Weight Loss Interventions for Intellectual Disabilities

This assignment delves into the topic of weight loss interventions specifically designed for adults living with intellectual disabilities. It critically examines various multi-component weight management programs, exploring their efficacy and addressing the unique challenges faced in this population. The analysis draws upon research studies and qualitative insights to provide a comprehensive understanding of the complexities involved in obesity management within the context of intellectual disabilities.

Healthcare Management Interventions of Obesity with Learning
Disabilities

Table of Contents
Chapter One: INTRODUCTION...............................................................................................3
1.1 INTRODUCTION................................................................................................................................................3
1.2 BACKGROUND OF STUDY .................................................................................................................................3
1.3 STUDY AIM AND OBJECTIVES.............................................................................................................................6
1.4 RATIONALE OF THE STUDY.................................................................................................................................6
1.5 STUDY SCOPE AND LIMITATIONS.........................................................................................................................6
1.6 EXPECTED OUTCOMES .....................................................................................................................................7
1.7 OVERVIEW OF CHAPTERS..................................................................................................................................7
Chapter Two: LITERATURE REVIEW..................................................................................10
1. APPROACHES OF HEALTHCARE FOR MANAGEMENT OF OBESITY AMONG INDIVIDUALS.....................................................10
2. FACTORS INFLUENCING THE EFFECTIVE HEALTHCARE MANAGEMENT OF OBESITY AMONG INDIVIDUALS SUFFERING FROM
LEARNING DISABILITIES..........................................................................................................................................10
3. ASPECTS RELATED TO THE ACHIEVEMENT OF OPTIMUM PRACTICES FOR THE HEALTHCARE MANAGEMENT OF OBESITY IN
INDIVIDUALS SUFFERING FROM LEARNING DISABILITIES................................................................................................11
Chapter Three : RESEARCH METHODOLOGY...................................................................12
2.1 RESEARCH METHODOLOGY..............................................................................................................................12
2.2 STUDY DESIGN..............................................................................................................................................12
2.3 DATA COLLECTION.........................................................................................................................................12
2.4 INCLUSION CRITERIA.......................................................................................................................................14
2.5 EXCLUSION CRITERIA......................................................................................................................................15
2.6 SAMPLE.......................................................................................................................................................15
2.7 RESEARCH PHILOSOPHY..................................................................................................................................17
Chapter Four: Findings and Discussions. ................................................................................19
3.1 INTRODUCTION..............................................................................................................................................19
3.2 FINDINGS AND DISCUSSIONS............................................................................................................................19
Health care Interventions.......................................................................................19
Issues faced by children suffering from obesity ...................................................21
Government Policies for Obese individuals with learning disabilities ................22
Consideration of Social Cognitive theory ............................................................24
Impact of Nutrition and exercise over health of Children ...................................26
Implementation of Interventions in School...........................................................30
Chapter Five: Conclusion and Recommendations ..................................................................38
4.1 CONCLUSION AND RECOMMENDATIONS.............................................................................................................38
4.2 LIMITATION OF RESEARCH:-.............................................................................................................................39
4.3 REFLECTION..................................................................................................................................................39
4.4 IMPLICATIONS...............................................................................................................................................40
4.5 RECOMMENDATIONS......................................................................................................................................41
4.6 RECOMMENDATIONS FOR FUTURE RESEARCH.......................................................................................................41
References................................................................................................................................42

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Chapter One: INTRODUCTION
1.1 Introduction
This study is associated with the assessment of the various healthcare management
interventions for obesity among people with learning disabilities. This will include an
assessment of the various subjectivities associated with the notion of the healthcare
interventions among individuals with learning disabilities with respect to the
prevention of obesity. This will include the review of various past literature and
studies associated with the topic, in addition to the development of research analysis
under the relevant context. This first chapter will include the aim and objectives of
the study, as well as the relevant background and the overall context of the
development of this research study.
1.2 Background of Study
Studies conducted by Bergström et al. 2013 were aimed towards assessment of
interventions to be maintained and the development of optimum diet controls and
plans for individuals suffering from intellectual disabilities. Through the
implementation of a randomised control trial (RCT) approach, the authors
highlighted various aspects related to the establishment of optimum diet plans and
interventions to be considered for maintenance of optimum health and weight of
individuals with learning disabilities. Moreover, the authors also highlighted related
challenges and discrepancies in relation to weight management among individuals
suffering from intellectual disabilities. An extensive review of the study will enable
identification of numerous underlying subjectivities involved, allowing documentation

