How to Overcome Obesity and Being Overweight Without Riduculous Financial Investments

All one needs to do is open a daily newspaper or turn on the evening news to find an article or newscast about the increase in the number of obese children; the decrease in their physical activity and attendance of Physical Education classes; increased consumption of fast and processed foods; and increased television and computer time. All of this is leading to a generation with poor health that may have a decreased lifespan and an inferior quality of life.

These reports put the spotlight on an epidemic and health crisis in this nation's children that is worsening every year. There is a call almost weekly to find viable solutions to obesity while the individuals affected are still young and, more importantly, before serious health conditions take root in them. Currently, federal and state governments are conducting research on obesity/overweight causes and prevention and are gradually developing and implementing treatment strategies. However, most of the responsibility still rests with the families of the afflicted children and the communities where they reside. These two entities need assistance to combat this epidemic. They need strong support to assist their overweight children as well as preventing it in the children who have not yet been negatively affected by the condition.

The Problem

The overweight and obesity epidemic has plagued this country's adults for the last two decades. What makes it more frightening is that now it affects the youth. Coupled with the increase in adult-onset diabetes and hypertension in children and the decrease in physical activity and active participation in physical education classes, the foundation for adulthood burdened with chronic diseases is being laid. There is a terrible need to retard and reverse the development of these health conditions in children before they reach adulthood because the "behaviors and the risks that children practice during childhood set the course for their health for a lifetime. Unless this course is changed, this generation of children is expected to live shorter, less healthy lives than their parents."(1)

These sentiments are echoed in the general public. The results of a survey, conducted by the Field Research Corporation (2) for the California Endowment, show that 92% California adults who were asked about their perceptions of the problems of obesity in children, contributing factors, and possible solutions consider the problem serious. Lack of exercise (44%) and too much fast foods and junk foods (42%) were cited as the main causes of obesity. The establishment of more recreational programs in their communities was supported by 96%. And more than half (53%) believe that a community approach is required to reduce the problem rather than leaving the problem to the child and family only. Sixty-three percent of African-Americans and 49% of Latinos agree.(2)

The Solution: Operation Wellness Camp

The creation and implementation of a health promotion and disease prevention summer (and at some point, a year-round) day camp for minority children aged 8-12 years through out strategic areas where children are most affected will help decrease this epidemic. Summer camps have been in existence for over a century and have played a large part in positive youth development. Research has shown repeatedly that camps increase the self-esteem, confidence, and independence; improve the social skills, behavior, and attitude; and develop the knowledge and motor and academic skills of its participants.

As a point of illustration only, this paper will concentrate on a camp hypothetically located in South Central Los Angeles, an area that is economically depressed, and whose residents are disproportionately affected by the adverse, chronic health conditions (i.e., heart disease, hypertension, diabetes, etc.) caused by being overweight and physically inactivity. The purpose of the project is to introduce children to and teach them about health promotion topics, specifically proper nutrition and exercise techniques. The camp should strive to lay a strong foundation for these children to begin to make decisions that will help them become healthier and maintain wellness. By the end of the summer, at least 80% of the children should demonstrate a better than average understanding of proper nutrition and better physical activity habits.

Healthcare Costs

The medical care costs of people with chronic diseases account for more than 75% of the nation's $1.4 trillion of medical care costs.(7) The estimated annual costs of certain conditions include: cardiovascular diseases - $300 billion; diabetes - $132 billion; overweight and obesity - $117 billion; physical inactivity - $76.6 billion; and smoking - $75 billion.(3,7)

Health Promotion and Disease Prevention Programs

The Centers for Disease Control and Prevention (CDC) is the leading federal agency for the development of a national strategy to combat obesity. It has a department called the National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) where these strategies are managed. The budget for this agency for fiscal year 2007, just under $818 million dollars, was cut approximately 9% from 2005. This budget equates to just $3 per person in the U.S., less than the cost of a fast food meal.(15) The Division of Nutrition and Physical activity, a section within the NCCDPHP, has a budget of just $41.5 million for fiscal year 2007.(15)

Comprehensive health promotion intervention programs make significant, positive changes in the behavior of children including increased physical activity and fruit and vegetable consumption; and improved eating habits, academic performance, and psychosocial functioning.(21) Research illustrates that "establishing healthy behaviors during childhood is easier and more effective than trying to change unhealthy behaviors during adulthood".(21) The results of a survey of California adolescents aged 12-17 years conducted by the Public Health Institute support this statement. This survey found that teenagers saw fewer barriers to healthy eating and exercise than did adults and that they have the potential to respond well to health promotion activities.(22) The results of the survey indicate that "interventions encompassing sustainable individual, educational, environmental, and policy changes can work together to reach [children and] adolescents in all facets of their daily lives within schools, the community, and their homes."(22)

There is a general consensus among several agencies that even though more research is necessary to determine the optimal method to combat obesity and inactivity in children, in the interim, programs must be put into operation to do the same.(15, 23) This is especially critical as the obesity epidemic in children is worsening and shows no signs of subsiding.

