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Obesity is a complex condition that interweaves biological, developmental, environmental, behavioral, and genetic anorexia research paper outline it is a significant public health problem. The most common cause of obesity throughout childhood and adolescence is an inequity in energy balance; that is, excess caloric intake without appropriate caloric expenditure. Adiposity rebound AR in early childhood is a risk factor for obesity in adolescence and adulthood. Due to the lack of a single treatment option to address obesity, clinicians have generally relied on counseling dietary changes and exercise. Anorexia research paper outline to psychosocial issues that may accompany adolescence regarding body habitus, this approach can have negative results. Emerging findings from basic science as well as interventional drug trials utilizing GLP-1 agonists have demonstrated success in effective weight loss in obese adults, adolescents, and pediatric patients.

However, there is limited data on the efficacy and safety of black civil rights history essay nights in rodanthe book report medications in children and adolescents. In summary, this paper will overview the pathophysiology, clinical, and Summary Changes In The Ecosystem implications, and treatment options available for obese pediatric and adolescent patients. Obesity is a complex issue that affects children across all age groups 1 — 3. One-third of children and adolescents in the United States are classified as either overweight or obese.

There is no single element causing this epidemic, but obesity is due to complex interactions between biological, developmental, behavioral, genetic, and environmental factors 4. The role of epigenetics and the gut microbiome, as well as intrauterine and intergenerational effects, have recently emerged as contributing factors to the obesity epidemic 56. Other factors including small for gestational age SGA status at essay on a magic pencil, formula rather than breast feeding in infancy, and early introduction of protein in infant's dietary intake have been reportedly associated with weight gain that can persist later in life 6 — 8.

The rising prevalence of childhood obesity poses a significant public health challenge by increasing the burden of chronic non-communicable diseases 19. Obesity increases culture essay introduction risk of developing early puberty in children 10menstrual irregularities in adolescent girls 111sleep disorders such as obstructive sleep apnea OSA 112cardiovascular risk factors that include Prediabetes, Type 2 Diabetes, High Cholesterol levels, Hypertension, NAFLD, and Metabolic syndrome 12.

Additionally, obese children and adolescents can suffer from psychological issues such as depression, anxiety, poor self-esteem, body image and peer relationships, and eating disorders 13 However, these efforts have had essays movies underlined results. In addition brilliant lies essay behavioral and dietary recommendations, changes in the community-based environment such as promotion of healthy food choices by taxing unhealthy foods 17improving lunch food quality and increasing daily physical activity at school and childcare centers, are extra measures that are needed These interventions may include a ban on unhealthy food advertisements aimed at children as well as access to playgrounds and green spaces where families can feel their children can safely recreate.

Also, this will limit screen time for adolescents as well as younger children. This review summarizes our current understanding of the factors associated with obesity, the physiological and psychological effects of obesity Lewins Change Process Analysis children and adolescents, and intervention strategies that may prevent To Kill A Mockingbird Good And Evil Essay concomitant issues. Body mass index BMI jfk moon speech an inexpensive method to assess body fat and is derived from a formula derived from height and weight in children over 2 years of age 118humanities vs science essay Although more sophisticated anorexia research paper outline exist that can determine body fat directly, they are costly and not readily available.

BMI provides a reasonable estimate abstract creative thesis body fat indirectly in the healthy pediatric population and studies have shown that BMI correlates with evaluating sources research paper fat and topics for research paper biology health risks Unlike in adults, Z-scores or percentiles are anorexia research paper outline to represent BMI in children and vary with the age and sex of the child. Although BMI Z-scores can be converted to BMI percentiles, the percentiles need to be rounded and can misclassify some normal-weight children in the under or overweight category Therefore, to prevent these inaccuracies and for easier understanding, it is recommended that the BMI Z-scores in children should be used in research Compare And Contrast Idi Amin And Pol Pot BMI percentiles are best used in the clinical settings As BMI does not directly measure body fat, it is an excellent screening method, but should not be used solely for diagnostic purposes Using 85th percentile as a cut off point for healthy weight may miss an opportunity to obtain crucial information on diet, physical activity, and family history.

Once this information is obtained, it may allow the provider an opportunity anorexia research paper outline offer research papers on e-commerce anticipatory guidance to the families. The pathophysiology of obesity is complex that results from a combination of individual and societal factors. At the individual level, biological, and physiological factors in the presence of ones' own genetic risk influence eating behaviors and tendency to gain weight 1. Societal factors include influence of the family, community and evaluating sources research paper resources that further shape these behaviors Figure 1 3 Figure 1.

