Linda SullivanRN, DSN, PNP-BC,FNP-BC

One can hardly pick up a newspaper or listen to a newscast without hearingabout one of the deadliest of all health problems among children: obesity. Justas taking a child to the doctor on a regular basis, keeping a child’s immuniza-

tions up to date, or providing adequate safety measures can have significant effectson a child, so can ignoring the factors that contribute to the incidence of obesity.Because the choices that caregivers make often are influenced by ignorance or fiscallimitations, it is essential that healthcare providers inquire at each visit about factors ina person’s life that reveal a need for assistance. Food choices, food preparation, exer-cise needs, and other issues that often surround and can compound the issue of obe-sity need to be revisited on each visit.

We know that obesity has widespread repercussions for children and can affectthem for years to come. No longer is there a 500-pound gorilla in the room that no onewill talk about; rather, there is an obvious and growing problem among children whoare overweight, and all now acknowledge that this problem is significant. Obesity canlead to a host of other problems, including heart, bone, endocrine, joint, skin, psycho-logical, and respiratory problems. Since 1963 there has been a 10% to 30% increase inthe incidence of type 2 diabetes among children (depending on which statistics youread). We know that type 2 diabetes is directly related to the incidence of obesity; asthe latter grows, so will cases of the former. In 2007, 22 million children under the ageof 5 were obese, and this number continues to increase every day.

Because the problems that accompany obesity can have such devastating effects, itis critical that healthcare providers become more proactive in our approach to all chil-dren. In the office setting, the approach should start by obtaining height, weight, andan accurate calculation of body mass index for every child. Performing a dietary evalu-ation is also important, as this can reveal a pattern that ultimately might lead to obe-sity. Discussing these findings with both the child and the parent and providing usefulinformation that they can use to modify behaviors and help correct problems whennecessary should also be part of every visit.

Preventing the complications of obesity is every healthcare provider’s responsibility.It is essential that we be mindful of the steps we need to take to accomplish thisgoal. We need to take on the fight against these burgeoning problems as advocatesfor our patients. We need to become proactive in our responses and interactions withchildren and parents so that we can change behaviors, beliefs, and attitudes towardobesity before it is too late—and that 500-pound gorilla stampedes us all.

Linda Sullivan, RN, DSN, PNP-BC, FNP-BC, is the director of advanced practice for the Mississippi Board ofNursing in Jackson. She can be reached at lsullivan@msbn.state.ms.us.

1555-4155/09/$ see front matter© 2010 American College of Nurse Practitionersdoi:10.1016/j.nurpra.2010.02.010

Guest Editorial

The Challenge of Childhood Obesity

244 The Journal for Nurse Practitioners - JNP Volume 6, Issue 4, April 2010