Components of a Successful Health Promotion Program

The main goal of any activity program should be to help children acquire the knowledge, skills, and attitude they need to have fun and develop life-long physical activity habits.(17) The following is a list of components of a successful program.

-Target minorities who live in high-risk, underserved, and low-income communities that make it difficult to sustain proper nutrition and exercise (10, 23)

-Provide information to children and their parents on the federal guidelines for nutrition and physical activity (10,16,23)

-Require participants demonstrate an understanding of fitness components by designing and implementing personal fitness plans (1)

-Help incorporate physical activity into children's lives by: exposing them to a wide range of fun activities that capture their interest and meet their needs; requiring goal-setting and self-monitoring of their physical activity; teaching skill-based activities that limits competition and builds confidence; providing structured problem solving; and providing methods to prevent and recover from relapses (1,17,24)

-Build social support in community settings by focusing on changing behavior through the buddy system and creating activity groups to provide friendship and support (24)

-Create or enhance access to facilities for physical activity by focusing on safe, inexpensive places that can be used during a convenient time of day for parents and children and offer active supervision (15,16,24)

Summer Camps

Summer camp programs provide almost all of the listed components of a successful health promotion program. They have been in existence for over a century and were created primarily to assist in positive youth development.(25) Their popularity, diversity, and number have increased tremendously over the years with the number of day camps for youth from high-risk communities is growing.(26)

Research has shown that attending camp has several positive outcomes for youth. These include increased self-esteem and confidence; acquisition of knowledge, skills, and abilities; improved behavior, attitudes, independence, and sense of security; physical, social, and spiritual growth; development of networks of support (27); improvement of social interactions; and appreciation of people who are different than themselves.(26) Campers report that they feel free to find out who they are and they feel the best about themselves when they are given the chance to establish their independence as well as to be part of a team.(26) Campers often feel that what they learn at camp will help them in other areas of their lives.(26) Because camps are not inherently beneficial, the above-mentioned results usually are generated from camps that intentionally and deliberately program these items into their strategic plan.(26)

Positive youth development is determined by camps that have a strategic plan in place that provided the overall structure for the camp as well as consistent, supportive interaction between campers and the staff.(25,28) In addition to contact with trained personnel, the programs that are most successful and have the best outcomes have a structure that is well-designed, is developmentally appropriate, gives opportunities for acquiring and improving skills, assesses results, requires accountability, and is physically and psychologically safe.(25,28)

A study that evaluated the effectiveness of a 4-H (head, heart, hands, health) camp indicated that the vast majority of the campers and their parents thought that camp was a positive and valuable experience, was extremely enjoyable, and provided many constructive learning experiences that would help them in their lives in the future.(29) The parents in this study stated that they noticed an improvement in their child's self-confidence and almost all stated that they were glad they sent their child to camp.(29)

A study conducted to examine the effects of camps programmed with the specific intention of teaching diabetes management among adolescents with type 1 diabetes found a favorable outcome. Researchers strategically targeted camper's sense of competence, autonomy, and relatedness. The staff was well equipped with training that focused on autonomy support which facilitated these outcomes. Results of this study led to two additional indications: 1.) that competitive focused activities might hinder opportunities for camper self-reliance, and 2.) camper-centered rather than leader-centered instruction appeared to be a more effective approach regarding autonomy support.(30)

The Project: Operation Wellness Camp In Detail

The project, "Operation Wellness Camp" is the creation and operation of a 10-week interactive health promotion summer day camp for minority children aged 8-12 years. The camp will be held from the third week in June 2007 through the last week in August 2007. This camp, (the first of many) located in South Central Los Angeles, will serve an economically depressed community whose residents are primarily African American and Latino. It will firmly address the conditions that contribute to the chronic diseases that disproportionately affect this population.