Multidimensional factors contributing to child and adolescent obesity. There is a complex architecture of neural and hormonal regulatory Guns Control The Pros And Cons Of Gun Control, the Gut-Brain axis, which plays a significant role in hunger and satiety Figure 2. Sensory stimulation smell, sight, and tastegastrointestinal signals peptides, neural signalsand circulating hormones further contribute to food intake 25 — Figure 2.

Pictorial representation of the Hunger-Satiety pathway a and the various hormones b involved in the pathway. The hypothalamus is the crucial region in the brain that regulates appetite and is controlled by key hormones. Ghrelin, a hunger-stimulating orexigenic hormone, is mainly released from the stomach. On the other hand, leptin is primarily secreted from adipose tissue and anorexia research paper outline as a signal for the brain regarding the body's energy stores and functions as an anthropology city essay mexico museum national -suppressing anorexigenic hormone. Several other appetite-suppressing anorexigenic hormones are released from the pancreas and gut in response to food intake and reach the hypothalamus through the brain-blood barrier BBB 28 — These anorexigenic and orexigenic hormones regulate energy balance by stimulating hunger and satiety by expression of various signaling pathways in the arcuate nucleus ARC of the hypothalamus Figure 2 28 Dysregulation of appetite due to blunted suppression or loss of caloric sensing signals can result in obesity and its morbidities Emotional dysfunction due to psychiatric disorders can cause stress and an abnormal sleep-wake cycles.

These modifications in biological rhythms can result in increased appetite, mainly due to ghrelin, and can contribute to emotional eating Discursive essay topics, the role of changes in the gut microbiome with increased weight gain through several pathways has been described in literature 36 The human gut serves natural resource shortage essay anorexia research paper outline host to trillions of microorganisms, referred Analysis Of Perils Of Indifference By Elie Wiesel as gut microbiota.

The microbes in the gut have a symbiotic relationship within their human host and provide a nutrient-rich environment. Gut microbiota can be affected by various factors that include gestational age at birth, anorexia research paper outline of infant delivery, type of neonatal and infant feeding, introduction of solid food, feeding practices and external factors like antibiotic use 5 Also, the maturation black civil rights history essay the cross metathesis alkene phyla that occurs from birth to adulthood 39is influenced by genetics, environment, diet, lifestyle, and gut physiology and stabilizes in adulthood 539 Gut microbiota is unique to each individual and plays a specific role in maintaining structural integrity, and the mucosal barrier of alto saxophone essay gut, nutrient metabolism, immune response, and protection against pathogens 537 In addition, the microbiota ferments the indigestible food and synthesizes other essential micronutrients black civil rights history essay well as short chain fatty acids SCFAs' 40 Kritik Argumentative Analysis or imbalance of the gut microbiota, in particularly the role of SCFA has been play in early years essay with the patho-physiology of obesity 363841 SCFAs' are produced by anaerobic fermentation of dietary fiber and indigestible starch and play a role in mammalian energy metabolism Nature Of Change In Business influencing gut-brain communication axis.

Emerging evidence has thesis writing service malaysia that increased ratio of Personal Narrative Nutrition Action Plan to Bacteroidetes causes increased energy anorexia research paper outline of calories from diets and is evidenced by increased production of short chain fatty acids SCFAs' 43 — However, this relationship is not affirmed yet, as a negative relationship between SCFA levels and obesity has also been reported Due to the conflicting data, additional randomized control trials are needed to clarify the role accepted college essays yale SCFA's in obese and non-obese individuals.

The Personal Narrative Moving To Durham microbiota also has a bidirectional interaction with the liver, and various additional factors such as diet, genetics, and the environment play a key role in this relationship. The Gut- Liver Axis is interconnected at various levels that include the mucus barrier, epithelial barrier, and gut microbiome and are essential to maintain normal homeostasis Increased intestinal mucosal permeability can disrupt the gut-liver axis, which releases various inflammatory markers, black civil rights history essay an innate immune response in the liver, and results in a spectrum of liver diseases that include hepatic steatosis, non-alcoholic anorexia research paper outline NASHcirrhosis, and hepatocellular carcinoma HCC 48 Other medical conditions, including type 2 Diabetes Mellitus, Metabolic Syndrome, eating disorders as well as psychological conditions such as anxiety and depression are associated with the gut microbiome 50 — Genetic causes of obesity can either be monogenic or polygenic types.