of optimum techniques related to management interventions of obesity among
individuals with learning disabilities.
In studies conducted by Spanos, Melville and Hankey (2013a), the authors
developed their research findings through critical and interpretative analysis of
relevant literature and research studies related to intervention measures for the
management of weight among individuals suffering from learning disabilities. The
inferential analysis presented by Spanos and colleagues (2013a) was conducted
through assessment of related literature ranging from the year 1982 to 2011. This
augments the overall effectiveness of the systematic review approach. The results of
findings acquired by the study assert the notion of numerous intervention measures
including avoid junk food, intake balanced diet, prefer daily exercise and regular
check ups. These interventions are based upon associated components, attrition
rates and respective methodology of interventions being undertaken. Moreover, the
development of the systematic review also allows for numerous approaches to be
appraised and the taking under consideration of the most appropriate approach of
intervention to be considered for management of weight of individuals with
intellectual disabilities.
Studies done by Robertson, et al. (2014) differ in that the study acquired data from
participants who self-reported the prevalence of intellectual disabilities. The study is
based upon the notion that individuals with intellectual disabilities tend to have higher
mortality and morbidity rates compared to others, including the prevalence of

obesity. The study conducted by Robertson et al. (2014) uses a cross-sectional
survey of 520 participants for the development of effective research findings. The
results of the study reflect that there are numerous aspects related to the prevalence
of overweight and obesity among individuals with learning disabilities. Furthermore,
Robertson et al. (2014) also identified the use of tobacco and the relative absence of
appropriate diet plans to be related to increased obesity among the individuals. The
study concludes with the notion that individuals with learning disabilities are
considered "vulnerable" and the establishment of augmented healthcare should
provide interventions to prevent these individuals from becoming overweight.
1.2.1 Paragraph 1
Apart from the assessment of patient perspectives regarding the notion of
intervention measures and management of obesity in individuals with learning
disabilities, it is necessary to undertake an evaluation of the perceptions of the
carers as well. Studies by Spanos, et al. (2013a) have addressed this particular
aspect. Through the establishment of qualitative studies, the authors highlighted the
perceptions of carers on interventions being used for the delivery of care for
individuals with intellectual disabilities for the maintenance of appropriate weight.
1.2.2 Paragraph 2
The findings of the study by, Spanos et al. (2013a) are based upon three major
themes that were assessed through semi-structured interviews: the perception of
carers towards interventions measures for patients, the perception of carers towards
the health of participants and barriers and facilities to implement appropriate care
measures for the patients. The conclusion of the study recommends the
establishment of tailored measures to be used for implementation of effective and
enhanced intervention for patients with intellectual disabilities.

1.3 Study Aim and Objectives
This study will aim to "assess the various healthcare management interventions of
obesity among people with learning disabilities." In order to achieve the overall aim
of this study, the following objectives have been defined:
 To evaluate the various healthcare approaches related to management of
obesity among individuals
 To appraise the factors influencing the effective management of obesity
among individuals suffering from learning disabilities To assess the aspects related to the achievement of optimum practices for
the healthcare management of obesity in individuals suffering from learning
disabilities
Research Question
The research question
 What are the new healthcare management interventions for obesity in
individuals with learning disabilities?
1.4 Rationale of the study
The rationale of the study is that it will help to evaluate the current health care
management intervention of obesity in individuals with learning disabilities. There are
many new interventions that have been used by the people in current health care

management to overcome the issues faced by people who suffer from obesity and
have learning disabilities.
1.5 Study Scope and Limitations
As a result of this particular research study, readers will be able to identify several
themes related to healthcare management of obesity among individuals suffering
from learning disabilities. In this regard, various related factors of influence will also
be discussed. This will enable enhanced comprehension regarding the topic while
utilising this and similar studies for the establishment of evidence-based practices- a
necessary norm in healthcare practices. Moreover, this study will also enable
identification of the most effective practices and approaches to be utilised in the
management of obesity among individuals with learning disabilities.
1.6 Expected Outcomes
The proposed research is based on performing an investigation into various
healthcare management interventions regarding obesity along with learning
disabilities. By conducting this research, the investigator will be able to identify that
the main causes that lead to an increase in obesity among people with learning
disabilities. It will further help in determining several factors that influence the
effective management of healthcare in terms of obesity so that future practices can
be improved. In addition to this, it will also identify several measures that can be
taken to reduce the number of cases of obesity cases so as to improve people's
standard of living.
1.7 Overview of Chapters
This dissertation consists of four chapters that are based upon the intrinsic
requirements of research.

