"Childhood obesity has more than tripled in the past 30 years. The prevalence of obesity among children aged 6 to 11 years increased from 6.5% in 1980 to 19.6% in 2008. The prevalence of obesity among adolescents aged 12 to 19 years increased from 5.0% to 18.1%." As a physician and leaders in the community, it is on our shoulders to formulate a plan for prevention of childhood obesity.

Childhood obesity is not solely an issue which must be resolved by targeting the effected youth. A multifaceted approach must be used to implement the proper protocols and instill the appropriate values into society, which may then potentiate a healthy style of living. This will in turn translate into decreased rates of childhood obesity, and subsequently childhood illnesses and deaths. The medical and orthopedic implications of childhood obesity are shocking.



Atherosclerosis and heart disease pathology starts before and during adolescent years, and with the increase in childhood obesity, these are on the rise also. During childhood growth, those who are overweight and obese do not increase in their spinal bone mineral content in order to fully compensate for the excessive weight they bear. This care lead to spinal pathology as the child ages. Slipped Capital Femoral Epiphysis (SCFE) is a change in the normal anatomical relationship the femoral head has in relation to the femoral neck. This condition is more prevalent in obese children. Blount disease is a disorder if the skeletal system, which effects the medial side of the proximal tibial epiphysis. The result is a varus deformity of the tibia. It is clear the implications of childhood obesity are grave, but how do you solve these issues?

Legislative reform is key in this "multifaceted" approach in battling childhood obesity. One proposed method may include targeting educational facilities in regards to what food products are permitted to be sold in the cafeterias as well as in vending machines. It is clear if high fat, high sodium, and high carbohydrate ridden foods are cleared from the menus of schools, children will decrease their exposure to the pollutants of the body known as "junk foods". Going hand-in-hand with this legislation includes the idea to enact mandatory physical education and fitness hours in all schools from elementary to high school levels. This will ensure all children are receiving adequate levels physical activity. It must be engraved in law and executed by all schools that children receive a mandatory set amount of physical activity hours. Thus, all school age children will receive the benefits of physical fitness activities.

Forcing change onto children will only achieve minor levels of success. The hearts and minds of the children as well as parents must be won over in order to ensure long lasting success in obesity prevention programs. This can be achieved in part by sparking interest in health-minded foods and cooking. This can be done in part by allowing children and parents to take part in school sponsored trips (so called "field trips") to local farmers markets. Under the supervision of dieticians, various meal options can be discussed with parents and children. The children and parents may then be able to select meal ingredients together. These raw materials can be taken back to the classroom, in order to make healthy meals for the children and parents to share between each other. This interactive approach to health care will win the hearts and minds of both children and parents. Fun filled events which promote healthily meals will convince children healthy foods are fun and savory, and the parents may be converted into cooking healthy for their families. If the parents are not interested in nutritional meals, then the child will suffer. After all, much of a child's nutrition comes from the meals prepared and bought by parents. If the parents are not convinced to change their lifestyle, then the child will probably also suffer. This two pronged approach to ignite interest in both the parents and the children is key to success in the battle against childhood obesity

A cultural shift in the United States must occur in order to promote healthy habits in the youth and adult population. For example, fast foods should not be viewed as an acceptable replacement for a meal, and an overweight child should not be viewed as a "norm". For example, these engrained notions and images in our minds in reference to nutrition and body habitus have been deemed acceptable, and have perpetuated the lifestyle which has ranked the United States as the "fattest" nation on the globe. Professional athletes, celebrities, actors and musicians must preach the importance of a health conscious life-style. Movies and music should not promote unhealthy living such as alcohol, smoking, and drugs. The heroes in cinema and on television should not carry these negative attributes. Children should be able to look up to these individuals to set an acceptable standard for what is in society is considered normal. Changes in what is considered socially acceptable will motivate children and the parents to eat healthy and stay physically active.

It is clear there are many targets must be focused on during the battle against childhood obesity. The battle may begin in the halls of the congress and senate, but the war rages on in the cafeteria, dining rooms, movie theaters and radio stations, for both parents and children to view. The society as a whole must therefore be targeted to convert mothers and fathers as well as sons and daughters to adopt healthier lifestyles and prevent childhood obesity.

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