Childhood obesity is a significant concern for public health in contemporary society. Approximately one-third of children are impacted by obesity or overweight during the later stages of elementary education, with severe obesity reaching its highest point (Rudolf et al., 2019). According to the World Health Organization (WHO) estimates, more than 60 million children were recorded overweight in 2018 (Wadden & Bray, 2019). The persistence of extremely high body mass index from childhood into adulthood accelerates non-communicable diseases and reduces the affected individuals’ life expectancy. Some of the health constraints children who are obese suffer from include neurological, endocrine, pulmonary, gastroenterological, and orthopedic disorders.
Obesity or overweight in children is attributed to the family’s socio-economic factors, including gender, parental weight, and lifestyle, such as feeding behavior. School-age children who are obese are predisposed to cardiovascular health complications, sleep apnea, and type 2 diabetes due to body tissues’ unresponsiveness to self-produced insulin. Moreover, childhood obesity is attributed to psychological stress and poor school performance (Rudolf et al., 2019). Health professionals are employing different strategies to circumvent obesity and the problems linked to it. For instance, medical experts examine the consequences of overweight on mental and social health among school-age children (Wadden & Bray, 2019). The treatment given to overweight children depends on the gravity of the condition.
Despite the efforts to alleviate global health from the stress of obesity during childhood, there is no clarity on the most reliable therapy to manage it. Currently, non-medical approaches, including changes in diet and physical exercise, and medical therapies such as pharmacotherapy and bariatric surgery, are being applied to remedy overweight problems. According to Wadden and Bray (2019), the combination of medical and non-medical treatments effectively alleviates obesity. However, no research evidence has shown that obese children with severe conditions do not respond to non-surgical intervention, leaving it contentious among health experts on the most appropriate therapy to mitigate overweight problems. This study will try to investigate the most effective way of treating obesity among adolescents and children.
Objectives of the Study
- To investigate the difference between medical and non-medical interventions used in managing diabetic school-age children.
- To identify the health effects of childhood obesity.
- To determine the relationship between obesity in children and an individual’s overall health as affected by non-communicable diseases.
Hypotheses of the Study
- There is no significant difference in the effectiveness of medical and non-medical interventions in managing diabetic school-age children.
- There are no health effects of being overweight during the childhood of an individual.
- There is no relationship between obesity in children and non-communicable diseases, which affects overall wellness.
Theoretical Framework
Health complications stemming from obesity cause the symptoms which yield discomfort to the overall health of an individual. On the other hand, nursing incorporates the practices to relieve patients from persistent and distressing signs of diseases. The theory of unpleasant symptoms focuses on attaining holistic health. Majorly, the clinical manifestations of illnesses are perceived in a broader perspective, with the central objective of exploring patients’ experience and general health conditions (Lenz & Pugh, 2018).
This study will ensconce the theory of unpleasant symptoms in evaluating the health status of children who are obese and determining the efficacy of the medical approaches aimed at mitigating obesity and related illnesses. The concept encompasses four aspects of health concerning symptoms: time, intensity, quality, and distress. Moreover, the factors associated with the signs are also considered: body physiological status, psychology, and prevailing situations in the patient’s life (Lenz & Pugh, 2018). Considering that obesity is directly linked to an individual’s metabolic processes and socio-economic status, the unpleasant symptoms theory concepts will be used in this study.
Applicability to Nursing
This study is significant not only for the nursing profession and health care field in general but also for people’s socio-economic welfare through policy implementation. Health professionals would apply the procedures aiming at alleviating overweight and associated complications after identifying the most effective treatment strategy for managing obesity in adolescents and children. The policymakers can also formulate and promulgate the laws which guide the treatment of obesity in school-age children to make their health better. Effective medication for type 2 diabetes in school-age children can also be guided through consistent efforts from all stakeholders, as will be indicated in the study results.
Literature Review
Obesity is one of the challenging health disorders all over the world. Being obese refers to having a high body mass index that equivalent to or exceeding 95 percent of sex and age (Fruh, 2017). When one is overweight at the age of 12, studies show that the chances of remaining obese till adulthood are high (Rudolf et al., 2019). According to Fruh (2017), obesity is a problem that needs to be given urgent clinical attention due to the effects it has on children’s daily lives. Diverse management concepts exist to mitigate childhood obesity; however, it is essential to have all treatment strategies at the family level to ensure that they are fit for child’s developmental needs. Moreover, it is necessary to understand that weight loss in childhood is a tedious and complicated process to undertake (Ruban et al., 2019). Health problems due to obesity are physical, psychological, and medical.
