Issue
The New York Times posted an article on February 24, 2017, about the obesity epidemic in America and the radical idea of bariatric surgery for these adolescents. The number of adolescents ages 12 to 19 who are severely obese has nearly doubled from 1999 to 2014, going from 5.2 to 10.2 percent. More doctors and parents are faced with the idea of bariatric surgery being the only option provided to produce lasting weight loss in obese adolescents. However, this is a controversial topic. This article asks which is worse: accepting uncertainty about long-term health risks from surgery or the likelihood of serious health risks from remaining obese. Obesity causes serious health risks including type 2 diabetes, hypertension, sleep apnea, acid reflux, high cholesterol, and isolation and depression. Obviously, something needs to be done about the issue but bariatric surgery may a radical and unnecessary option. https://www.nytimes.com/2017/02/24/health/obese-teenagers-bariatric-surgery.html?rref=collection%2Fsectioncollection%2Fhealth
Service Delivery
Play is an essential part of childhood, however, most children spend at least 4 to 5 hours per day in sedentary activity. Even though the issue presented is in adolescents, I think the way to prevent this issue from occurring is changing the mindsets of younger children. The habits developed as early as pre-k are often precursors to lifelong health patterns. I think that the best way to address this issue is through the educational system. This is the easiest way to get out to many children at once since they all attend school. This is also where the child spends much of time of their day, most of it being sedentary. A collaboration of teachers, OTs, and school nurses could come together in attempts to change the issue of adolescent obesity. We also need to address the family dynamics, which is an area that OT could assist. Without addressing the family dynamics, we are not addressing what is fully accountable for the rise of childhood obesity.
Policy
I have multiple policy ideas that would address childhood obesity and health promotion in the educational system. This could be provided through multiple parts of the day. Before school begins, children could be encouraged to play. This could be through playing on the playground or you could also take the option of walking around the school building with a teacher that changes out every week. Throughout the school day, the occupational therapist could provide the teacher with quick movement breaks every 20-30 minutes. This would not only provide more movement throughout the day but also increase attention in classes. Alternative seating could also aid in decreasing obesity. Children could have the option to sit in bean bags, therapy balls or even at standing desks. Occupational therapists and school nurses could have a block in their weeks where they could go into the classroom and address health issues from obesity and fun ways to incorporate exercise during play and while at home. They could speak about long term lifestyle changes versus dieting. They could also educate students on making conscious decisions about the activities done every day. Occupational therapists could even set up activities to show how healthy eating or exercise can be made to be fun, such as growing a simple garden and taking turns making healthy menus and cooking healthy food. Occupational therapists could also provide after school sessions to parents that could assist in analyzing a family’s routine, suggest strategies to increase leisure and play at home, encourage parents and students to engage in sports and dance and reduce time in front of the TV, and find fun things to promote movement that the family can do as a whole. Finally, one of the most important parts of this policy would be to make it a requirement to incorporate recess into the students’ day. We need to promote the value of recess to school administrators. Afterschool programs that are non-competitive could also promote engagement for students with obesity that may be more self-conscious, such as yoga, walking, or dance. Addressing childhood health patterns and habits as well as family dynamics when the children are young, can influence the long-term risk of adolescent obesity before negative patterns are developed.
Data
- Data needed to support the policies mentioned above would include:
- Amount of students in each school district
- Amount of teachers, OTs and school nurses willing to implement these policies
- Time that school starts, classes per day, and class length
- Sports that are currently provided at the schools
- Obesity rate in the schools
- When could a block of time be provided for the OT and school nurse per week to provide educational sessions
- Current family dynamics and health habits of children (although not necessary, as this kind of policy will still benefit all children, even if they already have health habits)
These policies would affect occupational therapy in the educational system in several ways. The policies would promote additional knowledge for other of the scope of practice for occupational therapy. In the education system, occupational therapy is often misunderstood for only working on handwriting, some sensory processing, and fine motor skills. However, occupational therapy can also work on the development of health habits to promote healthy occupational participation and performance throughout the lifetimes of children. Providing children with individualized, fun ways to incorporate gross motor play and healthy eating throughout the day is definitely within occupational therapy’s scope of practice. This policy could also be a great way to show the benefits of tier 1 occupational therapy services to administration and ultimately lead to other ways for occupational therapy to provide tier 1 services, such as classroom handwriting instruction or even a class about alternative seating to increase engagement and attention throughout the day.
Kolata, G. (2017, February 24). Doctors Consider a Last Best Hope for Obese Teenagers: Surgery. Retrieved March 05, 2017, from https://www.nytimes.com/2017/02/24/health/obese-teenagers-bariatric-surgery.html?rref=collection%2Fsectioncollection%2Fhealth
American Occupational Therapy Association. (2013). Addressing Childhood Obesity. Retrieved March 5, 2017, from https://www.aota.org/~/media/Corporate/Files/AboutOT/consumers/Youth/obesity.pdf