CHAPTER 1: INTRODUCTION
The first chapter encompasses an introduction to the overall topic under research
consideration. This further includes rationale of project and reasons behind
conducting this research. It also includes the aims and objectives of the research
along with the scope of this project. In addition to this, it also includes the expected
outcomes that will be achieved after conducting the research.
CHAPTER 2: LITERATURE REVIEW
The second chapter consists of a literature review that provides detailed information
about the current research topic from secondary data which has already been
investigated by other researchers. This will help the investigator in creating a
research base which will further assist the attainment of the research goals. The
literature review consists of two parts: study design and data collection. This study
design helps the researcher to identify and include the relevant data which will help
in conducting the investigation.
CHAPTER 3: RESEARCH METHODOLOGY
The third chapter will identify the research methodology to be taken under
consideration for the completion of results and findings of the study. The research
methodology proposed for completion of this study will be the systematic review
established through the PRISMA model of systematic review. This will enable
assessment of relevant literature intrinsically associated with the overall aim and
objectives of the study. Moreover, the systematic review will also permit the

assessment of various qualitative as well as quantitative studies related to the
subject, hence augmenting the findings of the study through evaluation of related
empirical as well as qualitative data. Hence, the selection of appropriate relevant
literature is mandatory for the development of effective and extensive research
findings and the attainment of the overall research objectives.
The third chapter will include relevant ethical considerations of the study as well. The
ethical considerations related to the study will be moral and legal regulations
associated with utilisation of secondary research studies. This includes obtaining
permission to access the research studies being included for establishment of
research findings. In addition, the limitations of the study will also be discussed in
order to assert relevant limitations of the study.
CHAPTER 4: FINDINGS & ANALYSIS
The fourth chapter consists of the findings of overall research by including an in-
depth description of investigation results. This will include the results of the thorough
literature search along with highlighted trends that have been found throughout the
investigation. These findings will then be organised in a systematic manner to
answer the research hypothesis.
CHAPTER 5: CONCLUSION
This is the final chapter of the study which will include the concluded summary
of research along with the limitations. In addition to this, it will also include a
reflection on the research to explain the overall experience of this investigation. It will
also present the implication of results that have been found in the research and then
proper recommendations to overcome the limitations so that future mistakes or
errors can be avoided.

Chapter Two: LITERATURE REVIEW
A literature review is a type of scholarly paper that consists of information
regarding the particular area of study which helps the reader to develop an
understanding of the topic. It is used within research as a secondary method of
data collection in order to gather relevant information to answer the hypotheses
made prior to research.
1. Approaches of healthcare for management of obesity among individuals
As per the observations of Sweeting and Caterson (2017), obesity issues
around the world have tripled since 1999. The adult population is now getting more
and more overweight and obese, hence it is necessary to manage this issue properly
in order to avoid health related consequences. There are a number of hierarchical
approaches to manage obesity that include sustainable lifestyle intervention, diet
specification and increasing the amount of physical activity. The National Health and
Medical Research Council (NHMRC), practice certain guidelines for the 5A
approach, which includes Ask, Assess, Advice, Assist and Arrange their follow up.
These all help to reduce obesity in an effective manner. In addition to this, there are
a number of other approaches that can help such as a very low-energy diet,
pharmacotherapy, bariatric surgery etc.
2. Factors influencing the effective healthcare management of obesity among
individuals suffering from learning disabilities

