thesis statement in obesity

Obesity Essay

Last updated on: Feb 9, 2023

Obesity Essay: A Complete Guide and Topics

By: Nova A.

11 min read

Reviewed By: Jacklyn H.

Published on: Aug 31, 2021

Are you assigned to write an essay about obesity? The first step is to define obesity.

The obesity epidemic is a major issue facing our country right now. It's complicated- it could be genetic or due to your environment, but either way, there are ways that you can fix it!

Learn all about what causes weight gain and get tips on how you can get healthy again.

On this Page

What is Obesity

What is obesity? Obesity and BMI (body mass index) are both tools of measurement that are used by doctors to assess body fat according to the height, age, and gender of a person. If the BMI is between 25 to 29.9, that means the person has excess weight and body fat.

If the BMI exceeds 30, that means the person is obese. Obesity is a condition that increases the risk of developing cardiovascular diseases, high blood pressure, and other medical conditions like metabolic syndrome, arthritis, and even some types of cancer.

Obesity Definition

Obesity is defined by the World Health Organization as an accumulation of abnormal and excess body fat that comes with several risk factors. It is measured by the body mass index BMI, body weight (in kilograms) divided by the square of a person’s height (in meters).

Obesity in America

Obesity is on the verge of becoming an epidemic as 1 in every 3 Americans can be categorized as overweight and obese. Currently, America is an obese country, and it continues to get worse.

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Causes of obesity

Do you see any obese or overweight people around you?

You likely do.

This is because fast-food chains are becoming more and more common, people are less active, and fruits and vegetables are more expensive than processed foods, thus making them less available to the majority of society. These are the primary causes of obesity.

Obesity is a disease that affects all age groups, including children and elderly people.

Now that you are familiar with the topic of obesity, writing an essay won’t be that difficult for you.

How to Write an Obesity Essay

The format of an obesity essay is similar to writing any other essay. If you need help regarding how to write an obesity essay, it is the same as writing any other essay.

Obesity Essay Introduction

The trick is to start your essay with an interesting and catchy sentence. This will help attract the reader's attention and motivate them to read further. You don’t want to lose the reader’s interest in the beginning and leave a bad impression, especially if the reader is your teacher.

A hook sentence is usually used to open the introductory paragraph of an essay in order to make it interesting. When writing an essay on obesity, the hook sentence can be in the form of an interesting fact or statistic.

Head on to this detailed article on hook examples to get a better idea.

Once you have hooked the reader, the next step is to provide them with relevant background information about the topic. Don’t give away too much at this stage or bombard them with excess information that the reader ends up getting bored with. Only share information that is necessary for the reader to understand your topic.

Next, write a strong thesis statement at the end of your essay, be sure that your thesis identifies the purpose of your essay in a clear and concise manner. Also, keep in mind that the thesis statement should be easy to justify as the body of your essay will revolve around it.

Body Paragraphs

The details related to your topic are to be included in the body paragraphs of your essay. You can use statistics, facts, and figures related to obesity to reinforce your thesis throughout your essay.

If you are writing a cause-and-effect obesity essay, you can mention different causes of obesity and how it can affect a person’s overall health. The number of body paragraphs can increase depending on the parameters of the assignment as set forth by your instructor.

Start each body paragraph with a topic sentence that is the crux of its content. It is necessary to write an engaging topic sentence as it helps grab the reader’s interest. Check out this detailed blog on writing a topic sentence to further understand it.

End your essay with a conclusion by restating your research and tying it to your thesis statement. You can also propose possible solutions to control obesity in your conclusion. Make sure that your conclusion is short yet powerful.

Obesity Essay Examples

Essay about Obesity (PDF)

Childhood Obesity Essay (PDF)

Obesity in America Essay (PDF)

Essay about Obesity Cause and Effects (PDF)

Satire Essay on Obesity (PDF)

Obesity Argumentative Essay (PDF)

Obesity Essay Topics

Choosing a topic might seem an overwhelming task as you may have many ideas for your assignment. Brainstorm different ideas and narrow them down to one, quality topic.

If you need some examples to help you with your essay topic related to obesity, dive into this article and choose from the list of obesity essay topics.

Childhood Obesity

As mentioned earlier, obesity can affect any age group, including children. Obesity can cause several future health problems as children age.

Here are a few topics you can choose from and discuss for your childhood obesity essay:

What are the causes of increasing obesity in children?
Obese parents may be at risk for having children with obesity.
What is the ratio of obesity between adults and children?
What are the possible treatments for obese children?
Are there any social programs that can help children with combating obesity?
Has technology boosted the rate of obesity in children?
Are children spending more time on gadgets instead of playing outside?
Schools should encourage regular exercises and sports for children.
How can sports and other physical activities protect children from becoming obese?
Can childhood abuse be a cause of obesity among children?
What is the relationship between neglect in childhood and obesity in adulthood?
Does obesity have any effect on the psychological condition and well-being of a child?
Are electronic medical records effective in diagnosing obesity among children?
Obesity can affect the academic performance of your child.
Do you believe that children who are raised by a single parent can be vulnerable to obesity?
You can promote interesting exercises to encourage children.
What is the main cause of obesity, and why is it increasing with every passing day?
Schools and colleges should work harder to develop methodologies to decrease childhood obesity.
The government should not allow schools and colleges to include sweet or fatty snacks as a part of their lunch.
If a mother is obese, can it affect the health of the child?
Children who gain weight frequently can develop chronic diseases.

Obesity Argumentative Essay Topics

Do you want to write an argumentative essay on the topic of obesity?

The following list can help you with that!

Here are some examples you can choose from for your argumentative essay about obesity:

Can vegetables and fruits decrease the chances of obesity?
Should you go for surgery to overcome obesity?
Are there any harmful side effects?
Can obesity be related to the mental condition of an individual?
Are parents responsible for controlling obesity in childhood?
What are the most effective measures to prevent the increase in the obesity rate?
Why is the obesity rate increasing in the United States?
Can the lifestyle of a person be a cause of obesity?
Does the economic situation of a country affect the obesity rate?
How is obesity considered an international health issue?
Can technology and gadgets affect obesity rates?
What can be the possible reasons for obesity in a school?
How can we address the issue of obesity?
Is obesity a chronic disease?
Is obesity a major cause of heart attacks?
Are the junk food chains causing an increase in obesity?
Do nutritional programs help in reducing the obesity rate?
How can the right type of diet help with obesity?
Why should we encourage sports activities in schools and colleges?
Can obesity affect a person’s behavior?

Health Related Topics for Research Paper

If you are writing a research paper, you can explain the cause and effect of obesity.

Here are a few topics that link to the cause and effects of obesity.Review the literature of previous articles related to obesity. Describe the ideas presented in the previous papers.

Can family history cause obesity in future generations?
Can we predict obesity through genetic testing?
What is the cause of the increasing obesity rate?
Do you think the increase in fast-food restaurants is a cause of the rising obesity rate?
Is the ratio of obese women greater than obese men?
Why are women more prone to be obese as compared to men?
Stress can be a cause of obesity. Mention the reasons how mental health can be related to physical health.
Is urban life a cause of the increasing obesity rate?
People from cities are prone to be obese as compared to people from the countryside.
How obesity affects the life expectancy of people? What are possible solutions to decrease the obesity rate?
Do family eating habits affect or trigger obesity?
How do eating habits affect the health of an individual?
How can obesity affect the future of a child?
Obese children are more prone to get bullied in high school and college.
Why should schools encourage more sports and exercise for children?

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Topics for Essay on Obesity as a Problem

Do you think a rise in obesity rate can affect the economy of a country?

Here are some topics for your assistance regarding your economics related obesity essay.

Does socioeconomic status affect the possibility of obesity in an individual?
Analyze the film and write a review on “Fed Up” – an obesity epidemic.
Share your reviews on the movie “The Weight of The Nation.”
Should we increase the prices of fast food and decrease the prices of fruits and vegetables to decrease obesity?
Do you think healthy food prices can be a cause of obesity?
Describe what measures other countries have taken in order to control obesity?
The government should play an important role in controlling obesity. What precautions should they take?
Do you think obesity can be one of the reasons children get bullied?
Do obese people experience any sort of discrimination or inappropriate behavior due to their weight?
Are there any legal protections for people who suffer from discrimination due to their weight?
Which communities have a higher percentage of obesity in the United States?
Discuss the side effects of the fast-food industry and their advertisements on children.
Describe how the increasing obesity rate has affected the economic condition of the United States.
What is the current percentage of obesity all over the world? Is the obesity rate increasing with every passing day?
Why is the obesity rate higher in the United States as compared to other countries?
Do Asians have a greater percentage of obese people as compared to Europe?
Does the cultural difference affect the eating habits of an individual?
Obesity and body shaming.
Why is a skinny body considered to be ideal? Is it an effective way to reduce the obesity rate?

Obesity Solution Essay Topics

With all the developments in medicine and technology, we still don’t have exact measures to treat obesity.

