Obesity in childhood and adolescence is increasing at an alarming rate (10). This increase appears to be largely due to societal changes. Nowadays children generally do not to walk to school. Compared to the past, less time is devoted to physical activity in school. After school, children have fewer opportunities for playing outside. Many go straight home and lock themselves in, waiting for parents to come home from work. At home, they settle down into chairs and watch television. Snacking while watching TV is common at this time.
Surfing the Internet and playing video games commonly takes time away from outside activities (11). The availability of cheap food enhances caloric intake. When busy parents return home at night, they often prefer eating out to preparing healthy meals at home. A trip for hamburgers or pizza typically provides both diversion and unneeded calories. All ofthese factors combine to promote weight gain in children and adolescents.
To reverse these trends, it will be necessary to bring about major changes in the behavior of society as well as individuals (12). New recreational facilities are needed to promote physical activity. Safe havens for physical play are required. Schools need to spend more time in teaching healthy life habits. Parents must be made aware of how to improve the household to reduce the tendency for weight gain in the family. School lunches should be modified to be less calorically dense as well as healthier. These social issues and will require a concerted effort at local, state, and national levels.
The medical model for treatment of obesity in childhood so far had only limited success. Reports of success in achieving weight loss through professional intervention for individual obese children have not been encouraging. Thus, to deal with the problem of population childhood obesity, the social changes described above undoubtedly will be required.
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