According to Doherty et al. (2018), there are a number of factors which affect
or restrict the proper management of obesity in people who are working to reduce
their weight. These factors include natural states of development that a person's
body experiences, such as prenatal factors, adiposity rebound, adolescence,
adulthood etc. These are all situations which influence the effective management of
an obesity healthcare plan among individuals as at that time the body is experiencing
a sort of changes. At these critical periods of development, a learning disability
and/or a lack of proper knowledge about health may affect an individual's
management of obesity.
3. Aspects related to the achievement of optimum practices for the healthcare
management of obesity in individuals suffering from learning disabilities
As pointed out by Cortese et al. (2013), the impact or result of treatment depends
upon the way practitioners or professionals choose to treat people and cure them.
So in order to deal with the obesity issue it is essential to adopt an effective method
or approach that would help improve this condition. With that said, while providing
treatment, it is necessary for the nurse or health care practitioner to present
subjectivism in term of their practice. This means that during treatment the nurses
must behave in a more lenient and polite manner with the patient so that they can
listen to and accept the nurses' advice. The reason behind this is that behaviour as
well as practice adopted by a person for the treatment of obesity influence the
outcome of healthcare management to a great extent, especially those who are
suffering from a learning disability.

Chapter Three : RESEARCH METHODOLOGY
2.1 Research Methodology
Research methodology refers to the inherent approach utilised for the
achievement of targeted aim and objectives of academic research studies (Creswell
& Clark, 2007). This includes the selection of appropriate tools, data and research
analysis methods for the topic of research consideration. This section will entail a
brief outline of the selected methodology for this study on healthcare management
interventions of obesity among people with learning disabilities. This will enable the
reader to understand and comprehend the research approach being undertaken for
the attainment of the research aim and objectives.
2.2 Study Design
This study will be undertaking the approach of qualitative research methodology
through the analysis of a literature review. This entails the inclusion of secondary
research data for the evaluation of the topic of research i.e. healthcare management
interventions of obesity among people with learning disabilities. The study design
has been undertaken through the selection of various secondary research studies
against the PRISMA model for the development of a systematic review. This has
enabled the identification and inclusion of only the most relevant research studies
related to the notion of interventions for obesity among individuals suffering from
learning disabilities.
2.3 Data Collection

The data collection process is one that involves the collection of data from
relevant sources. The aim of data collection is to answer research questions and test
hypotheses. There are two major categories of data collection: primary and
secondary (Nafkha, Gajowniczek, & Ząbkowski, 2018, p.514). Secondary data
collection is a method which gathers data that has already been published. The
sources of secondary data include magazines, books, online portals, journals, and
others. These sources of secondary data provide an abundance of data. However,
when choosing secondary data for a study, it is important to develop and use specific
criteria. This is because the criteria used for accessing secondary data plays a key
role in improving research validity and reliability. Some of the factors that are
considered when gathering secondary data include the date of publication, the
reliability of the source, depth of analysis, nature of data collection and analysis
methods, among others (Al-Habil,2014, p.381).
The second type of data collection is primary, which can be further classified
into quantitative and qualitative data collection. In quantitative research, primary data
is gathered in the form of numbers. The methods that are used for data collection in
quantitative research include a closed-ended questionnaire, correlation, regression,
and others (Steele & Rawls, 2015, p.134). The use of quantitative methods for data
collection is effective because it helps in the standardisation of data and it is easier
to make comparisons. The other method of primary data collection, qualitative data
collection is a method that does not involve the use of numbers. In fact, the
qualitative data collection method is associated with the use of words, feelings, and
emotions. The collection and analysis of qualitative data are effective in obtaining an
in-depth understanding of the research (Teater et al., 2017, p.422).
For the selection of the studies for the secondary research several databases
have been used. These include Google, Bing, Yahoo, Arxiv, TandFonline, Wiley,

Researchgate, Medline, NCBI and Academia. Moreover, the use of appropriate
keywords was maintained in order to attain only relevant search results against the
various articles being explore for articles to be included in this study. This included
keywords such as “interventions of obesity”, “interventions of obesity in learning
disabilities” and “obesity and learning disability”. Among the various search results,
the studies were scrutinised in terms of relatedness to the research topic and the aim
and objectives of this study. This resulted in the acquisition of only the most relevant
data for the accomplishment of the research objectives. The scrutiny process for the
selection of the relevant data for this study has been summarised in the PRISMA
model provided in the next section.
Furthermore, the approach of data analysis and assessment was based upon
the “interpretative research philosophy” (Creswell & Creswell, 2017). This was used
as the basis for the development of extensive inferential analysis of the various
secondary research studies gleaned through the systematic review and inclusion of
relevant research studies. This study uses the descriptive analysis approach in order
to enumerate the various findings of the study. Moreover, in order to augment and
appraise the relevant findings of the research study a comparison of the studies
against other relevant literature has also been conducted (Creswell et al., 2003;
Creswell & Creswell, 2017). This allows for enhanced outcomes from the discussion
of the various findings of the study.
2.4 Inclusion criteria