Here are some insights you can discuss in your essay:

How do obese people suffer from metabolic complications?
Describe the fat distribution in obese people.
Is type 2 diabetes related to obesity?
Are obese people more prone to suffer from diabetes in the future?
How are cardiac diseases related to obesity?
Can obesity affect a woman’s childbearing time phase?
Describe the digestive diseases related to obesity.
Obesity may be genetic.
Obesity can cause a higher risk of suffering a heart attack.
What are the causes of obesity? What health problems can be caused if an individual suffers from obesity?
What are the side effects of surgery to overcome obesity?
Which drugs are effective when it comes to the treatment of obesity?
Is there a difference between being obese and overweight?
Can obesity affect the sociological perspective of an individual?
Explain how an obesity treatment works.
How can the government help people to lose weight and improve public health?

Writing an essay is a challenging yet rewarding task. All you need is to be organized and clear when it comes to academic writing.

Choose a topic you would like to write on.
Organize your thoughts.
Pen down your ideas.
Compose a perfect essay that will help you ace your subject.
Proofread and revise your paper.

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As a Digital Content Strategist, Nova Allison has eight years of experience in writing both technical and scientific content. With a focus on developing online content plans that engage audiences, Nova strives to write pieces that are not only informative but captivating as well.

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$Obesity Essay$

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How To Write A Strong Obesity Research Paper?

Table of Contents

Obesity is such a disease when the percent of body fat has negative effects on a person’s health. The topic is very serious as obesity poisons the lives of many teens, adults and even children around the whole world.

Can you imagine that according to WHO (World Health Organization) there were 650 million obese adults and 13% of all 18-year-olds were also obese in 2016? And scientists claim that the number of them is continually growing.

There are many reasons behind the problem, but no matter what they are, lots of people suffer from the wide spectrum of consequences of obesity.

Basic guidelines on obesity research paper

Writing any research paper requires sticking to an open-and-shut structure. It has three basic parts: Introduction, Main Body, and Conclusion.

According to the general rules, you start with the introduction where you provide your reader with some background information and give brief definitions of terms used in the text. Next goes the thesis of your paper.

The thesis is the main idea of all the research you’ve done written in a precise and simple manner, usually in one sentence.

The main body is where you present the statements and ideas which disclose the topic of your research.

In conclusion, you sum up all the text and make a derivation.

How to write an obesity thesis statement?

As I’ve already noted, the thesis is the main idea of your work. What is your position? What do you think about the issue? What is that you want to prove in your essay?

Answer one of those questions briefly and precisely.

Here are some examples of how to write a thesis statement for an obesity research paper:

The main cause of obesity is determined to be surfeit and unhealthy diet.
Obesity can be prevented no matter what genetic penchants are.
Except for being a problem itself, obesity may result in diabetes, cancers, cardiovascular diseases, and many others.
Obesity is a result of fast-growing civilization development.
Not only do obese people have health issues but also they have troubles when it comes to socialization.

20 top-notch obesity research paper topics

Since the problem of obesity is very multifaceted and has a lot of aspects to discover, you have to define a topic you want to cover in your essay.

How about writing a fast food and obesity research paper or composing a topic in a sphere of fast food? Those issues gain more and more popularity nowadays.

A couple of other decent ideas at your service.

The consequences of obesity.
Obesity as a mental problem.
Obesity and social standards: the problem of proper self-fulfilment.
Overweight vs obesity: the use of BMI (Body Mass Index).
The problem of obesity in your country.
Methods of prevention the obesity.
Is lack of self-control a principal factor of becoming obese?
The least obvious reasons for obesity.
Obesity: the history of the disease.
The effect of mass media in augmentation of the obesity level.
The connection between depression and obesity.
The societal stigma of obese people.
The role of legislation in reducing the level of obesity.
Obesity and cultural aspect.
Who has the biggest part of the responsibility for obesity: persons themselves, local authorities, government, mass media or somebody else?
Why are obesity rates constantly growing?
Who is more prone to obesity, men or women? Why?
Correlation between obesity and life expectancy.
The problem of discrimination of the obese people at the workplace.
Could it be claimed that such movements as body-positive and feminism encourage obesity to a certain extent?

Best sample of obesity research paper outline

An outline is a table of contents which is made at the very beginning of your writing. It helps structurize your thoughts and create a plan for the whole piece in advance.

…Need a sample?

Here is one! It fits the paper on obesity in the U.S.

Introduction

Hook sentence.
Thesis statement.
Transition to Main Body.
America’s modern plague: obesity.
Statistics and obesity rates in America.
Main reasons of obesity in America.
Social, cultural and other aspects involved in the problem of obesity.
Methods of preventing and treating obesity in America.
Transition to Conclusion.
Unexpected twist or a final argument.
Food for thought.

Specifics of childhood obesity research paper

A separate question in the problem of obesity is overweight children.

It is singled out since there are quite a lot of differences in clinical pictures, reasons and ways of treatment of an obese adult and an obese child.

Writing a child obesity research paper requires a more attentive approach to the analysis of its causes and examination of family issues. There’s a need to consider issues like eating habits, daily routine, predispositions and other.

Childhood obesity outline example

As the question of childhood obesity is a specific one, it would differ from the outline on obesity we presented previously.

Here is a sample you might need. The topic covers general research on child obesity.

The problem of childhood obesity.
World’s childhood obesity rates.
How to diagnose the disease.
Predisposition and other causes of child obesity.
Methods of treatment for obese children.
Preventive measures to avoid a child’s obesity.

On balance…

The topic of obesity is a long-standing one. It has numerous aspects to discuss, sides to examine, and data to analyze.

Any topic you choose might result in brilliant work.

How can you achieve that?

Follow the basic requirements, plan the content beforehand, and be genuinely interested in the topic.

Option 2. Choose free time over struggle on the paper. We’ve got dozens of professional writers ready to help you out. Order your best paper within several seconds and enjoy your free time. We’ll cover you up!

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Obesity - Free Essay Examples And Topic Ideas

Obesity is a medical condition in which excess body fat has accumulated to an extent that it may have a negative effect on health. Essays on obesity could explore its causes, the health risks associated, and the societal costs. Discussions might also revolve around various interventions to address obesity at an individual and community level. We have collected a large number of free essay examples about Obesity you can find at PapersOwl Website. You can use our samples for inspiration to write your own essay, research paper, or just to explore a new topic for yourself.

Problem: Childhood Obesity in America

As you've probably heard, more children are becoming overweight today in America than ever before. Experts are calling this an "obesity epidemic." To first understand childhood obesity we must ask ourselves what is obesity? Obesity is a diet-related chronic disease involving excessive body fat that increases the risk of health problems. Many doctors have expressed obesity has an increasing problem in today's youth as obesity can lead to many health issues such as type 2 diabetes, high blood pressure, heart […]

Childhood Obesity Parents are the Blame

In current years, children becoming more obese in their entire childhood development has become common. Obesity in children could be due to various reasons such as family structure, busy family life experienced in the modern days, and insufficient knowledge of foods containing high calories. Parents ought to be accountable for what they do or fail to do that amounts to a negative influence on their children's weight and cause them to be overweight or obese during their childhood period. When […]

Social Media and Body Image Essay

Have you ever looked in the mirror and said something negative about yourself? According to the Merriam Webster dictionary body image is, ""a subjective picture of one's own physical appearance established both by self-observation and by noting the reactions of other. Negative body image and low self-esteem are real problems and I want to discover the causes, how much of a factor social media is, and ways that people can get help to move past it. Many people see things […]

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Childhood Obesity – Causes and Potential Long-Term Effects

Abstract There is growing concern about the state of children’s health. Every year there is an increase in the number of overweight and obese children. What causes this and what does it mean for them long-term? There are many contributing factors to children’s weight issues. Some of these factors are limited access to healthy food, more time spent in front of a screen, and less physical activity. Long-term health affects include a rising risk of Type 2 diabetes, coronary heart […]

How are Fast Food Advertising and Childhood Obesity Related

By 1950s, fast food industry boom was in full swing. It was secured in 1951. In the 1950s, McDonald has become a staple of the American diet. Fast food restaurants have been grown more and more and by now, there are over one hundred and sixty thousands fast food restaurants in the United States, becoming a one hundred and ten billion dollar industry. One can’t deny that fast food has become really important in American life nowadays. Whether Americans are […]

History of Type II Diabetes

Type II Diabetes Abstract This paper explores the disease Type II Diabetes and the many components it has. Type II Diabetes affects many people around the world, but is different than most diseases because it is not transferred by genetics. This form of diabetes is brought upon by unhealthy lifestyle choices which makes it unique because living a healthier life can make it go away. When Type II Diabetes affects someone, they are not able to control their blood sugar […]

Childhood Obesity is an Epidemic in the USA

Introduction Childhood obesity has become an epidemic in the United States and other western industrialized societies. "Childhood obesity affects more than 18 percent of children in the United States, making it the most common chronic disease of childhood" (Obesity Action Coalition). According to the OAC, the percentage of children suffering from childhood obesity has tripled since 1980. A child is considered obese if their body mass index for their age is greater than 95 percent. Childhood obesity is both an […]

Childhood Obesity Today

In America, childhood obesity is on a rise today. Children can gain obsessive weight because of environmental factors. Vending machines, low cost on snacks, and a increase in the fast food chain are contributing factors towards obesity. Genetics can also play a part in childhood obesity. Many children come from a generation of overweight families. Most parents don't see the harm in letting their children gain tons of weight. Obesity can cause many health problems. Childhood obesity affects the health […]