The camp will provide information on a wide range of methods and activities for improving wellness. These methods will focus on better eating habits and proper exercise. Other areas that may be touched upon include personal safety, tobacco use, and stress relief. The children will be involved as active participants who are given guidance in the best ways to create a healthier lifestyle for themselves. To this end, training the campers in techniques needed to acquire better health habits will be intentionally programmed into the strategic plan of the camp. What makes this camp unique is the fact that campers will design their own personal health promotion plans under the guidance of their instructors.

There are Boys & Girls Clubs, YMCAs, and the Parks and Recreation Department but no health promotion camps in the target area. This camp will distinguish itself from these organizations by its steadfast commitment to the development of health promotion behavior of its campers. The children who participate in this camp will be given more individual attention than they may be accustomed to getting which is expected to be beneficial.

While the program will assist those children who are currently overweight and obese, it will not be limited to them. All children will be invited regardless of their weight. The reasoning behind this is the fact that while fewer than 20% of children currently are overweight, this rate balloons to about 67% of adults. This means that those children who are not overweight or obese now will most likely become so when they reach adulthood. Therefore, it is imperative that the same health promotion strategies are applied to normal weight children as to their overweight peers.

This project strives to take advantage of the fact that children are impressionable and that the seeds of behavior change can be planted and take root easier in them than in adults. What the project will achieve is the laying of a sturdy foundation of knowledge, leading to behavior and attitude changes that will drive the adoption of healthier lifestyle habits in the children. This project is an appeal to parents' desire for healthy, well-adjusted children who have an opportunity to live a better, fuller life. This project answers the call that communities have been asking for and takes a more assertive role in preventing diseases within its population by providing facilities and programs to achieve that goal. This camp addresses the need for individual and family responsibility in combating the weight problem of this country because the children with the help of their parents will do the work. The camp will be a positive agent for change in the community, starting with the children.

Conclusion

Overweight and obesity is becoming an epidemic in the children of this country. Because our children represent the not so distant future and the foundation of our country, it is imperative that this foundation is strengthened now with the seed knowledge and healthy habits. These conditions, if not dealt with now, will result in an increase in chronic diseases and healthcare costs and decrease in life span and quality of life. The challenge of treating of overweight and obesity is that it is considered a personal problem and that it is the responsibility of the individual affected. For behavior change to occur and be long-lasting, commitment by the individual as well as his or her community must be made.(10,15) Some solutions to the overweight and obesity problems suggested by the Surgeon General include educating individuals, families, and communities on federal dietary and exercise guidelines and creating more community-based obesity prevention and treatment programs.(10)

Research indicates that children who eat properly and get the right amount of physical activity and exercise have the cognitive energy to learn and achieve, have better academic performance, improved self-esteem and mental health, and have better school attendance.(14) Regular exercise helps individuals improve cardiovascular health; lose weight and maintain weight loss; improves bone, muscle, and joint health; reduces psychosocial illnesses including depression and anxiety; improves self-esteem, mood, and feelings of well-being; and reduces feelings of stress.(6)

This camp addresses the need for individual and family responsibility in combating the weight problem of this country because the children, with the help of their parents, will do the work. The camp will be a positive agent for change in the community, starting with the children. It will impact the future of the South Central Los Angeles community by proactively engaging and investing in the children now while the opportunity affords us a chance to do so.

References

1. Council of State Governments. Trends and Policy Solutions in Healthy States - Youth Obesity. Active Bodies, Active Minds: Getting Kids and Schools Active. Retrieved on September 21, 2006 from http://www.healthystates.csg.org/

2. Field Research Corporation. March 31, 2004. A Survey of Californians about the Problem of Childhood Obesity (October - November 2003). Retrieved on September 8, 2006 from http://www.calendow.org/news/press_releases/2004/03ChildObesityCOMPLETEReport3-04.pdf

3. National Institute of Diabetes and Digestive and Kidney Diseases, Weight-control Information Network. Statistics Related to Overweight and Obesity. Retrieved September 6, 2006 from http://www.win.niddk.nih.gov/statistics/index.htm

4. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics. Prevalence of Overweight and Obesity among Adults: United States, 2003-2004. Retrieved September 6, 2006 from http://www.cdc.gov/nchs/pressroom/06facts/obesity03_04.htm

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29. Klem, M. 2006. An Evaluation of the Effectiveness of Life Skill Development in Missouri's 4-H Youth Resident Summer Camps. Retrieved on September 8, 2006 from http://www.acacamps.org/research/06symposium.php

30. Ramsing, R. 2006. The Role of Theory Based Programming in Camp: A Three-Year Evaluation of Diabetes Camps. Retrieved on September 8, 2006 from http://www.acacamps.org/research/06symposium.php