Page 103 Complete Your CE Test Online - Click Here that they are being “scolded” they may rebel against healthy eating and lifestyle suggestions[9,36] . Recommendations must be practical. If the family has a limited income, the adults who purchase food may be more likely to purchase what is inexpensive, regardless of its health benefits, than what is healthy, especially if the costs exceed what they are able to spend. Think about the causes and risk factors for obesity. If family members are overweight or obese, it is likely that their dietary and lifestyle habits contribute to the child’s unhealthy weight. It is also likely that the entire family would benefit from adopting a more healthy diet and increasing the amount of exercise they get[9,36] . Schools play an important role in facilitating the development of a healthy environment. What kinds of food are being served in the school cafeteria? What kinds of foods and beverages are available in vending machines on school property? Nursing consideration: Healthcare providers, families, and friends must be aware that some eating disorders are triggered after affected persons have attempted to diet. The rewards they receive for losing weight (i.e. positive comments, improved performance in athletics, etc,) may make adolescents feel that they need to lose weight even to the point of near starvation (i.e. anorexia nervosa). Or they may indulge in purging behaviors (i.e. self-induced vomiting, abuse of laxatives and diuretics). The point is to be aware of those who are at risk for eating disorders as they adopt more healthy diets[20,21] . Here are some recommendations for counseling parents, children, and adolescents about weight loss[9,36,37,38] : ● ● Involve the entire family in efforts to adopt more healthy diets and to increase physical activity. ● ● Encourage the entire family to eat the same meal. The overweight or obese child or adolescent should not have to eat “different” foods from the rest of the family. For example, it is unrealistic to expect the affected child or adolescent to eat fruits and vegetables and lean meats while the rest of the family eats fried foods and elaborate desserts. ● ● Physical exercise should involve the entire family. Do not make exercise a punishment or something that is boring. Find an activity that family and friends enjoy and can do together to help the child or adolescent lose weight. ● ● Find out if the affected child or adolescent has friends that can support him/her in weight loss efforts. Going out for hamburgers and fries after the high school basketball game is not a good option for someone who needs to lose weight. Friends should encourage the intake of more healthy options such as salads or grilled chicken. Some recent research studies provide some more information about how to prevent or treat overweight or obesity in children. The results from one such study showed that having an older sibling who is overweight or obese is a strong predictor of childhood obesity. This is especially true if the sibling is of the same sex[39] . A research team evaluated data from a 2011 online survey of 3663 adults with at least one child younger than 18 years of age[39] . The survey contained questions about food-related behaviors of parents and children. Examples of such behaviors were eating at fast-food restaurants, physical activity, and eating while watching television[39] . Results showed that for children in two-child families with a parent who was obese or overweight, there was no statistically significant increase in the risk for obesity. But younger children with older siblings who were obese were almost six times more likely to be overweight or obese. There were also significant gender differences. Younger girls with an obese older sister were 16 times more likely to be overweight or obese. However, if the older sibling was a boy, the risk was about seven times greater[39] . Another recent study showed that early intervention reduces obesity risk in children[37] . Researchers recruited and trained four community nurses in Australia to deliver eight home-based educational sessions regarding healthy infant nutrition and activity habits. The sessions were given to 497 first-time mothers. Follow-up showed that this education significantly reduced the risk for obesity in children aged two years in Australia[37] . Prevention and reduction in obesity in adults Why do adults find it so difficult to lose weight? Why do they find it so hard to prevent weight gain? Many experts believe that one of the biggest obstacles to achieving and maintaining a healthy weight is environmental. Most, if not all, adults know that a diet high in calories and fat is not healthy. They also know that a diet high in fiber, fruits, and vegetables and getting plenty of exercise leads to weight loss and maintenance of a healthy weight[38] .However, their environments can make it very difficult to put into practice what they theoretically know is the best course of action to take. Culture, as well as environment, makes it all too easy to live a sedentary lifestyle and eat foods that are quick and easy to fix or buy as well as being high in fat and calories[38] . Experts agree that support groups, healthy diet consultations, and increasing physical exercise are among the best approaches to lose weight and maintain a healthy weight. These healthy behaviors need to be life-long behaviors[9] . Unfortunately, many Americans want to find a way to lose weight quickly without making lifestyle changes. They look for the next fad diet or weight loss pill as a means of losing weight without dieting or exercising. Unfortunately, many of these fads or “quick fixes” are espoused by celebrities that influence many of the devotees and should be avoided. Research indicates that popular low-carbohydrate diets offer no long-term weight loss solutions. Swift early weight loss may make dieters happy, but this early weight loss is due to water loss, not loss of fat. These types of crash or fad diets seldom provide long-term benefits unless they are accompanied by the ability to make long-term modifications of eating patterns (i.e. healthy eating) and incorporation of physical activity into the dieter’s lifestyle. Without such long-term modifications, persons often develop what is referred to as the ‘yo-yo” dieting syndrome, episodes of repeated rapid weight loss followed by weight gain[9] . Nursing consideration: “Yo-yo” dieting can be more harmful than obesity because it can place severe stress on the body[9] . There are many weight loss scams that are readily available thanks to the Internet. Fad weight loss products can be quickly and easily purchased online and sometimes even over-the-counter. Here are some warning signs to alert consumers to a weight loss scheme[40] . The weight loss scam: ● ● Promises a “quick fix” such as “lose 10 pounds every week.” ● ● Uses words such as “guaranteed” or “scientific breakthrough.” ● ● Is marketed in a foreign language. ● ● Is marketed via mass e-mails. ● ● Is marketed as an herbal alternative to an FDA-approved drug or as having effects similar to prescription drugs. The FDA frequently transmits notifications concerning weight loss scams. Several FDA notifications dealt with products that have been promoted and sold as weight loss interventions on various websites. These products contain sibutramine, a controlled substance that was removed from the market in 2010 because it significantly increases blood pressure and pulse and can pose a serious risk for clients with a history of coronary artery disease, congestive heart failure,