History and Types of Diabetes

The first sign of diabetes was discovered in 1500 B.C.E by the Egyptians. According to one study, ancient Indians were familiar with the condition and had even determined two types of the condition. They called it "honey urine" and tested for it by determining if the ants were drawn to the urine. The first mention of the word diabetes was by the Greeks. It means "to go through", it was named this because of its main symptom: the excessive passing […]

Childhood Obesity in the American Nation

Childhood obesity is still rising in this nation. One out of three Americans is obese. The outlook for children is not much better, as adolescent obesity has quadrupled over the last thirty years. "As of 2012, almost 18 percent of children aged 6-11 years were obese" (Newman, 1). Despite the considerable public awareness of the negative impacts of obesity, this challenge persists. The situation for youngsters is hardly brighter; over the last few decades, the rate of youth obesity has […]

The Causes and Preventions of Childhood Obesity

When trying to find out if a child is considered for obesity, they need to have a body mass index that is between the ranges of the 85th percentile and the 95th percentile. When speaking about childhood obesity it is for children between the ages of infancy and early adulthood which is eighteen years of age. Obesity is one of the most preventable diseases especially if caught early enough. There are many different reasons for the cause of childhood obesity, […]

Risk Factors from Alzheimer’s Disease

About 40 million people are affected by dementia, with the majority of these individuals being over the age of 60. This number is expected to double in the next 20 years, reaching around 80 million by 2050. Approximately 60-70% of all dementia cases are caused by Alzheimer's disease, affecting between 2.17 and 4.78 million people. Out of those, 46% have a moderate or severe form of the disease. It is estimated that by 2050, between 7.98 and 12.95 million people […]

Tackling Childhood Obesity in Rural Mississippi

Childhood obesity is a growing health issue in the United States. Children with higher Body Mass Indexes than the recommended by the National Institutes of Health are more prone to adverse health effects later in life. Obesity in early age can translate into adulthood and increases the risk of developing cardiovascular diseases and diabetes (Franks 2010). The highest rates of childhood obesity can be observed in the southeastern corner of the United States, Mississippi, in particular, with the highest prevalence […]

Childhood Obesity: Global Epidemic and Ethical Concerns

Abstract Numbers continue to climb for those who have childhood obesity. This serious issue has been brought to the attention of the public who have been taking preventative measures and action in hopes to reduce the number of cases. In a number of countries, public policies have been implemented to prevent obesity. However, in the U.S. efforts made are not enough or have not been effective to stop the obesity rate from increasing. Proposals for solutions to this health problem […]

Obesity in Childhood

There are numerous issues that society faces on a daily basis. One of the issues that society faces is obesity. It is one of the leading risks of death and has been ongoing since the 1960s and 1970s. Obesity is an issue that continues to grow not only in the United States but also in developing countries as well. Not only does obesity affect adults but it has become a serious issue for children. According to an article, "approximately 12.7 […]

Childhood Obesity, a Crisis that could be Cure

Obesity is a crisis that is affecting many countries, their most vulnerable citizens being children. Bad eating habits, high calorie intake, genetics, and lack of activity or exercise are some of the elements that, either combined or individually, are the cause for childhood obesity in America, Latin America, and many other nations. In the United States, rural areas have higher rates of childhood obesity, as do Hispanics and Blacks (Davis 2011). Keywords: Obesity, Childhood. Childhood Obesity, a Crisis that could […]

Impact Media on Eating Disorders

With all of our current understanding so far we can see how much of an impact media has on triggering eating disorders. Research has only just begun to analyze the relationship between social media outlets such as facebook, body image and symptoms of eating disorders. Facebook is available at the fingertips of most adolescents today which allows them easy access to seek social comparison and negative feedback. Therefore it is an essential area to examine in relation to eating disordered […]

Factors that Influence Childhood Obesity

The cause of pediatric obesity is multifactorial (1). There is not a single cause, nor solution, found that leads to all cases of pediatric obesity. Parental discipline in regard to the child is not proven to lead to less adiposity or obesity in children. Parental feeding strategy may actually be a cause of obesity with restrictive approach to food by the parent shown to increase the proclivity for the restricted foods (2). Likewise, when parents allowed their children to have […]

Childhood Obesity and Physical Activity

Most children and teens have access to a tablet, smartphone, television, laptop or a video console. They are sitting around on-screen time more and more as the days go by. Research from the CDC states obesity has nearly doubled since the 1970s in the United States. It is estimated now that 20 percent of children and adolescents are affected by obesity. Too much screen time, the accessibility to the internet and not enough physical activity are the biggest reasons the […]

What is Childhood Obesity?

Introduction Childhood obesity has become a widespread epidemic, especially in the United States. Twenty five percent of children in the United States are overweight and eleven percent are obese (Dehghan, et al, 2005). On top of that, about seventy percent of those children will grow up to be obese adults (Dehgan, et al, 2005). There are many different causes that can be attributed to the childhood obesity. Environmental factors, lifestyle preferences, and cultural environment play pivotal roles in the rising […]

Child and Adolescent Obesity in the United States

Child and adolescent obesity in the United States has nearly tripled sincethe 70s. About 1 out of every 5 children suffer from childhood obesity. It is the duty ofmothers and fathers to prevent and find solutions to child and adolescent obesity. Thispaper will seek to explain the many causes and current results which parents can execute.Child and adolescent obesity comprises of several likely causes such as poor diet and lowphysical activity including numerous adverse effects. Therefore, changes in familyhousehold structures […]

Childhood Maltreatment and Substance Abuse

Including in the article of the topic and discerning the studies to steer readers to be educated on the broad input of childhood maltreatment possibly going hand and hand with abuse of substances. In surrounding this topic, you can pull out the gist of all the studies and background information to bring a responsible observation that is proven. That which is humans who are brought into or raised into a childhood maltreatment experience such as, emotional or physical neglect along […]

Childhood Obesity and Adolesence

Childhood obesity can be prevented in many ways. Parents are the main ones with a say so on obesity. They allow their children to digest all kinds of bad foods. Parents should introduce on a daily basis different kinds of healthy foods. They should also promote is by showing children how healthy food are good for the body. You have some children that won’t eat healthy things because of the color and the way it looks. Obesity is one of […]

A Big Problem – Bad Healthcare is Aiding Childhood Obesity

A study done in 2002 found that, almost 14 million children are obese, that is 24 percent of the U.S. population from ages 2 to 17. This number just keeps rising as the years go by. Some people would argue that the increasing numbers are due to sugary dinks and foods sold in vending machines at schools, or not enough healthy food options. Other parties can argue that this number keeps increasing because of bad healthcare and not enough opportunities […]

Childhood Obesity Rate Can be Decreased

Child obesity has become a major concern as it continues to increase every year in the US. Many parents are uneducated about the risks of childhood obesity. Parental awareness and increasing physical activity are steps towards making a change in the rates of childhood obesity. There are many side effects of childhood obesity that can obstruct a child’s future. However, positive changes to children’s health can be achieved through the influence of adults. Child obesity has become a more critical […]

Is Obesity a Problem?

Is Obesity a Problem? Have you ever wondered how dysfunctional obesity can be for a person? What impact does it make on health and personal life? Usually, a person who has not encountered this problem rarely thought about it. You can watch TV shows about people overweight just for entertaining or laugh at a friend who got overweight without understanding the importance of this problem. Personally, I did not understand the seriousness of the situation in which an overweight person […]

Diabetes and Renal Failure

Diabetes and Renal Failure Introduction This is a research article about prevalence of renal failure and its early detection among patients who have long standing diabetes mellitus. End stage renal disease significantly increases the risk of death and requires expert health care. Although diabetes is the most predominant cause of chronic renal disease, maximum individuals with diabetes are not investigated based on national guidelines. Chronic kidney disease warrants improved detection using standardized criteria to improve outcomes. Proper screening of diabetic […]

Mental Health and Obesity

The obesity rate in America is at an all-time high, and it seems there is no end in sight. Obesity not only affects adults, but children as well. The Center for Disease Control and Prevention (CDC) defines obesity as “Weight that is higher than what is considered as a healthy weight for a given height.” (CDC, 2016) Soccer not only improves physical health and lessens obesity, but also mental health. Working out at least once a day makes a person […]

Poverty and Obesity

It is a known fact that the individual exert influences on the environment and vice versa. However, no man is an Island and as such, these influences reflect through various levels of social and interpersonal relationships. The social environment of the individual include interaction with peers, friend and family members, through such mechanism as role modeling, social support and social norms (Mary, Karen, Ramona, Karen .Annu. Rev. Public Health 2008.Creating Healthy food and Eating Environments, para 2). The physical environment […]

Childhood Obesity a Serious Problem in the USA

Childhood obesity is a serious problem in the United States. Obesity is condition in which a child is significantly overweight for his or her age and height. It is a very common condition and is estimated to have around 3 million cases in the United States each year. Every day more children are getting diagnosed with obesity, and some as young as 4 years old. When a child gets diagnosed with obesity at a young age, it can be very […]

How To Write an Essay About Obesity

Understanding obesity.

