© 2018 American Occupational Therapy Association
Obesity is a complex, multidimensional challenge that compromises occupational participation for children and families. Children who are overweight or obese are at serious risk for being stigmatized, bullied, or marginalized, and they often are medically compromised. They cope daily with occupational participation issues at home, in school, on playgrounds, and in their communities. Prevention and health promotion assessment and intervention in occupational therapy are imperative for the profession to make a significant and sustainable difference in the lives of these children and families. Innovative client- and occupation-centered programming promotes health, well-being, and quality of life for this population. It is incumbent upon occupational therapy practitioners to prevent occupational marginalization, deprivation, and alienation while promoting occupational justice for children who are overweight or obese.
The obesity epidemic is a societal need to address, as it affects occupational needs of individuals, communities, and populations. The epidemic also affects the health of individuals and communities in many areas: social, physical, psychological, spiritual and economic. As a profession, we have an unfolding and expanding opportunity to develop solid, evidence-based and scientific strategies to intervene with individuals and communities coping with the childhood and adult obesity epidemic from a prevention and health promotion perspective. (Pizzi, 2013, p. 81)
High blood pressure and high cholesterol, which are risk factors for cardiovascular disease (CVD). In one study, 70% of obese children had at least one CVD risk factor, and 39% had two or more.
Increased risk of impaired glucose tolerance, insulin resistance, and type 2 diabetes.
Breathing problems, such as sleep apnea and asthma.
Joint problems and musculoskeletal discomfort.
Fatty liver disease, gallstones, and gastro-esophageal reflux (i.e., heartburn).
Psychological stress such as depression, behavioral problems, and issues in school.
Low self-esteem and low self-reported quality of life.
Impaired social, physical, and emotional functioning (para. 13).
In occupational therapy, a thorough evaluation of a child, including contextual factors (i.e., family and school) is critical because the transaction between children and environments in which they live and engage in play, learning, and other everyday activities significantly influences their development and health. . . . A systems perspective offers a lens through which there is inclusion of quality of life, health, and contributory factors that impede or support participation and occupational performance. (Pizzi & Vroman, 2013, pp. 103–104)
Consultation with schools regarding the promotion of physical activity, play and recess, and positive mental health for all children;
Creation of systemwide programs that incorporate movement, nutrition, and healthy routines;
Development of culturally specific occupation-based educational strategies that can be implemented in schools and communities to help children maintain healthy weight; and
Diversity training for students and teachers to eliminate bullying behaviors and weight bias.
Educate families and youth, in fun and interesting ways, about the body and its systems and about how increasing physical activity and nutrition makes the body stronger for occupational engagement;
Use positive messages about making water a more desirable and interesting option than fruity and sugar-added juices during breaks, and educate families about the health benefits of water; and
Develop family education sessions, individual treatment sessions, and community-based workshops that educate through activity.
Implement comprehensive programs that promote the intake of healthy foods and reduce the intake of unhealthy foods and sugar-sweetened beverages by children and adolescents.
Implement comprehensive programs that promote physical activity and reduce sedentary behaviors in children and adults.
Integrate and strengthen guidance for noncommunicable disease prevention with current guidance for preconception and antenatal care to reduce the risk of childhood obesity.
Provide guidance on, and support for, healthy diet, sleep and physical activity in early childhood to ensure children grow appropriately and develop healthy habits.
Implement comprehensive programs that promote healthy school environments, health and nutrition literacy and physical activity in school age children and adolescents.
Provide family-based, multicomponent, lifestyle weight management services for children and young people who are obese. (pp. viii–xi)
Develop and implement family-centered care and education for families with parents and children who are overweight or obese.
Interweave health promotion and prevention throughout all occupational therapy curricula related to obesity and healthy weight management.
Create school-based occupational therapy interventions that meet the individualized education program and health and wellness needs of children who are obese or overweight.
Create multilingual and culturally appropriate educational materials, in clear and understandable language, that explain the direct link between obesity and academic achievement.
Develop fun and engaging community-based, occupation-centered after-school programs that enable physical activity and healthy food choices, some of which could also be family centered.
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