Every one of the studies utilised for the deliberate survey will be founded on
the essential and optional research plan. The investigations which will be considered
for this precise survey will be distributed between the years of 2010 to 2015. The
studies included must look into the effect of the psychological wellness benefits on
the weight treatment of individuals who are experiencing learning difficulties. All
examinations that comprise of individuals or participants from the age of 35 to 80 will
be considered as the qualified criteria. Every single study concentrate will be
founded on the journals and articles that have been distributed in the English
language.
2.5 Exclusion Criteria
Studies written in a language other than English will not be included. Studies
with a test subject age below 35 years will also not be included and test subjects
who are experiencing loss of learning ability. All journals and articles before 2008 will
not be included in order to conduct appropriate investigation on given topic. In
addition, all investigations that did not meet the criteria for consideration were
rejected by the review process.
2.6 Sample
In research, a sample is referred to as the group of people and objects that
are drawn from a larger population for study. It is important to choose a sample,
which is the representative of the population. It helps in generalising research
findings to a large population. It is important to select a sample from the population
because gathering data from the entire population is not practical, due to both cost
and time factors (Carrus, 2011, p.187).
Sampling methods are broadly divided into two categories: probability and
non-probability sampling. In probability sampling, each member of the population has
the opportunity to represent the population. In non-probability sampling, there is no

specific probability (Leese, 2017, p.1597). Non-probability sampling can be further
classified into different types. One of these types is convenience sampling, a method
on which the researcher gathers data from participants who can be accessed
conveniently. The second type includes haphazard sampling in which the researcher
selects participants in a haphazard manner (Murtonen, 2015, p.684). This sampling
method is different from probability sampling because it often involves the selection
bias. The purpose sampling technique is one in which the researcher selects a
particular group of people for data collection because they possess knowledge and
expertise in a given area. The quota sampling technique is a type of non-probability
sampling in which the researcher allocates specific quota to the sample. In the
snowball sampling technique, the researcher selects participants who provide
information about other participants (Nafkha, Gajowniczek, & Ząbkowski, 2018,
p.514).
One factor that is important to consider when sampling is the sample size.
When deciding the sample size, it is important to study the population. There are
various constraints that limit the sample size used for a study including a lack of
time, financial constraints, and others (Teater et al., 2017, p.42). One of the key
factors that are considered in deciding the sample size is the type of data analysis
method. The use of a qualitative data analysis method often involves a small sample
size. However, in a quantitative method, a large sample size is preferred. The

heterogeneity of the population and the number of variables in research also have an
impact on the choice of the sample (Wynn & Israel, 2018, p.795).
One of the challenges involved in sampling includes sampling bias. This is
referred to as the tendency to favour specific participants because of their
characteristics. A poor sampling plan is the reason behind the sampling bias. One of
the common types of sampling bias is the non-response, which occurs when the
participants are unable to appear in the sample because of various reasons (such as
a lack of Internet connectivity in a study that takes place online). The bias is likely to
occur when the researcher selects the wrong population or when the design chosen
for a study is not appropriate (Carrus, 2011, p.187).
2.7 Research Philosophy
Research philosophy is concerned with the nature and source of knowledge in
the collecting and analysing of data (Wynn & Israel, 2018, p.795). One of the types
of research philosophy is ontology, which is concerned with the nature of reality.
Ontology is further classified into objectivism and subjectivism. Objectivism is based
on the assumption that social objects exist in reality, while subjectivism is based on
the study of social phenomenon on the basis of perceptions of social actors. The
second type of research philosophy is epistemology, and this is defined as the
acceptable knowledge of a field of study (Zhang, 2002, p.39). It can be further
classified into resources and feelings. In resources, the researcher uses natural
perspectives for data collection and analysis. In the second type, the researcher
studies feelings and emotions. Epistemology is further classified into positivism,
realism, and interpretivism. The positivist approach is based on observable social
entity. The research strategy used in this philosophy is based on the collection of
data and development of hypotheses. In the positivist research philosophy, a highly
structured approach is used for data coaction and analysis (Schafer, 2018, p.283).