Before writing an essay about obesity, it's crucial to understand what obesity is and its implications. Obesity is a medical condition characterized by an excess accumulation of body fat, often defined by a body mass index (BMI) of 30 or higher. It is not just a cosmetic concern but a complex health issue associated with various diseases, such as heart disease, diabetes, and high blood pressure. Start your essay by outlining the causes of obesity, which may include genetic factors, lack of physical activity, unhealthy eating patterns, and environmental and psychological factors. Discuss the global prevalence of obesity and its rise in recent decades, indicating a significant public health concern.

Developing a Thesis Statement

A strong essay on obesity should be centered around a clear, concise thesis statement. This statement should present a specific viewpoint or argument about obesity. For instance, you might discuss the societal factors contributing to the rise of obesity, analyze the effectiveness of current interventions and policies, or argue the need for a multifaceted approach to tackle this health issue. Your thesis will guide the direction of your essay and ensure a structured and coherent analysis.

Gathering Supporting Evidence

To support your thesis, gather evidence from a variety of sources, including medical studies, public health reports, and statistical data. This might include data on obesity rates in different populations, research on the health risks associated with obesity, or studies evaluating the effectiveness of diet and exercise programs. Use this evidence to support your thesis and build a persuasive argument. Be sure to consider different perspectives and address potential counterarguments.

Analyzing the Impact of Obesity

Dedicate a section of your essay to analyzing the impact of obesity. Discuss the physical health consequences, such as increased risk of chronic diseases, as well as the psychological and social implications, including stigma and reduced quality of life. Consider the economic burden of obesity on healthcare systems and society. This analysis should provide a comprehensive understanding of the far-reaching effects of obesity.

Concluding the Essay

Conclude your essay by summarizing the main points of your discussion and restating your thesis in light of the evidence provided. Your conclusion should tie together your analysis and emphasize the significance of addressing obesity as a critical public health issue. You might also want to suggest areas for future research or propose potential strategies to combat the obesity epidemic.

Reviewing and Refining Your Essay

After completing your essay, review and edit it for clarity and coherence. Ensure that your arguments are well-structured and supported by evidence. Check for grammatical accuracy and ensure that your essay flows logically from one point to the next. Consider seeking feedback from peers, healthcare professionals, or educators to further refine your essay. A well-written essay on obesity will not only demonstrate your understanding of the issue but also your ability to engage with complex health and societal challenges.

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Obesity in America: Cause and Effect Essay Sample

It is clear that the American lifestyle has contributed to the increasing prevalence of obesity. With estimates from the Washington-based Centers for Disease Prevention in the Department of Health and Human Services indicating that one in three American adults is overweight, it is evident that the country is facing an obesity epidemic. To better understand the causes and effects of obesity, research is needed to further explore the issue. For those struggling with obesity, coursework assistance may be available to help them make the necessary lifestyle changes in order to live a healthier life.

Writing a thesis paper on the topic of obesity can be extremely challenging. It requires extensive research and time to adequately cover the subject. However, there are services available that can provide assistance with the writing process. Pay for a thesis allows for the benefit of having an experienced professional provide guidance and support throughout the entire process.

Causes of Obesity

Every phenomenon must have a reason. In order to write a cause and effect essay , you need to analyze the topic carefully to cover all aspects. Obesity is considered to be a complex illness, with a number of factors contributing to its development. These can be:

hereditary;

As you may have guessed, it is the latter category of causes and effects that we are interested in. At this point, we care about the five ones that have made the biggest contribution.

Product Range

The main cause of obesity is junk food and an unbalanced diet rich in simple carbohydrates, fats, and sugars, plus a bunch of additives. Manufactured, processed, refined, and packaged meals are the most popular. Thanks to advances in technology, Americans have come to mass-produce meals that keep fresh longer and taste better. It takes less time to prepare unhealthy, processed foods in the microwave than it does to cook them yourself.

Lack of a work-life balance, high-stress levels, insufficient sleeping hours contribute to body weight gain. Not only do these factors contribute to this, but failing to take the time to do your homework can also have a negative impact on your physical health. Without a healthy, balanced approach to work, rest, and play, you may find yourself increasingly dependent on a sedentary lifestyle that can lead to overweight consequences. Many Americans work 50, 60, or more hours a week and suffer from a deficit of leisure hours. Cooking processed foods saves them hours and money, even though they end up costing them a lot more – by causing cardiovascular disease. In addition, obese people feel stressed on a regular basis in the United States metropolitan areas. Many of them are simply binge eating under the influence of negative emotions. Chronic overeating leads to a disturbance in the appetite center in the brain, and the normal amount of food eaten can no longer suppress hunger as much as necessary, affecting the body mass.

Food Deserts

The term ‘ food desert ‘ refers to poor areas (urban, suburban and rural) with limited access to fresh fruit, grains, and vegetables – places where it is much easier to access junk food. A grocery shop in a food desert that sells healthy foods may be 10-15 miles away, while a mini-market or cheap shop that sells harmful snacks is close to the house. In such a world, it takes much more effort to eat healthier, form eating habits, and stay slim.

Everyone’s Passion for Sweets

Consuming sweets in large quantities is addictive: the more and easier we give the body energy, the more the brain uses serotonin and dopamine to encourage it – it will make obese people want sweets again and again during the day. Cakes and pastries are fast carbohydrates that easily satisfy hunger and increase body mass. Despite the harm of sweets, obese people experience the need for them to satiate. Sweetened carbonated drinks are one of the main sources of sugar in the American diet. Moreover, some individuals may be more adversely affected by such diets than others: patients with a genetic predisposition to obesity gain body mass faster from sugary drinks than those without it. This leads to childhood obesity.

The Harm of Tolerance

Every year, the body positive movement is becoming more and more popular all over the world. It would seem that this major trend should have freed us from the problems associated with the cult of thinness and society’s notorious standards. In many ways, a positive attitude towards the body has proved fruitful. For example, the notion of beauty has clearly broadened. Now on fashion shows and magazine covers, you can see not only a girl with perfectly retouched skin and without a single hint of body fat but also an ordinary person with its inherent features: overweight, wrinkles, hair, and individual skin features. In general, all the things that we are all so familiar with in real life.

Does it really make that much sense? Is this a positive thing in terms of the cause and effect topic regarding obesity? In short, opinions are divided. Extremes aren’t easy to overcome. Not everyone manages to do it. Researchers have concluded that due to plus size having become positioned as a variant of the norm, more persons have become obese. Many obese Americans have formed the opinion that it is really quite normal, and they have become oblivious to the damage it does to their health. This is what we are going to focus on next.

Effects of Obesity

We all know that obesity is dangerous to health. However, medical studies show that most adults are unaware of the number of complications and diseases that obesity in America entails. So they are fairly comfortable with becoming gradually fatter. But indifference is replaced by concern when obesity related diseases begin to occur.

For interesting examples of students writing that also reveal the causes and effects of other phenomena, consult the custom essay service offering essays by professionals. In this way, you will realize the importance of highlighting the effects right after the causes.

Is obesity an aesthetic disadvantage, an inconvenience, a limitation in physical activity or is it an illness after all? How does it affect health, and what are the consequences? The visible signs of obesity are by no means the only complication associated with this condition. Obesity creates a high risk of life-threatening diseases such as atherosclerosis, hypertension, heart attack, myocardial infarction, and kidney and liver problems. Moreover, it can also lead to disability.

Cardiovascular Disease

This is the most serious and damaging impact on the body and blood vessels in particular. Every extra kilo is a huge additional load on the heart. Obesity increases the risk of heart attacks. Experts from the American Heart Association have developed a paper on the relationship between obesity and cardiovascular disease, which discusses the impact of obesity on the diagnosis and outcomes of patients with atherosclerotic cardiovascular disease, heart failure, and arrhythmias. Childhood obesity aggravates the course of cardiovascular disease from a very early age. The fact that even kids and adolescents are obese is associated with high blood pressure, dyslipidemia, and hyperglycemia.

The result is excessive insulin production in the body. This, in turn, leads to an overabundance of insulin in the blood, which makes the peripheral tissues more resistant to it. As a consequence of the above, sodium metabolism is disturbed, and blood pressure rises. It is important to remember that excessive carbohydrate food intake leads to increased production of insulin by the pancreas. Excess insulin in the human body easily converts glucose into fat. And obesity reduces tissue sensitivity to insulin itself. This kind of vicious circle leads to type 2 diabetes.

Effects on Joints

Obesity increases the load on joints to a great extent, especially if one undergoes little or no physical activity. For instance, if one lives in a megalopolis, where all physical activity consists of getting off the sofa, walking to the car, and plumping up in an office chair at work. All this leads to a reduction in muscle mass, which is already weak, and all the load falls on the joints and ligaments.

The result is arthritis, arthrosis, and osteochondrosis. Consequently, a seemingly illogical situation is formed – there is practically no exercise, but joints are worn out harder than in the case of powerlifters. In turn, according to a study by the University of California, reducing body weight reduces the risk of osteoarthritis.

Infertility

In most cases, being obese leads to endocrine infertility, as it causes an irregular menstrual cycle. Women experience thyroid disease, polycystic ovarian syndrome, problems with conception, and decreased progesterone hormone. Obese men are faced with erectile dysfunction, reduced testosterone levels, and infertility. It should be noted that the mother’s obesity affects not only her health but also the one of her unborn child. These children are at higher risk of congenital malformations.