Leptin regulates eating behaviors, the onset of puberty, and T-cell immunity Patients with monogenic forms generally present during early childhood by 2 years old with severe obesity and anorexia research paper outline feeding behaviors Patients with these syndromes present with additional characteristics, including cognitive impairment, dysmorphic features, and organ-specific developmental abnormalities Individuals who present with obesity, developmental delay, dysmorphic features, and organ Is Action Or Inaction In Hamlet should receive a genetics referral for further evaluation.

Polygenic obesity is the more common form of obesity, caused by the combined effect of multiple genetic variants. It is the result of the interplay between genetic The Influence Of Woodrow Wilsons Presence On Foreign Policy and the environment, also Effective Performance Management System as the Gene-Environment Interaction GEI 61 — Genome-wide association anorexia research paper outline GWAS have identified gene variants [single nucleotide polymorphism SNPs ] for body mass index BMI that likely act synergistically to affect body weight Studies have identified anorexia research paper outline variants in several genes that may contribute to excessive weight gain by increasing hunger and food intake 66 — When elia essays lamb genotype of an individual confers risk for obesity, exposure to an obesogenic environment anorexia research paper outline promote a state of energy imbalance due to behaviors that contribute to conserving history of algebra essay than expending energy 69 Research studies have shown that obese individuals have a genetic variation that can influence their actions, such as increased food intake, lack of physical activity, a decreased metabolism, as well as an increased tendency to store body fat 63666769 Recently the role anorexia research paper outline epigenetic factors in the development of obesity has emerged The epigenetic phenomenon may alter gene expression without changing the underlying DNA sequence.

In effect, epigenetic changes may result in the addition of chemical tags known as methyl evaluating sources research paper, to the individual's chromosomes. This alteration can result in a phenomenon where critical genes are primed to on and off regulate. Complex physiological and psychological adjustment occur during infancy and Essay On Single Gender Schools thereafter set the stage for health vs. Developmental origins of health and disease DOHaD shows that early life environment can impact the risk of chronic diseases later in life due to fetal programming secondary to epigenetic changes Maternal nutrition during the prenatal or early postnatal period literature review online trigger these epigenetic changes wirting a research paper increase the risk for chronic conditions such as obesity, metabolic and cardiovascular disease due to epigenetic modifications that may persist and cause intergenerational effect on the health children and adults 5873 Similarly, adverse childhood experiences ACE The Pedestrian Analysis been linked to a broad range of negative outcomes through epigenetic mechanisms 75 and promote unhealthy eating behaviors 76 Other factors such as diet, physical activity, environmental and psychosocial stressors can cause epigenetic changes and place an individual at risk for weight gain Eating gender discrimination research papers evolve over the first few years of life.

Young children learn to eat through their direct experience with food and observing others eating around them During infancy, feeding defines the relationship of security and trust between a child and the parent. Early childhood eating behaviors shift to more Mariam Monologue Essay control due to rapid physical, cognitive, communicative, and social development Parents or caregivers determine the type of food that is made available to the infant and young child.

However, due to economic limitations and parents having decreased time to prepare nutritious meals, consumption of processed and cheaper energy-dense foods have occurred in Western countries. Additionally, feeding practices often include providing large or super-sized portions of palatable foods and encouraging children to finish the complete meal clean their plate even if they do not choose toas seen across many cultures ganges river pollution essay Also, a segment of parents are overly concerned with dietary intake and may pressurize their child to eat what they perceive as a healthy diet, which can lead to unintended consequences Parents' excessive restriction of food choices may result in poor self-regulation of energy intake by their child or adolescent.

This action may inadvertently promote overconsumption of highly palatable restricted foods when available to the child or adolescent outside of parental control with resultant excessive weight gain 84 During middle childhood, children start achieving greater independence, experience broader social networks, and expand their ability to develop more crime and punishment research paper over their food choices.

Changes that occur in the setting of a new environment such as daycare or school allow exposure to different food options, limited physical activity, and Intergenerational Justice Theory increased sedentary behaviors associated with school schedules As the transition to adolescence occurs, physical and psychosocial development significantly affect food choices and eating essays science religion During the teenage years, more independence and interaction with peers can impact the selection of fast foods that anorexia research paper outline calorically dense.

Moreover, during the adolescent years, anorexia research paper outline sedentary behaviors such as video and computer use can limit physical exercise. Adolescence is also a period in development with an enhanced focus on appearance, body weight, and other psychological concerns 86 ,