Another branch of epistemology is realism. In this research, the aim of the
research is to disclose reality. Realism philosophy is based on the assumption that
reality exists independent of the human mind. There are two types of realism: direct
and critical. Direct realism is based on the assumption that the world is portrayed
through personal senses of human beings. In contrast, critical realism is based on
the assumption that the experiences of human beings do not portray the real world
(Nafkha, Gajowniczek, & Ząbkowski, 2018, p.514).
In this present study, an interpretivism research philosophy will be used as it
is most suitable for the qualitative data collection method. The main reason behind
its suitability is that the researcher will be able to interpret data with the support of
theories and hypothesis. In addition to this, it also supports in gathering and
evaluating data from the authors point of view that can help in collecting more
authenticate, valid and reliable information for the accomplishment of the set
objectives.

Chapter Four: Findings and Discussions.
3.1 Introduction
In this section, the various findings of the study through the extended
literature review of the selected articles will be presented. In addition, the various
findings will be assessed against relevant literature to appraise and augment findings
developed through the inferential analysis of the available data for the study. This will
be developed in the context of the relevant findings related to the study objectives
under consideration.
3.2 Findings and Discussions
Health care Interventions
Building and sustaining a good lifestyle is typically a sign of successful weight
loss. However, in adult obesity intervention, the rate of loss of follow-up is 20-80%. In
childhood obesity intervention, the compliance of children's physical activity and
behavioural intervention is worse than that of dietary intervention [22,23–26] and the
nutrition of children during the intervention. Whether the intake is balanced, whether
the exercise intensity is achieved, and whether the weight loss is stable, as well as
growth and development status, all need to be monitored from time to time. Parents
of overweight children need to contact the medical workers in a timely manner to
adjust the treatment plan. In recent years, it has been reported that short-term
"dynamical interview" (MI) methods can reduce the rate of loss of follow-up [27-29].
Dynamic Interview (MI) is a patient-centred communication method in which patients
speak about their condition, and physicians listen and guide patients to understand
the adverse effects that their current behaviour may have on their lives, thereby
encouraging patients to identify behavioural changes themselves [30, 31].
Robertson, et. al. (2014) use Power Interview (MI) to communicate with parents to
discuss their child's weight and health status, improve parental motivation, increase

compliance, and reduce loss of follow-up [32]. Another method that can be used is
side-by-side intervention to reduce the rate of loss of follow-up. Hsieh [33] and other
family-based, monthly telephone follow-up and health education, 293 untreated
hypertensive patients (intervention group) including nutrition control and adjustment
of stroke risk factors and other nutritional health education, another 97 The general
health education was performed as a control group for patients with untreated
hypertension. After 6 months, the systolic blood pressure of the intervention group
was significantly decreased by 2.0 mmHg, and the systolic blood pressure of
patients with hypertension decreased by 5.9 mmHg. These findings suggest that
continued uninterrupted follow-up can help the persistence and effectiveness of
obesity interventions (Chapman et al., 2008).
According to van Egmond-Fröhlich et al., (2012) the development of sensitive
quality of intervention measures has a great hindrance on weight gain, especially
among individuals with learning disabilities. At the same time, excessive fat and
excessive weight load affect the speed and power of muscle contraction, thus
affecting the athletic ability of the body. The cardiopulmonary function of obese
students is relatively poor. The body's ability to consume, transport, and utilise
oxygen in the muscle is limited, and the level of endurance is significantly affected.
Obese children have a large accumulation of waste and abdomen fat, the positional
flexion index is relatively low, and the flexibility is relatively poor. In general, obese
children compared to normal children of the same age display lower speed,