Corresponding Inconveniences

Public consciousness is still far from the notion that obese people are sick individuals. The social significance of the issue is that people who are severely obese find it difficult to get a job. They experience discriminatory restrictions on promotion, daily living disadvantages, restrictions on mobility, clothing choices, discomfort with adequate hygiene, and sexual dysfunction. Some of these individuals not only suffer from illness and limited mobility but also have low self-esteem, depression, and other psychological problems due to involuntary isolation by watching television or playing video games. Therefore, the public has to recognize the need to establish and implement national and childhood obesity epidemic prevention programs.

Society today provokes unintentional adult and childhood obesity among its members by encouraging the consumption of high-fat, high-calorie foods and, at the same time, by technological advances, promoting sedentary lifestyles like spending time watching television or playing video games. These social and technological factors have contributed to the rise in obesity in recent decades. Developing a responsible attitude towards health will only have a full impact if people are given the opportunity to enjoy a healthy lifestyle. At the level of the community as a whole, it is therefore important to support people in adhering to dieting recommendations through the continued implementation of evidence-based and demographic-based policies to make regular physical activity and good nutrition both affordable and feasible for all. It is recommended to cut down on the food consumed.

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Making Childhood Obesity a Priority: A Qualitative Study of Healthcare Professionals' Perspectives on Facilitating Communication and Improving Treatment

Costela lacrimioara serban.

1 Functional Sciences Department, “Victor Babes” University of Medicine and Pharmacy Timişoara, Timişoara, Romania

Salomeia Putnoky

2 Microbiology Department, Centre for Studies in Preventive Medicine, “Victor Babes” University of Medicine and Pharmacy Timisoara, Timisoara, Romania

3 Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden

4 Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom

5 School of Anthropology and Museum Ethnography, University of Oxford, Oxford, United Kingdom

Paulina Nowicka

6 Department of Food Studies, Nutrition, and Dietetics, Uppsala University, Uppsala, Sweden

Adela Chirita-Emandi

7 Department of Microscopic Morphology Genetics Discipline, Center of Genomic Medicine, Regional Center of Medical Genetics Timis, “Victor Babes” University of Medicine and Pharmacy Timisoara, Timisoara, Romania

8 Regional Center of Medical Genetics, “Louis Turcanu” Clinical Emergency Hospital for Children, Timişoara, Romania

Associated Data

The original contributions presented in the study are included in the article/ Supplementary Material , further inquiries can be directed to the corresponding authors.

In Romania, one in four children has excess weight. Because childhood obesity is a sensitive topic, many healthcare professionals find it difficult to discuss children's excess weight with parents. This study aims to identify barriers and facilitators in childhood obesity-related communication, as perceived by healthcare professionals in Romania. As part of the STOP project, healthcare professionals (family physicians, pediatricians, and dieticians) who treat children with excess weight were invited to a telephone interview. The semi-structured questions were translated from a questionnaire previously used at the Swedish study site of the STOP project. Interviews were transcribed and then used for thematic analysis. Fifteen doctors and three dieticians (16 females and 2 males), with average 18.2 ± 10.1 years of experience, were interviewed. Four main themes were identified. Professionals reported that when children began experiencing obesity-related stigma or comorbidities, this became the tipping point of weight excess, where parents felt motivated to begin treatment. Barriers in communication were part of several layers of distrust, recognized as tension between professionals and caregivers due to conflicting beliefs about excess weight, as well as lack of trust in medical studies. Most respondents felt confident using models of good practice, consisting of a gentle approach and patient-centered care. Nonetheless, professionals noted systemic barriers due to a referral system and allocation of clinical time that hinder obesity treatment. They suggested that lack of specialized centers and inadequate education of healthcare professional conveys the system does not prioritize obesity treatment and prevention. The interviewed Romanian doctors and dieticians identified patient-centered care as key to treating children with obesity and building trust with their caregivers. However

their efforts are hindered by healthcare system barriers, including the lack of specialized centers, training, and a referral system. The findings therefore suggest that, to improve childhood obesity prevention and treatment, systemic barriers should be addressed.

Trial Registration: ClinicalTrials.gov , {"type":"clinical-trial","attrs":{"text":"NCT03800823","term_id":"NCT03800823"}} NCT03800823 ; 11 Jan 2019.

Introduction

Excess weight in children is prevalent worldwide. Although plateauing trends were observed in many high-income countries in Europe, in medium and low-income countries childhood obesity prevalence has increased in the last decade ( 1 ). In Romania, almost one in four children has overweight or obesity, as shown in a pooled analysis of more than 25,000 school age Romanian children ( 2 ) and the European Childhood Obesity Surveillance Initiative (COSI) ( 3 ).

Childhood obesity is recognized as a significant concern in the 2014–2020 Romanian National Health Strategy (HG, No.1028/18.11.2014) and efforts have been made to implement policies supporting healthy food and activities in the school setting. Additionally, media campaigns were coordinated to promote a healthy lifestyle. The Health Ministry's strategy did not formally name the healthcare professionals who should treat childhood obesity; however, family physicians, general, and specialist pediatricians (endocrinologists and specialists in diabetes and metabolic diseases), together with dieticians, are key to childhood obesity treatment.

Communicating with children and families about excess weight represents a crucial clinical skill for healthcare professionals in the prevention and management of childhood obesity ( 4 ). Focusing on obesity is difficult for several reasons, including time constraints and a concern about how the message is perceived ( 5 ). Previous studies have shown that many healthcare providers hold negative attitudes toward people with obesity ( 6 ). Such stigma can lead to reduced quality of care for people with obesity despite the best intentions of healthcare professionals ( 6 , 7 ). A joint international consensus statement for ending weight stigma was recently published, in an attempt to raise awareness of the negative consequences of weight stigma among a broad group of stakeholders, including healthcare providers, researchers, the media, policymakers, and patients ( 8 ). However, even when healthcare professionals do not endorse weight stigma, the social stigmatizing of obesity may affect the quality of care. Healthcare professionals are often avoiding discussing obesity with patients and their families, for fear of offending them and losing their trust ( 9 ).

The success of childhood obesity treatment depends on improving healthcare professionals' education, attitudes, and practices related to communication about obesity, as well as coordinated efforts to reduce weight stigma on the community level ( 10 , 11 ). A recent meta-analysis has shown that numerous studies explored weight stigma and healthcare communication in North America and Western Europe ( 12 ). However, similar studies have not been performed in Central/Eastern Europe, and no study has investigated how Romanian healthcare professionals perceive communication about excess weight. Overall, research on childhood obesity treatment in Central/Eastern Europe is limited, as shown by a recently updated Cochrane review ( 13 ).

This study presents the first analysis of barriers and facilitators Romanian healthcare professionals face when communicating with and treating families of children with excess weight. Through this, we aim to develop an in-depth understanding of the locally-specific conditions healthcare professionals face, and thereby contribute to the improvement of childhood obesity treatment in Romania.

Participants

Healthcare professionals (family physicians, pediatricians, and dieticians) who treat children with excess weight were recruited for the study. Doctors were identified through a public registry of 242 family physicians and 54 pediatricians. A formal list of pediatric dieticians was not available, therefore, a sample of the author's professional contacts were invited to participate. All healthcare professionals were recruited in Timisoara, a metropolitan area in western Romania. Timisoara's metropolitan area is home to almost half a million inhabitants and is one of Romania's economic hubs, as shown by gross domestic product per region ( 14 ). Potential participants were initially invited by email. The invitation emails explained the purpose and procedure of the current study. Interviews were scheduled with those who responded within a 3-week timeframe. The number of participants has met the criteria for data saturation established by Guest et al. ( 15 ).

Interview Guide

The present study is part of the EU funded project “Science and Technology in childhood Obesity Policy” (STOP) (Grant Agreement No. 774548). We used the questionnaire and interview guide developed by Sjunnestrand et al. ( 9 ) at the STOP project's Swedish study site. The semi-structured interview questions aimed to capture respondents' experiences of communicating with parents about their children's excess weight and to identify the perceived barriers and facilitators for inception of obesity treatment. The Swedish guide was translated into English and then to Romanian with minor reformulations and cultural adaptations.

The interviews were conducted one-on-one by a female researcher (SP), with professional experience in medicine and dietetics (MD, Ph.D.) and teaching experience of 26 years. She asked all respondents the same set of core questions, as well as individualized follow-up questions based on the responses, using think-aloud and verbal probing techniques ( 16 ). Both techniques provide a better understanding of the cognitive processes induced by the questions, enabling participants to express their own thought processes and raise additional issues. All interviews were conducted via telephone. The interviews were audio recorded and then transcribed verbatim by members of the research team (IJS, CLS, MB, AD). Field notes were made after the interviews.

Thematic Analysis

The interview transcripts were analyzed in Romanian, using thematic analysis. The transcribed interviews were read, re-read and then coded by ACE and CLS, using an inductive approach (data driven), rather than being limited to a pre-existing coding frame stipulated by the initial hypothesis ( 17 ). Thus, identified themes related to the responses rather than the specific interview questions. In using an inductive approach, we did not employ a predetermined theoretical framework; however, the coders were particularly interested in data that addressed barriers and facilitators to communication. All codes were defined in a codebook following a template ( 18 ). ACE and CLS had several meetings to follow the progress of analysis and to discuss the coding. Themes and subthemes were developed from the codes, following wider team discussions between ACE, CLS, KE and PN, in which a few disagreements were resolved and consensus achieved. Relevant quotes for the subthemes were translated from Romanian to English by ACE and CLS.