Multiple factors are linked to the development of overweight in children, and all the intervention techniques for mitigating it should focus on the predisposing agents. The major treatment options include behavior modifications, diet changes, and routine exercises to burn down calories. Studies have unveiled that strict diet regulations should be prescribed and monitored by health professionals since children require special nutrition for maximum growth (Ruban et al., 2019). Whether a child has genes that make him or her gain weight or is obese because of eating unhealthy food, a combination of lifestyle and medication if the conditions worsen is necessary.
Currently, the Drug and Food Administration has approved and recommended the drugs that can be Orlistat as the first-line medicine in treating obesity. However, some other drugs, such as metformin, have demonstrated promising results in treating obesity amongst adolescents. The lifestyle interventions can reduce the rates at which children gain weight and the deposition of fats. The remedies can also defer type 2 diabetes risk factors; however, their efficacy needs to be reliable.
Mendy et al. (2017) argued that exercises and eating dietary food are difficult to maintain amongst children and adolescents because they require supervision by the parents, caregivers, or teachers, which may not happen all the time. Although adult literature has shown that lifestyle changes reduce the lipid profiles, the pediatric literature does not demonstrate the same results.
Children who have been unable to lose weight through lifestyle methods should undergo weight loss surgery. One of those types of operations is bariatric, which is usually recommended by the primary doctor or pediatrician. The incision is mostly administered to children who have severe obesity, and the intervention is urgently needed. Studies have shown that the method is effective for children who have conditions associated with high blood pressure, sleep apnea, and diabetes (Kenney et al., 2017). The goal of the intervention is to reduce weight and the effects associated with it and produce the minimum risks possible.
Surgery is the choice of treatment after the other management options failed. Irrespective of the type of Bariatric surgery used, studies have shown that it is superior to other non-medical and medical interventions (Mendy et al., 2017). According to Mendy et al. (2017), a high degree of weight loss was recorded among the group that underwent the control group’s surgery. Improvement of morbidities associated with obesity was also observed, and there was a reduction. Additionally, the inquiries demonstrate that the surgery has long-term effects on diabetes resolution compared with other medical and non-medical methods (Hruby & Hu, 2015). Therefore, the treatment option has proved to be the most effective management strategy for diabetes and associate morbidities.
The American Academy of Pediatrics’ latest guidelines explains that the adverse effects of obesity shorten children’s lifespan. While doctors can help mitigate the effects of obesity in youngsters through lifestyle methods, the adjustments do not usually make significant changes to their lives for overweight young ones, especially those above 100 pounds. Therefore, there is a need to use other medical interventions with low risks and produce results quickly. The bariatric surgery’s complications are rare and insignificant, and they include the deficiency of micronutrients more, especially iron (Westman & Steelman, 2016). This problem can be easily alleviated by getting supplements to restore the body to its normal condition. Therefore, surgery is one of the most effective ways of treating obesity in children.
Methodology
Study Design
The quantitative research design will be considered for this study to achieve the set objectives. The methodology will identify different medical and non-medical interventions in managing obesity, and co-morbidities, including insulin-dependent diabetes among school-age children. Moreover, the research will quantify the impact of overweight among children and how it associates with holistic health. The criteria to be used in the methodology will ensure accurate observation of overweight in children (Mohajan, 2018). The implication of the collected data will be useful in determining the most effective medical and non-medical treatments for obesity among adolescents and pupils in elementary schools.
Sampling
Cluster sampling will be applied in this research to achieve the sample size needed. It will include 500 children aged between six and eight years old. Through systematic random sampling, schools will be assigned interventions and control conditions. Some of the selection factors will include the 6th-grade status in the fall of 2020 and the availability of weight, sex, and height information. These baseline statistics will be used to ensure that the sample size fits into the right criteria. Exclusion factors to be used include students’ inability to participate in physical activities or type 2 diabetes diagnosis. Systematic random sampling will be used for the research since it reduces errors when selecting the individuals participating in the research. The strategy will also give all schools equal chances of being included in the program.
Informed Consent and Ethical Consideration
The consent to participate in the study will encompass informing the target population about the research program. A clear explanation of the concept will be explained to the expected participants. The willing participants will be given informed consent to sign, including safety and compensation plans, in response to any risk that might impact their lives. Ethical permission to conduct the research will be obtained through the College Research and Ethics Committee Review Board, which will evaluate the intended activities concerning child health and the relevance of the study.
