How nurses can help fight childhood obesity

November 26, 2012
By Megan M. Krischke, contributor October 26, 2012 -

The rate of childhood obesity in the United States has more than tripled over the past 30 years. Today, more than 1 in 3 children and adolescents are either overweight or obese, putting them at risk for conditions such as diabetes, hypertension and high cholesterol. Because of the respect and trust nurses have from patients and society as a whole, they are in a position to powerfully influence factors contributing to childhood obesity, on both individual and systemic levels.

Tara Arnold, RN, BSN, CPN, an in-patient pediatric nurse at Providence Portland Medical Center, in Portland, Ore., is fighting childhood obesity on many levels. Within the hospital she has done presentations to help nurses assess pediatric patients and has trained staff on scripting for discussing weight-related matters with patients. She also takes healthy food demonstrations into the community, and was featured on a local news segment offering education about the amount of sugar in soda and flavored milk. In addition, she is currently running for Mrs. Oregon on a pediatric-obesity prevention and family-health promotion platform.

“Talking about weight is a very sensitive issue and we don’t want to lose trust with our patients. It has even been shown that people who feel judged about their weight are more likely to add extra pounds,” she stated. “We use a caring approach in scripting which invites patients and families to share their concerns with us. People need to be ready for and desiring change in order for change to occur. This approach helps us to know what help a family is truly seeking.” Some of the questions nurses at Providence ask patients and families are:
  • What is your energy level like?
  • Do you have any questions about your current health?
  • What does a healthy lifestyle mean to you?
  • What have you noticed about your child’s self esteem?
  • What concerns do you have about your child’s future health?
Michele Polfuss, PhD, RN, CPNP-AC/PC, who works for the department of endocrinology at Children's Hospital of Wisconsin, explains that children are at the center of several different systems, each of which impacts a child’s health.

“Factors such as a parent’s work schedule, the walkability and safety of the neighborhood, whether or not there is a grocery story nearby, what mandates are in place for school lunches, and access to health care all play a role in how a child eats and their level of activity,” she said.

Often parents have limited nutritional knowledge and need coaching on how to help their child and their entire family pursue a healthy lifestyle. Polfuss and Arnold suggest these guidelines: 5 fruits and vegetables a day 3 meals a day (adolescents often skip meals) 2 hours or less of recreational screen time 1 hour of physical activity that increases the heart rate 0 sugary beverages--those with 4 or more grams of sugar per serving.

Providence offers a 10-week pediatric weight management program called Healthy ‘n Fit that involves the whole family. Each of the 10 sessions includes 45 minutes of physical activity, along the lines of a school physical education class, and 45 minutes of nutrition education from a dietician. Physicians can refer families who want to change their lifestyle to the program.

In order to fight childhood obesity on a systemic level, Polfuss encourages nurses to get involved in their community—to serve on the PTA or volunteer in classrooms. Arnold suggests nurses expand their own nutritional knowledge base by attending dietician conferences and that they get involved with their state legislatures.

“Many children, especially those in low-income families, eat two meals a day at school. Nurses should be informing and influencing the decisions their states are making about the food children are served,” Arnold stated.

Nurses looking for more avenues of action can turn to the American Academy of Pediatrics’ recently-launched Institute for Healthy Childhood Weight. The aim of the institute is to provide practical weight control solutions to health care providers, communities and families based on best practices and emerging scientific evidence.

Both Arnold and Polfuss emphasized the importance of nurses being role models of the lifestyles they are encouraging in their patients. “Because nurses are seen as role models, our patients and our communities are watching what we do. They see if we are eating a donut and soda for breakfast and they see if we are out walking on our lunch breaks,” commented Polfuss. “Nurses are a very powerful group. Through their creativity and their everyday choices they can fight childhood obesity.”