The study received ethics approval from the Scientific Research Ethics Committee Board of the “Victor Babes” University of Medicine and Pharmacy Timisoara (no.06/02.03.2020). Participant confidentiality is maintained throughout the manuscript. Each quote is labeled to indicate the position of each respondent and the interview number, as follows: (1) gender (F -female/M-male), (2) number within group, (3) group: primary care (PC) represented by family physicians and general pediatricians; secondary care (SC) represented by specialist pediatricians (gastroenterology, cardiology, nephrology, orthopedics, genetics); tertiary care (TC) represented by pediatric specialists designated for obesity healthcare (endocrinology, diabetes) and dieticians; (4) years of experience. The COnsolidated criteria for REporting Qualitative research (COREQ) checklist ( Supplement 1 ) was used in creating the report.

Initially, 21 participants agreed to be interviewed; however, three of them were not available to schedule an interview in the proposed timeframe due to time constraints (2 persons) and health issues (1 person). The final analysis included interviews with 18 respondents, all of whom verbally expressed informed consent and provided answers to all questions.

In total, 18 physicians and dieticians (16 females and 2 males), with average 18.2 ± 10.1 years of experience (range 5–35 years), were included in the analysis. Physicians in primary care (2 family physicians, 6 general pediatricians) had on average 17.75 ± 10.4 years of experience. Physicians in secondary care (5 specialist pediatricians in cardiology, nephrology, genetics, orthopedics, and gastro-enterology) had on average 21.2 ± 9.0 years of experience. Healthcare professionals in tertiary care (one pediatric specialist in endocrinology, one specialist in diabetes care and 3 dieticians) had on average 15.2 ± 12.0 years of experience. The average interview time was 26 min (range 14–49 min). Four main themes and eight sub-themes were identified (presented in Figure 1 ).

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Main themes and sub-themes identified.

Tipping Point of Weight Excess

The first theme, “Tipping point of weight excess,” captured the triggers that motivated families to seek obesity treatment. The respondents noted that families did not perceive excess weight as a problem until a tipping point was reached and obesity became a priority. The determining moment for families/individuals was associated with the burden of stigma (first subtheme) and emerging comorbidities (second subtheme).

Burden of Stigma

Although some physicians described excess weight discussions as routine, the majority felt that children's excess weight was a sensitive subject for caregivers. This was especially the case for physicians who were the first to raise the topic. On the contrary, dieticians did not consider excess weight as a particularly sensitive topic, as they saw families after they had been self-referred or referred by a physician, and were therefore already prepared for discussions of excess weight.

Most healthcare professionals deliberately used non-offensive words in raising the issue of childhood excess weight:

“ I try to be very careful, I don't use the words obesity or fat, I may say that he/she weighs a few extra kilograms and that he/she should take some measures to prevent worse situations, (…) I try an approach with kid gloves, more gentle, to see how parents react” (F5PC30).

Practitioners were aware of the effects obesity stigma can have on families, and actively tried to avoid connotations of stigma when speaking to patients and parents:

“ trying to keep a balance between avoiding stigma for the patient and explaining that excess weight is a problem,. it is not about aesthetics or trying to fit into a body ideal, it is about the health consequences of obesity (.) To stigmatize is not in our interest, as we try to obtain the patient's compliance” (F3TC33).

However, children and families often encountered stigma before meeting the physician. Parent and family awareness was sometimes triggered by a shocking event in a social context or a school setting, such as an incident of bullying. For example, one physician said:

“ I think there is a context, in school, or somewhere else, a situation that triggers this, and all of a sudden the parent understands -.Ooo! my child is…- even though in the last years the child was chubby and nothing happened”(F2TC6) .

Stigma burden in the school setting was reported in almost all interviews. “ Older children, girls, are generally bothered by being overweight because they have problems at school. They are bullied (…)” (F2TC6). In school, stigmatization by peers was worse in sports contexts, where physical capabilities and endurance were evaluated: “ the child cannot integrate in the sports class because he cannot cope and his peers laugh or the teacher points out the difference in performance” (F2TC6). According to most respondents, stigmatization at school was a key tipping point that urged children and parents to seek help. For example, one physician spoke about a patient who said “ that she really wants to lose weight because she gets tired too easily and is ashamed during sport classes and in school” (F4PC9). Another respondent also mentioned: “ When children are socially discriminated against, the parents are starting to feel that something is wrong and want to make a change” (F1TC12) .

Emerging Comorbidities

Respondents reported that some families approached healthcare practitioners only when the child's excess weight became moderate or severe: “ Never with small excess (weight), always when the excess outruns some threshold, when they feel it's beyond their control (.) in most, when the excess is moderate to severe” (F5TC23). In many cases, families contacted physicians due to comorbidities of excess weight rather than due to the excess weight itself:

“ Most do not contact us due to being overweight, rather (.) for other ( causes ). asthma, hypertension or diabetes or something else, but do not come to the hospital due to obesity, do not come to ask for help in losing weight” (F7PC15).

In preschoolers, orthopedic complaints, gastroenterological issues, recurrent respiratory infections, and sleep disturbance were mentioned as drivers to seek medical care. As one respondent described:

“ A very high percentage asks for help when other health problems arise, that can be felt. That is, concretely, the child feels ill, the child does not breathe well, the child snores, does not sleep at night, does not rest” (F2PC7).

Another respondent noted:

“ They decide [to seek help] when their children have an orthopedic problem, they have joint pain, pain in their lower limbs or back or when they have respiratory infections, (…) more frequently compared to their friends” (F1PC30).

In adolescent patients, comorbidities usually found in adults, such as arterial hypertension, metabolic syndrome, and endocrine dysfunctions were reported.

Physicians reported that, even after seeking help for a child's obesity-related illness, parents still did not recognize obesity as the underlying issue, and sometimes did not understand that excess weight could contribute to the condition for which they seek treatment:

“ Most of them come for gastroenterology consultation, due to high levels of transaminase or irritable bowel syndrome or dyspepsia, which are clearly connected with obesity. But they (the caregivers) do not see obesity as a problem, they only see these symptoms and focus on them” (F4SC12).

Nonetheless, physicians explained that, even when parents did not recognize obesity as a problem, they used the child's referral for another condition to initiate a conversation about obesity: “ They come for other pathologies - breathing problems, most often, and then, we take the opportunity to talk about obesity” (F2PC7).

Layers of Distrust

The second overarching theme identified in the interviews was layers of distrust . This theme captures disagreements about excess weight and food practices in the family, alongside an intrafamilal “blame game.” It also captures conflicting views of obesity, as expressed by families and healthcare professionals, and families' lack of trust in the medical system. Two subthemes were identified: family in disagreement and tension between doctors and families.

Family in Disagreement

Respondents noted that family members often disagreed about the meaning and severity of excess weight, and that this had implications for children's treatment. As one respondent said,“ (.) most unsuccessful outcomes are due to family disagreeing views” (F3PC10). According to the respondents, the presence of both parents in the clinical consultation increased the level of agreement and strengthened the chances of treatment success. When children were accompanied by one caregiver, usually the mother, she disclosed that other member(s) of the family did not agree with seeking help for the child's excess weight, usually because they felt excess weight was not urgently problematic. One respondent explained that “ [m]ost of the time both parents agree that there is a problem, (but) the way they respond to the problems is different. At least one of them tends to neglect or minimize the importance of this problem ” (M2SC18).

When children were accompanied by only one caregiver, absent family members were frequently blamed for the child's obesity: “ (.) the guilt is usually assigned to grandparents, or someone else than the person that accompanies the child. (.) Others are (accused of) secretly giving chocolate, snacks and potato chips ” (F7PC15). When possible, a more complete picture of the familial situation was ascertained by conducting separate discussions with different caregivers involved in the child's care: “ things are not exactly as the parents present them. When we talk to grandparents, we learn that the parents are also buying and eating unhealthy foods and then things are more complicated” (F3TC33).

Tension Between Doctors and Families

The gap between healthcare professionals' and families' understandings of childhood excess weight was another source of tension. Respondents said that communication barriers occurred more often in meetings with low-income families or with grandparents. Among poorer and older family members, the respondents explained, children's excess weight was associated with higher social status, health and beauty. For example, one respondent said a grandmother confronted her, saying “ [y]ou (the doctor) cannot tell me that something is wrong with my grandchild, that he is too fat. He is a child that eats well” (F1SC16). Another respondent described remarks such as: “ - Ma'am, this is not a problem, I mean, I am also white, fat and beautiful”; this practitioner explained that “ [t]his creates a communication barrier, that I felt that I will have no success, no matter how I approach it” (F2PC7).

