Write the problem, etiology, signs and symptoms for the following scenario A 12
ID: 122683 • Letter: W
Question
Write the problem, etiology, signs and symptoms for the following scenario
A 12 year old girl comes to see the DTR at an outpatient clinic for help with weight loss. She is currently 59” tall and weighs 187#. She enjoys reading and watching TV, but she doesn’t get much physical activity. Both of her parents work outside of the home, so she spends a lot of time at home alone, where she is responsible for making her own meals. She tends to snack consistently after school on “junk” food and then fixes herself a frozen pizza or frozen meal for dinner. 1.
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Explanation / Answer
It may be a challenge to get your 12-year-old to eat healthy, but proper nutrition is essential for growth and development and peak performance in school. A healthy diet is about balance and variety.
The USDA recommends 1,800 calories per day for an inactive 12-year-old male and 1,600 per day for an inactive female. Physical activity will increase calorie needs. However, it is not recommended that a 12-year-old count every calorie consumed. At this age, the focus should be on making calories count by choosing nutrient dense foods. Foods such as fruits and vegetables are nutrient dense because they provide a lot of nutrition for very few calories.
Problems with overweight children:
• Overweight children are highly likely to end up being overweight as adults and to experience the health problems associated with adult obesity like type 2 diabetes, heart disease, gallstones, gout and sleep apnoea.
• Doctors have seen an increase in the number of children treated for type 2 diabetes associated with overweight, poor diet and lack of exercise. This is the type of diabetes that used to occur almost always in people over 50.
• Obese children are exposed to discrimination, ridicule, social rejection and isolation and can suffer low self-esteem and depression.
Etiology:
It is widely accepted that increase in obesity results from an imbalance between energy intake and expenditure, with an increase in positive energy balance being closely associated with the lifestyle adopted and the dietary intake preferences. However, there is increasing evidence indicating that an individual's genetic background is important in determining obesity risk. Research has made important contributions to our understanding of the factors associated with obesity. The ecological model, as described by Davison et al., suggests that child risk factors for obesity include dietary intake, physical activity, and sedentary behaviour. The impact of such risk factors is moderated by factors such as age, gender. Family characteristics parenting style, parents’ lifestyles also play a role. Environmental factors such as school policies, demographics, and parents’ work-related demands further influence eating and activity behaviours.
Genetics are one of the biggest factors examined as a cause of obesity. Some studies have found that BMI is 25–40% heritable. However, genetic susceptibility often needs to be coupled with contributing environmental and behavioural factors in order to affect weight. The genetic factor accounts for less than 5% of cases of childhood obesity. Therefore, while genetics can play a role in the development of obesity, it is not the cause of the dramatic increase in childhood obesity.
Basal metabolic rate has also been studied as a possible cause of obesity. Basal metabolic rate, or metabolism, is the body's expenditure of energy for normal resting functions. Basal metabolic rate is accountable for 60% of total energy expenditure in sedentary adults. It has been hypothesized that obese individuals have lower basal metabolic rates. However, differences in basal metabolic rates are not likely to be responsible for the rising rates of obesity.
Review of the literature investigates factors behind poor diet and offers numerous insights into how parental factors may impact on obesity in children. They note that children learn by modelling parents’ and peers’ preferences, intake and willingness to try new foods. Availability of, and repeated exposure to, healthy foods is key to developing preferences and can overcome dislike of foods. Mealtime structure is important with evidence suggesting that families who eat together consume more healthy foods. Furthermore, eating out or watching TV while eating is associated with a higher intake of fat. Parental feeding style is also significant. The author's found that authoritative feeding (determining which foods are offered, allowing the child to choose, and providing rationale for healthy options) is associated with positive cognitions about healthy foods and healthier intake. Interestingly authoritarian restriction of “junk-food” is associated with increased desire for unhealthy food and higher weight.
Government and social policies could also potentially promote healthy behaviour. Research indicates taste, followed by hunger and price, is the most important factor in adolescents snack choices. Other studies demonstrate that adolescents associate junk food with pleasure, independence, and convenience, whereas liking healthy food is considered odd. This suggests investment is required in changing meanings of food, and social perceptions of eating behaviour.
Signs and symptoms:
Childhood obesity can profoundly affect children's physical health, social, and emotional well-being, and self esteem. It is also associated with poor academic performance and a lower quality of life experienced by the child. These potential consequences are further examined in the following sections,
Being a little overweight may not cause many noticeable problems. However, once you are carrying a few extra kilograms (or pounds), you may develop symptoms that affect your daily life.
Health:
Obesity can cause day-to-day health problems such as:
• breathlessness
• increased sweating
• snoring
• inability to cope with sudden physical activity
• feeling very tired every day
• back and joint pains
• low confidence and self esteem
• feeling isolated
Obesity can also cause changes you may not notice, but that can seriously harm your health, such as high blood pressure (hypertension) and high cholesterol levels (fatty deposits blocking your arteries). Both conditions significantly increase your risk of developing a cardiovascular disease, such as:
• coronary heart disease, which may lead to a heart attack
• stroke, which can cause significant disability and can be fatal.
Another long-term problem that can affect obese people is type 2 diabetes. It is estimated that just under half of all cases of diabetes are linked to obesity. The main symptoms of diabetes are:
• feeling very thirsty
• going to the toilet a lot, especially at night
• extreme tiredness.
Psychological:
In addition to the day-to-day health problems, many people may also experience psychological problems. These can affect relationships with family members and friends and may lead to depression.
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