Page 84 Complete Your CE Test Online - Click Here 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, arrhythmias, or stroke. It can also cause dangerous interactions with other medications[41,42,3,44] . The FDA warns consumers not to purchase or use the following products because they contain sibutramine: ● ● Jimpness Beauty Fat Loss capsules. ● ● Super Slim. ● ● Diet Master. Seeking and using quick weight loss scam products is only one of several common mistakes people who want and need to lose weight make. According to an online article from Psychology Today, here are the 10 biggest mistakes people who want to lose weight can make[45] : ● ● Failing to incorporate exercise into their lifestyle behaviors. (Lifelong health behaviors are necessary to lose weight and not gain it back.) ● ● Underestimating the effort it takes to lose weight. (There is no quick fix to weight problems. It takes a lot of work.) ● ● Failing to make weight loss a priority. (Weight loss is not a casual undertaking. It needs to be a priority.) ● ● Blaming oneself for weight loss struggles. (Some people may believe that if they are not losing weight fast enough or that, if they gain back a few pounds, they are hopeless. Don’t be so hard on yourself!) ● ● Diagnosing self with rare conditions if weight loss does not occur quickly. (Some people convince themselves that they are seriously ill or that they can never lose weight because of some unknown “condition.” Patience is required.) ● ● Failing to take steps to control stress. (Many people eat when they are stressed. Dieting is an added stressor. Learn coping strategies to deal with stress.) ● ● Underestimating how much is being eaten every day. (Dieters need to honestly evaluate what and how much they eat.) ● ● Skipping meals. (Not eating for long periods of time makes it more likely that when someone finally does eat, he/she will eat many more calories than if they would have eaten at normal intervals.) ● ● Depending on fad diets. (As previously mentioned, fad diets and weight loss products seldom produce long-term results and can be dangerous.) Weight loss surgery Surgery as a means of treating obesity is becoming more popular. This is especially true for those persons for whom healthy diet, exercise, and other positive lifestyle changes did not help to lose enough weight[46] . Weight loss surgery, also referred to as bariatric surgery, is not for everyone. Prior to such surgery, complete physical and mental health examinations are conducted. Weight loss surgery requires permanent lifestyle changes. Such surgery can help reduce the risk of some weight- related problems such as type 2 diabetes, hypertension, and sleep apnea. There are also potential significant risks and complications of weight loss surgery[46] . Guidelines for weight loss surgery vary, but such surgery is generally considered when the BMI is 40 or higher and a life-threatening or disabling condition exists that is related to being overweight[46] . General guidelines may include may include that clients[6,47] : ● ● Have a BMI over 40, which means about 100 pounds overweight or 200% of one’s ideal body weight. ● ● Have a BMI between 35 to 40 with at least one obesity-related medical condition. ● ● Cannot achieve a long-term weight loss by diet and exercise initiatives alone. ● ● Are committed to lifelong lifestyle changes. ● ● Are committed to long-term follow-up medical care.