Respondents noted that families often refused to participate in studies concerning excess weight. A recurrent opinion was that parents worried their children would be treated as “guinea pigs” in clinical studies: “ I don't know what it's like in other countries, but in Romania they don't like to be studied. They fear they will become a guinea pig. I think it's a matter of perception and I don't know how it could be changed” (F4SC12). Respondents suggested that families' concerns were driven by not understanding the benefits of research and the belief that no feedback will be provided, as well as low parental education level, the socio-cultural valuation of children's excess weight, and the additional effort that research participation involves: “ The complexity of these studies and the fact that we ask parents and children make an extra effort, efforts that I do not think they are willing to make (…) Somewhere here is the barrier” (M2SC18). A potentially key reason for refusal to participate in studies was lack of trust in the healthcare system. One respondent reported that she encountered similar refusal to participate in studies on diabetes and obesity across Romania:

“ Because there is a general distrust in the medical staff in Romania (.). Distrust is also showed by the refusal to vaccinate children (.) We did not experience this 10-12 years ago, instead, recently, for a study regarding diabetes, two years ago it was a mass refusal, and not only in Timisoara but also in other parts of the country. (…) In studies that require blood sampling, interventional studies or studies that include medication, there are already more reluctant. I can't say that these refusals are justified, but unfortunately I found refusals like that … without any a justification” (F3TC33).

Models of Good Practice

Most respondents reported they use various models of good practice to ensure appropriate communication, aiming to empower patients and their families to start treatment. This theme consisted of the two subthemes: gentle approach and patient-centered care.

Gentle Approach

Respondents recognized the crucial role of language in the clinical encounter: “ Words, including gentle words, can have an impact. We must not be brutal in the way we communicate with the families, in any form” (F4PC9). Many practitioners reported using a probing interview approach to assess caregivers' awareness of excess weight: “ after I have taken care of the acute pathology that brings them to me, I ask questions like what age did the child start to gain weight, and so, I find out if it is a problem for them, because for many it is not a problem” (F6PC30). Other respondents reported using a direct approach without labeling the child obese. This was usually achieved by highlighting children's deviations from the normal growth curve: “ based on measurements, we show them exactly the situation of their child versus normal growth line for age and gender (.). On a reference chart we can show the family (.) the healthy weight for the height of their children” (F3TC33).

When approaching families who were not aware of the risks associated with excess weight, respondents described using a gentle approach that included seeking a “ level of awareness, to be sure that they understand what I want to say to them, (.) that I am not talking about aesthetics, rather, thinking about possible risks that they undertake if they continue with increasing weight” (F5TC23).

Healthcare professionals recognized that trust could be built step-by-step only when a channel of communication had been opened, with recommendations delineated gradually: “ I think, foremost, you have to earn their cooperation and trust and then recommendations can be enacted progressively, but with their consent. First they must understand and then they will accept” (F5TC23). Respondents also frequently reported focusing on what could be done and achieved, using positive language. For example, one physician describes speaking to families as follows:

“ you have to look at the positive side all the time: your child has a few extra kilograms, but let's look at the good side, he/she is in a growing period and it's much easier to do something now, as the child is much more physically active and then let's see how we can improve in the future (…) and that kind of works. So, I always tell them that it is much easier for the child to lose weight during periods of growth” (F7PC15).

To improve communication, respondents made efforts to empower patients and families. For example, one respondent said

“ [i]t helps to communicate and listen to their problems actively. Many times, they just need to be listened to. When they feel understood, they have even more confidence; somehow, they feel that they can do it. They often need encouragement and self-confidence that they can make changes” (F1TC12).

Another respondent said she made sure to praise her patients: “ I praise the child directly. I ask him if some things have improved (…), I ask how he feels, toward maintaining or losing weight” (F1PC30).

Patient-Centered Care

Respondents communicated to families that they were on their side: “ I think it matters a lot to be perceived as an ally, as a person who wants what's best for them and not as an extremely authoritarian figure. As an ally who knows what she is talking about and who gives them informed advice, having experience in this field” (F2PC7). Respondents also said they adapted to the families' concerns by offering personalized advice, taking into account families' wishes and their financial and social needs. For example, a dietician trying to dismiss a family's perception that healthy food was expensive said:

“ I gave them information about the price of foods a child can eat. To prove that it is not so expensive for a child to eat healthy (.) I give them options and examples - Look, instead, he can eat something that is four times cheaper and healthier. I even give them variants of shopping lists, including stores where to do grocery shopping. (.) From the moment I explain the cost (of healthy foods), that it's not so expensive, they have less preconceptions” (F2TC6).

According to the respondents, good practice entailed the successful involvement of the family in providing supportive environment for the child. They encouraged family members to share home cooked meals and act as role models of healthy eating. When grandparents were in charge of cooking for the child, the respondents invited them to the clinic to attend discussions regarding healthy food choices. For example, one respondent noted, “ [i]n a subsequent conversation we invite the grandparents, (.) and then the grandparents have to support the treatment plan by sharing the same meals as the grandchildren” (F3TC33).

Almost all respondents agreed that children's presence in clinical visits was beneficial, except if the children were too young to join the discussions. However, even if young children were kept busy with other activities during the visit, the respondents thought it was good for them to be present and to hear the discussion, as one physician pointed out “ [t]hey ( the small children ) understand more than we think” (F4SC12). If the children were older, respondents said that compliance and outcomes were improved if the child was engaged in the treatment plan. Indeed, one respondent noted that “ doctors can sometimes work better with the child than with the parent” (F7PC15). Some practitioners reported using an age-and gender-specific approach:

“ If the child is small, I do not approach the child, I approach the parent. If the child is a female preadolescent, I try to approach it differently. I tell the parent very clearly that if she does not control her excess weight at this age, she is at risk to have distorted body image perception that might lead to eating disorders in adolescence. In boys, I mainly focus on sports and mention that social success with the group of young people is also related to the physical aspect” (M3SC25) .

Systemic Barriers

Although most respondents felt confident using models of good practice, they noted systemic barriers to good practice, specifically a referral system, and time constraints that did not accommodate obesity treatment, showing that obesity does not fit the system. Additionally, respondents suggested that lack of specialized centers and poor education of healthcare professionals indicated the system doesn't prioritize obesity treatment and prevention.

Obesity Does Not Fit the System

Respondents frequently noted that clinical consultations should empower families. For this to be achieved, patients needed time to build trust, and healthcare practitioners needed time to adapt to each family's needs; however, time constraints sometimes hindered this. As one respondent described: “ You have to have a lot of time for explanations with these families, (…) you gain their trust this way (.) however doctor's consultation time is shorter than I would need (.) honestly with a patient with obesity, I consume time for 3 consultations” (F5TC23). Another respondent explained: “ One cannot do a consultation for obesity in 15 or 20 minutes, as for acute pathologies” (F3TC33).

Healthcare settings and processes were also cited as barriers. One respondent noted that a barrier in seeking treatment for the child's excess weight might be related to the hospital setting:

“ It is a cultural fear of being in a physician's office or in hospital. Parents say: “I don't want to take my child to the hospital because he gets a disease there." Perhaps, de-medicalization of the subject would be a solution, in the sense of not being addressed in a clinical setting as a medical treatment, rather as a behavioral treatment” (F1TC12).

Some respondents worried that adolescents with risk for morbid obesity were lost in the transition to adult care: “ we lose them there because when they turn 18, they no longer have a trusting vote with us (pediatricians) … . They see themselves as adults and as an adult they do not respect what they are told.unfortunately.” (F3TC33).

The System Does Not Prioritize Obesity

Several respondents noted that, as opposed to diabetes or cardiovascular diseases, the Romanian medical system does not consider obesity prevention or treatment a priority. As one respondent said: “ Obesity is not seen as a medical condition, it is not seen as a condition that needs treatment. That's why the (healthcare) system works poorly here” (M2SC18). Respondents mentioned lack of training as one example of the deprioritizing of obesity. One pediatrician said: “ I am not very convinced that we, the physicians, are properly educated to understand that obesity is a disease.” (F2PC7). Another aspect of the deprioritizing of obesity was the delay in referrals, with specialist doctors saying that general practitioners did not address childhood obesity in time:

“ (.) the family physician, or the physicians in schools should have observed that the child has excess weight and they should have addressed it, and get in contact with specialists to receive adequate monitoring. Practically, the system (the medical network for management of obesity) does not exist” (M2SC18).

Respondents suggested that multiple professionals should be involved in obesity care, including dieticians, psychologists and social services, as needed. However, consultations could rarely be scheduled in 1 day and respondents cited multiple visits as a contributor to families' reduced treatment participation. To increase coordination amongst multiple professionals, respondents underlined the need for specialized centers for childhood obesity treatment, as one respondent noted:

“ Medical barriers are organizational. (.) all consultations should be scheduled and well-coordinated. I'm talking about a consultation with the medical team, followed by a meeting with the dietician and with the psychologist, so that all this can be performed conveniently during one morning. Then the child does not have to miss school once for the doctor appointment, once for the dietician, once for the psychologist” (F3TC33).

All respondents underlined the need for a systemic approach, with childhood obesity prevention and intervention promoted by government policies, media, kindergartens and schools, family physicians, and general pediatricians.

This is the first study in Romania and in Central/Eastern Europe to investigate the barriers and facilitators healthcare professionals face when communicating with and treating families of children with obesity. The analysis shows that healthcare professionals identified the burden of stigma and the presence of comorbidities as the “tipping points” that lead families to seek help. However, they found that disagreements between family members about the seriousness of obesity, alongside families' distrust of the healthcare system, posed barriers to treatment. To build trust and engage families in treatment, the participating healthcare professionals followed models of good practice, consisting of a gentle approach and patient-centered care. Yet the respondents argued that treatment was often limited due to systematic barriers, including the referral system and time constraints, as well as the lack of specialized centers and poor education of healthcare professional. These were cited as examples of the healthcare system's deprioritizing of childhood obesity treatment and prevention.