Data Collection
The study will employ a well-designed questionnaire and interviews to collect data from the children who are obese. The questionnaire will capture the patient’s health condition and seek information on whether they have diabetes or not. Moreover, it will evaluate the treatment measures taken to remedy obesity for the child over a specific time to allow for the need for the body mass index changes. The medical interventions will be separated from non-medical therapies, and the data will be analyzed inferentially using statistical tools to determine and compare their effectiveness. Interviews will be conducted with the children, with teachers and parents in their presence at the earlier stages to ensure that the study’s maximum output is achieved. Before data collection, informed consent for a child to participate in the study will be given by the parents or guardians and their learning institution’s head.
Data Analysis
Data analysis crowns the outcome as per the data collected for proper interpretation. The research will employ the variance analysis (ANOVA) analysis, and correlation analysis (Spearman’s Correlation test or Mann Whitney test) will be computed to test the hypothesis and significance level. The research will investigate the impact of medical and non-medical interventions on childhood obesity.
The number of patients will be the dependent variable, and the nature of medical interventions applied and their effectiveness as the independent variables. ANOVA will be used because it recognizes the characteristics of both independent and dependent parameters. The difference between the study’s variables will determine if they are related (Mohajan, 2018). The correlation will be comparable as it gives the critical relationship between the quantities measured in the study.
As stated in the introduction, the null hypotheses play an essential role in the outcome of the analysis. The section is vital as it brings more understanding of the study question’s metrics (Willmott, 2020). As per the ANOVA and correlation outcome, the researcher can either accept or reject any of the hypothesis forms at the set level of confidence. In this research, a significance of 5%, which is 0.05, will be applied. The level is important in the decision of accepting or rejecting the null. There is a minimal risk at a 5% significance level, which implies a higher confidence interval in the research. Therefore, it will be easy to eliminate any bias level during the study with 95% confidence.
Nature of the Results
The reliability of the results will be achieved by aligning the procedures for quantitative analysis with the study’s objectives. It will ensure that the research produces impactful outcomes with relevant interventions to implement in mitigating obesity. In this study, the researcher looks at the impact of medical and non-medical interventions on childhood obesity. Research by Lombardi et al. (2020) has affirmed that the intervention’s nature plays a major role in the treatment and management of obesity disorders. Therefore, the researcher will assess the correlation coefficient, and if it supports the null hypothesis, it will be accepted. Otherwise, the decision will be rejected.
References
Fruh, S. M. (2017). Obesity: Risk factors, complications, and strategies for sustainable long-term weight management. Journal of the American Association of Nurse Practitioners, 29(1), 3–14. Web.
Hruby, A., & Hu, F. B. (2015). The epidemiology of obesity: A big picture. Pharmaco Economics, 33(7), 673–689. Web.
Kenney, E. L., Wintner, S., Lee, R. M., & Austin, S. B. (2017). Obesity prevention interventions in us public schools: Are schools using programs that promote weight stigma? Preventing Chronic Disease, 14, 1–14. Web.
Lenz, E. R., & Pugh, L. C. (2018). The theory of unpleasant symptoms. In M. J. Smith, & P. R. Liehr (Eds.), Middle range theory for nursing (4th ed). Springer Publishing Company.
Lombardi, G., Ziemann, E., & Banfi, G. (2020). Whole-body cryotherapy: Possible application in obesity and diabesity. In P. Capodaglio (Ed.), Rehabilitation interventions in the patient with obesity (pp. 173−188). Springer.
Mendy, V. L., Vargas, R., Cannon-Smith, G., & Payton, M. (2017). Overweight, obesity, and extreme obesity among Mississippi adults, 2001-2010 and 2011-2015. Preventing Chronic Disease, 14, 1–9. Web.
Mohajan, H. K. (2018). Qualitative research methodology in social sciences and related subjects. Journal of Economic Development, Environment and People, 7(1), 23−48. Web.
Ruban, A., Stoenchev, K., Ashrafian, H., & Teare, J. (2019). Current treatments for obesity. Clinical Medicine, 19(3), 205–212. Web.
Rudolf, M., Perera, R., Swanston, D., Burberry, J., Roberts, K., & Jebb, S. (2019). Observational analysis of disparities in obesity in children in the UK: Has Leeds bucked the trend? Pediatric Obesity, 14(9), 1–7. Web.
Wadden, T. A., & Bray, G. A. (2019). Handbook of obesity treatment (2nd ed.). The Guilford Press.
Westman, E. C., & Steelman, G. M. (2016). Obesity: Evaluation and treatment essentials (2nd ed., pp. 195–203). CRC Press.
Willmott, H. (2020). On research methodology. The Journal of Organization and Discourse, 1(1), 1–4. Web.