endurance, power, flexibility, etc., and their physical quality is poor. Physical fitness
is closely related to children's participation in physical exercise. Studies (Ebenegger
et al., 2012; Cortese et al., 2013) have shown that obese children's diets are mostly
high-calorie foods, and in addition to the physical education classes that must be
attended, they basically do not engage in any physical exercise. In view of the poor
physical condition of obese children, in addition to the need to control the high-
calorie diet in children's daily life, it is necessary to continuously encourage physical
exercise (Marshall et al., 2003; Güngör et al., 2016).
According to Ebenegger et al. (2012), mental health refers to the state in
which the individual's psychological activities are, and a normally functioning mental
state is suitable to take on the development and changes of life, study, work and
social environment. Children are in a critical period of rapid psychological
development, and it is of vital importance to promote children's mental health
development. Obesity not only poses a great threat to children's health but also
affects children's mental health, especially among those suffering from learning
disabilities (Spanos et al., 2014).
Issues faced by children suffering from obesity
Obese children are often ridiculed and bullied by classmates due to factors
such as fat body shape, slow response, and slow movement. Therefore, they tend to
develop personality problems such as inferiority, loneliness, and depression.
Unhealthy personality defects make it difficult for obese children to integrate into the
group, which causes serious social obstacles and makes them unwilling to actively
communicate with others, thus they become more isolated, lose interest in learning,
experience poor learning, and decline in academic performance. This vicious circle
will become more and more serious as the age of obese children increases. In
response to this situation, schools and parents should regularly intervene in mental

health, guide and encourage obese children, give more attentive care to obese
children, improve their self-confidence, correct various adverse mental health
problems of obese children in a timely manner, and promote prevention of obesity
(Sailer et al., 2006).
Government Policies for Obese individuals with learning disabilities
The government’s policies and actions without losing the opportunity of implementing
them as they are the key to curbing the development of obesity among children and
adolescents. The European Child Obesity Working Group (ECOG) called for the fight
against obesity at the 2005 special session. Families, schools, medical experts, the
government, businesses and the media should work together to prevent obesity in
children and adolescents. At present, 19 countries in Europe have issued "National
Action Plans against Obesity", including the promotion of physical activity, the
development of dietary guidelines, national health education, early intervention of
high-risk factors for obesity, and restrictions on sugary products in schools, sugary
drinks fast food vending machines, etc. The US government raised obesity as a key
public health issue in 1999, and President Clinton called for the importance of
obesity prevention and dietary adjustment and physical activity.
(Paragraph 2)
In 2010, US President Barack Obama launched a nationwide campaign to boycott
childhood obesity and called for various companies to regulate food production and
encourage children to exercise more and maintain a healthy diet. At present, many

food manufacturers in the United States have reached an agreement with the
government to re-develop food formulas in a variety of ways, including blending fat
and sugar content, adding low-calorie ingredients, and adjusting the size ratio of
each product, committing to 2012 as a deadline. Over the years, food calories were
reduced by a total of 1 trillion calories, and by 2015, a total of 1.5 trillion calories
were cut. Legally, in order to reduce obesity, diabetes risk factors and the onset of
cardiovascular disease, the US federal government and most states and cities, as
well as some countries such as Mexico, are considering the mandatory taxation of
sugary drinks to reduce their consumption [54]. The US will also be invested in other
programs that promote national health. The new US medical law [55] also clearly
stipulates that new medical insurance should cover the medical examinations
recommended by the US Preventive Services Task Force (USPSTF), including
screening for cancer and cardiovascular disease in the population. The detection
rate in the medium; and the authorised fund for small businesses or institutions, such
as schools, to allocate funds to provide a healthy workplace; and to establish a fund
to encourage the development of childhood obesity intervention model. It is expected
that if the prevalence of obesity falls to the level it was at in 1998 by 2023, then the
United States will save $3 billion in medical expenses (Spanos, Melville and Hankey,
2013)
(Paragraph 1)
According to a study by van Egmond-Fröhlich et al. (2012), the factors that
affect overweightness and obesity are varied in nature and can fall under the
categories of biogenetic, economic, environmental and sociocultural. Nevertheless,
the individual perspectives on adolescent healthcare, socio-cultural factors, lifestyles
and the interaction with immediate social groups (family, friends, social networks and
community) are also factors that influence protective behaviours to health, so they