The respondents' observation that children's experiences of weight stigma were the main motivation for treatment seeking suggests that treatment was initiated too late, and that children starting treatment had already experienced emotional and social hurt related to obesity. Children and adolescents with obesity who experience stigma suffer from psychological, physical, and behavioral difficulties that increase the risk of social isolation and weight gain ( 19 ). In addition, experiences of stigma have detrimental effects on healthy eating and engaging in physical activity ( 20 – 22 ), access to treatment ( 23 ), and adherence to weight loss related treatment ( 21 , 24 ), suggesting that children who begin treatment after having experienced stigma might not fully benefit from it.

The respondents characterized childhood obesity an “invisible disease,” with family members seeking treatment only after observing comorbid conditions. Delayed treatment seeking, until childhood obesity becomes severe or complicated by other diseases, has been observed in other studies ( 25 – 28 ). Moreover, in a United States based study, Eli et al. ( 29 ) found that parents of young children believe that obesity becomes a problem only at the beginning of primary school, when children might face bullying, or when comorbidities occur.

To make the “invisible” nature of excess weight concrete, the healthcare professionals in our study reported that they used growth charts to objectively compare the child's weight status to with a healthy weight reference population. Growth charts are useful and acceptable tools that professionals commonly use to improve counseling and facilitate behavior change ( 30 ). Therefore, these charts should be shown to parents before children develop obesity, to assist early prevention efforts. The recent study by Sjunnestrand et al. conveys the importance of teaching parents to understand child growth charts early on, and thus prevent obesity and associated comorbidities ( 9 ).

Several layers of distrust within the family and between the family and the medical practitioners were noted in the interviews. Within the family, respondents said that often only one parent or some family members recognized the excess weight, while others did not, leading to disagreements on how to help the child. Similar findings were reported in an Australian interview study by Jackson et al. ( 31 ), who found that, in almost half of the families, fathers either did not recognize the child's excess weight or were in denial about it. The authors therefore proposed addressing children's excess weight as a familial issue, rather than as an individual's problem, in order to get the family to work together ( 31 ). Between the family and the medical practitioners, tension arose around definitions of childhood obesity. Moreover, respondents underscored that families were reluctant to participate in clinical trials for obesity treatment, suggesting distrusts of the healthcare system. This reluctance, according to the respondents, could indicate fear of being experimented on. At the time of publication there were no studies in Romania investigating communication between healthcare practitioners and families of children with obesity in relation to clinical studies. However, studies investigating patient's satisfaction with the Romanian healthcare system, showed high levels of dissatisfaction, and lack of trust in medical services and healthcare professionals ( 32 , 33 ). Patient dissatisfaction was related to communication barriers with healthcare professionals, as well as low quality accommodation, food and hygiene in hospitals, which thus failed to provide patients with a sense of security ( 32 – 34 ). Distrust toward medical services might lead to distrust toward medical studies. The local STOP project team in Romania has observed that recruitment to the study ( 35 ) has been limited. Similar concerns were reported in a US-based study which evaluate clinical trial acceptance ( 36 ). It has been suggested that addressing patients' fears with detailed explanations of methodology and patient safety measures could improve recruitment. Davidson and Vigden have recently evaluated the acceptance of participation in childhood obesity studies in Australia ( 37 ). They found that parents' decision to enroll in obesity programs was influenced by experiences with previous attempts to lose weight and their child's emotional state ( 37 ).

In our study, tension between families and healthcare professionals created barriers in communication. This is in line with a meta-synthesis of qualitative studies showing that different perceptions of excess weight between families and doctors are common barriers ( 12 ). These barriers, unless understood and addressed, might limit treatment success ( 38 ). In this study, the respondents addressed these barriers by using models of good practice when communicating with families about children's excess weight. A gentle approach, which increased parental awareness about childhood obesity while avoiding offense, was key. Previous research has shown the importance of avoiding judgment in developing successful communication with families of preschoolers with obesity ( 39 ). However, clinical practice alone does not improve communication skills, and when communication skills are lacking, practitioners usually avoid difficult conversations ( 38 ). Therefore, formal training is crucial in improving communication with families ( 40 ). In the present study, the respondents identified lack of training as a barrier to communicating with families. This barrier should be addressed by governmental policies to improve clinical continuing education.

Models of good practice reported by the respondents also included a patient centered care approach. Practitioners adapted treatment recommendations to the possibilities and needs of patients and families. Promotion of informed choice as part of the patient centered care approach has been emphasized in different medical fields ( 41 , 42 ). It includes a stepwise approach culminating with patients expressing their own choice, after the healthcare professional has presented different treatment pathways with their pros and cons ( 41 , 42 ).

A key finding was that respondents identified changes in the healthcare system as crucial to improving capacity for childhood obesity interventions. They noted that primary care physicians were often slow to refer families, and that families initiated treatment in secondary and tertiary care, only after comorbidities were observed. If obesity treatment were promoted in primary care, excess weight could be addressed earlier, with benefits to both patients and the healthcare system, as shown by a recent guideline issued by World Health Organization ( 43 ). Interestingly, while Romania and Sweden have different healthcare systems, Sjunnestrand et al. also reported that healthcare practitioners felt systematic changes were needed to improve treatment referral and uptake ( 9 ). Additionally, because childhood obesity treatment in Romania is associated with secondary and tertiary care, the respondents noted that families might refuse or postpone obesity treatment due to fears related to hospital settings. Offering a community-based, multi-disciplinary setting for childhood obesity treatment might increase the acceptability of treatment. The healthcare system could also benefit by limiting overcrowding in secondary and tertiary care and encouraging earlier treatment initiation ( 44 ).

Strengths and Limitations

This is the first study to investigate Romanian healthcare professionals' perspectives on communicating with families about childhood obesity. The study used the interview guide developed by Sjunnestrand et al. ( 9 ), who interviewed a homogenous group of pediatric nurses working in primary care centers in Sweden. In the present study, the interviews were conducted with a heterogeneous group of healthcare professionals from primary, secondary and tertiary care, in order to present various perspectives on communication with families of children with excess weight in Romania. Thus, while the study benefited from using an established interview guide, the different categories of healthcare professionals interviewed precluded a meaningful comparison with the Swedish dataset. A formal list of pediatric dieticians was not available, as at the time of the study a national association of dieticians did not exist. Therefore, we invited the authors' personal contacts to participate, and we recognize this may have limited the diversity of dietician participants. The dieticians invited could not provide contact for other colleagues involved pediatric nutrition, possibly because of low numbers or lack of formal association. Future research involving dieticians would be strengthened by the use of snowball sampling, which could provide a more diverse sample. The study was potentially limited by selection bias, since participants who agreed to be interviewed might have had a particular interest in childhood obesity. The study was also limited by the low response rate, likely due to the interview timeframe, which overlapped with the COVID-19 pandemic lockdown.

Future Directions

While this study has focused on healthcare professionals' perceptions of communicating about and treating childhood obesity, it would be important to understand families' experiences, as well. We plan to investigate the experiences of parents and children as part of the More and Less Study Europe ( 35 ). The study's findings convey the importance of establishing a professional network in Romania for the management of childhood obesity. Moreover, services provided by dieticians should be included in the Romanian Health Insurance network, to facilitate the integration of dietetics service into standard childhood obesity treatment. In addition, the primary medical care in kindergarten and schools in Romania, might be used, in a step-by-step approach, for raising awareness about childhood obesity, reducing obesity stigma, and encouraging treatment initiation.

Conclusions

The interviewed doctors and dieticians in Romania identified patient-centered care as key to treating children with obesity and building trust with their caregivers. However, their efforts are hindered by healthcare system barriers, including the lack of specialized centers, training and a referral system. The findings therefore suggest that, to improve childhood obesity prevention and treatment, systematic barriers should be addressed.

Data Availability Statement

Ethics statement.

The studies involving human participants were reviewed and approved by Scientific Research Ethics Committee Board of the Victor Babes University of Medicine and Pharmacy Timisoara (no.06/02.03.2020). The patients/participants provided their written informed consent to participate in this study.

Author Contributions

AC-E, PN, and AE developed the interview guide. SP conducted the interviews. AC-E and CLS wrote the first draft of the manuscript under supervision of PN. KE contributed to the analysis and to the writing of the manuscript. All authors contributed to final editing of the document and approved of the last version of the manuscript.

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Acknowledgments

The authors want to thank the physicians and dieticians that participated in the interviews. We acknowledge Iulia Jurca-Simina (IJS), Costela Lacrimioara Serban (CLS), Meda Bugi (MB), and Ana-Maria Dragomir (AD), who transcribed the interviews.

Abbreviations

The content of this document reflects only the authors' views and the European Commission is not liable for any use that may be made of the information it contains.

Funding. The STOP project received funding from the European Union's Horizon 2020 research and innovation program under Grant Agreement No. 774548.

Supplementary Material

The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fpubh.2021.652491/full#supplementary-material

Supplement 1

COREQ checklist. Includes the COREQ checklist for this submission.

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