By: Jennifer L. Long, RN, NCN
Obesity is an eating disorder and it is affecting our childhood population at an alarming rate. It shows no prejudice in any part of our country. There are two needs for why we eat; one is a physiological need to sustain energy and nutritional requirements, and a psychological force that drives our eating behaviors. The question is, what motivates children to consume healthy foods and can early behavior change improve the present and future health outcomes for today’s children?
According to the Theory of planned Behavior and the Health Action Process Approach, behavior follows directly from a conscious decision to act. This summarizes beliefs around the favorability and controllability of action (Gardner, 2011). There are theories that suggest that behavior can occur through different routes that can compete with each other. One is a deliberative route, which involves previous thought and cognitive effort. The other is the automatic route, which is defined by environmentally cued responses that require no effort and are completely involuntary. Habits are considered learned behaviors that occur with repetition and over time become automatic responses. If habits are a result of learned behavior, children who have developed poor eating habits learn such behavior from influences in their environment. Many factors can influence health behaviors of young children. According to the Social Cognitive Theory, cognitive and personal variables such as self-efficacy/ motivation, social/ environmental variables such as, poverty and limited access to health care, are all important determinants of health behavior. The Health Self-Empowerment Theory acknowledges the influence of social/ environmental variables as well as cognitive/ personal variables, on health-promoting behaviors. It also states that engaging in health-promoting behaviors and avoidance of health-risk behaviors are influenced by five empirically based, modifiable, self-empowerment-oriented variables; health motivation, health self-efficacy, self-praise of health-promoting behaviors, health knowledge and responsibility and active coping strategies and skills for managing stress and depression (Tucker, 2012). While eating and exercise are direct influences on weight, other psychological factors must be considered as indirect. “Depression might indirectly influence weight loss by increasing emotional eating behavior or by reducing dietary adherence (Stotland, 2005).” According to Tucker, out of those five theory variables, health motivation may be the most important in determining the potential for engaging in health-promoting behaviors.
If parents are unable to provide support as healthy examples, schools must step up and provide the education and facilitate a healthy environment to promote change. The goal is to provide early opportunities to promote healthy habits that continue into adulthood and decrease the prevalence of obesity and obesity related health issues, such as diabetes and heart disease. “Adolescent obesity has increased dramatically over the past several decades, with 34% of adolescents and young adults, ages 12 to 19 currently overweight or obese (Pbert, 2012).” School nurses are readily accessible and offer the skills and credibility to provide ongoing support to children at no extra cost. They are positioned to be an active role in the treatment and prevention of obesity. Healthy diet, exercise counseling and behavioral management training are all shown to decrease BMI in youth. In trying to identify other factors causing the rise in obesity, it is shown in the literature that loss of control (LC) is prevalent among overweight children and adolescents (Goossens, 2009). Recent studies have shown the relationship between negative emotions and loss of control, it is significantly related to symptoms of anxiety and depression in children and adolescents seeking treatment (Goossens, 2009). “The Affect Regulation Model proposes that individuals who lose control over their eating and start to binge believe that eating provides distraction and comfort from painful negative emotions (Goossens, 2009).” This model is what introduced what is now known as emotional eating and looks at this as a coping mechanism to regulate and decrease negative emotions. In children who suffer from anxiety, emotional eating may be a way of dealing with the hyper arousal they experience, where as depressed individuals, emotional eating may provide more positive emotions. “Early detection of LC and its emotional precedents can be of importance for the prevention and treatment of overweight and eating pathology (Goossens, 2009).” It is important to screen those seeking treatment for the presence of negative emotions and loss of control to ensure an adaptive and effective treatment plan.
I believe that parents are on the frontlines when it comes to setting a example of health-promoting behaviors. If there is lack of education equipping these parents with tools to help their children, it is community leaders and specialists left to provide the resources and availability to promote health and wellness.
“Transformation Begins With Nutrition”- Jennifer Long, RN,NCN.
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