Obesity and Careful Physical Examination

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The past several decades have seen an escalating trend in the rate of childhood obesity not only in the United States where 25%-30% of children are affected, but also in many of the industrialized nations. Childhood obesity has continued to be a major issue in the public health care system. The economic cost of the medical expenses as well as the lost income resulting from the complications of obesity both in children and adults has been estimated at almost $100 billion (Barnes, 2011). Overweight children are more exposed to the danger of becoming overweight in their adulthood unless they ensure healthier eating habits and exercise. It is worth noting that the current lifestyle in which many children spend a lot of time watching television as well as the consumption of sugary and fatty foods has significantly contributed to the high prevalence of childhood obesity. Regarding the causes of childhood obesity, several theories of etiology including genetic, developmental, and environmental, have been proposed. Despite the prevalence of childhood obesity rising dramatically over the past 3 or 4 decades, major challenges still face the fight against the condition due to its underdiagnosis and undertreatment. It is worth noting that with careful physical examination and evaluation of disease history, unnecessary diagnostic procedures and the need for expensive equipment can be avoided. Given the rising concern about childhood obesity, this paper will discuss several issues. These include the history, epidemiology, etiology, course and prognosis onset, and how the disorder is represented in the DSM IV TR with its associated features.

The health risks associated with obesity are said to have been known by the ancient Greek physician Hippocrates who asserted that those people who were naturally fat had a higher risk of encountering sudden death than those who were lean. Greek physicians are credited for making the observation that infertility and infrequent menses in women was caused by obesity. About five centuries after Hippocrates, Galen who was a Roman physician made a distinction between immoderate and moderate forms of obesity. It is supposed that the immoderate form was an anticipation of what is currently classified as morbid obesity (Bray, 2009).

Though clinical observations made in the ancient times had brought to light the risk of diabetes and sudden death associated with obesity, the significance of excess mortality and morbidity caused by obesity has only received full appreciation more recently. Data obtained as early as 1901 indicated that people with excess weight, particularly around the abdomen had a shortened life expectancy. Further systematic studies have confirmed this risk and these results led to the World Health Organization classifying obesity on the basis of increasing BMI (Bray, 2009).

According to the statistics gathered since the 1960s, the prevalence of childhood obesity has been on the rise with the years between the 1980s and 1990s indicating a three times increase from nearly 5% to almost 15% for both children and teens (Centers for Disease Control and Prevention, 2011, p. 42). The National Health and Nutritional Examination Survey (NHANES) have been conducting studies on the prevalence of childhood obesity since the 1960s. According to its records, there has been an increasing trend in the rates of childhood obesity between 1963 and 2008 for children aged between 2 and 19 years. For instance, about 4.2% of children aged between 6 and 11 years and 4.6% of children aged 12-19 years were obese during the years between 1963 and 1970 (Marks, 2011).

The statistics for 1988 showed that the prevalence rate for the children aged 6-11 years had rose to about 11.3% whereas that for 12-19 year olds had escalated to 10.5%. The next statistics to be released for the year 2001 were even more shocking since the rates of childhood obesity for the 6-11 year olds had reached over 16%. From...
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