should be taken into account. From the point of view of psychological-cognitive
theories, an individual is capable of voluntarily adopting behaviours in favour of
health if they are aware of risks and the consequences of their habits and are
provided with the necessary elements (resources, skills and knowledge) to help
modify these habits.
Consideration of Social Cognitive theory
The design of a program focused on prevention of health problems requires a
good understanding of why individuals adopt healthy behaviours. In this research the
Social Cognitive Theory (SCT) was the reference to deepen knowledge of which
elements affect eating habits and physical exercise in teenagers (Chapman et al.,
2008). The SCT presents a complex perspective about how the environment
influences behaviours of individuals and how they, in turn, affect the environment.
The theory considers, too, that a person reacts in different ways to social influences,
depending on their personal characteristics (for example age, sex and physical
attractiveness). According to the SCT, the reciprocal and dynamic interactions
between personal, environmental and behavioural factors define a series of
behaviour patterns that are regulated by cognitive processes which allow an
individual to visualise the consequences of a behaviour, even before doing it
(Hamilton et al., 2007).
Relations of Lung capacity to body mass index

Previous studies (Chapman et al., 2005; Ells et al., 2006; Rimmer et al., 2007)
have shown that chest circumference and lung capacity are highly correlated, and
also that the vital capacity body mass index is more accurate and objective for
evaluating human lung function. The results of the study showed that the lung
capacity of the obese group was significantly lower than that of the normal group. It
can be seen that the lung capacity of the obese group is worse than that of the
normal group. In summary, the cardiopulmonary function of children in the obese
group is relatively weak, and the lung ventilation function is affected to a certain
extent, and the incidence of hypertension is relatively high (Cook et al., 2015).
Excess fat, as an extra load in the daily life of the human body, exerts additional
pressure on the heart and lung system to cause fatigue, which reduces the pumping
function of the heart, thereby affecting the development of the body's aerobic
capacity.
As per Cortese et al. (2013), if there is a lack of enthusiasm and initiative,
therefore, in terms of social activities, the motivation for success is not high. In
addition, the stress factors in the obese group were weaker than those in the control
group, indicating that the obese group was over-stressed during the examination.
Studies have shown that children with simple obesity have psychological behaviour
problems, low self-esteem, lack of self-confidence, and have loneliness, depression,
anxiety and other negative emotions. Simple obesity refers to a situation that results
when caloric intake exceeds energy expenditure. Excessive anxiety often leads to
excessive stress in exams, which presents a certain hindrance to learning. In
summary, although children with simple obesity have no obvious learning disabilities,
obesity has a certain impact on children's learning motivation, and learning
motivation is an important factor that affects academic performance (Güngör et al.,
2016). Therefore, in the prevention and treatment of simple obesity, on one hand, we

must improve their psychological status; on the other hand, we should pay more
attention to understanding obese children, encourage them to participate in various
social activities, and strengthen motivations that are conducive to learning and
progress to boost academic performance (Cortese et al., 2013).
Impact of Nutrition and exercise over health of Children
According to Ebenegger et al. (2012), food, nutrition, exercise and sedentary lifestyle
are intertwined in daily life, and their good practices or styles are associated with
health or illness. Teachers, children and parents should know these issues both in
terms of their biological and sociocultural aspects so that they can collaborate in the
formation of healthy habits with the explicit purpose of preventing chronic and
degenerative diseases. From the third grade onwards, the concept of the Ideal Food
Pyramid appears which teaches the food groups and the amount of each that should
be included in the diet. Schools also emphasise physiological aspects of nutrition
and health such as digestion, absorption and excretion. There are sketches to link
these issues with health and illness, as well as the importance of exercising and
reducing sedentary activities. There is no connection between children's obesity and
their learning of this information; it is just an introduction to serious problems that are
related to of food, nutrition and exercise-sedentary lifestyle (Ebenegger et al., 2012).
A survey applied to ministries of education and health (Marshall et al., 2003),
universities, national programs and non-governmental organisations, related to
nutrition education activities in primary schools in 50 countries, showed that nutrition

education is practically absent; the programs are sporadic and have little coverage,
with inadequate educational materials and lack of political support to incorporate
nutrition education into primary education (Marshall et al., 2003).
In a study on overlapping development and learning problems, Güngör et al.,
(2016) find a high coincidence (comorbidity) of the same in seven types of
developmental disorders: difficulties in hearing or dyslexia, in attention deficits,
hyperactivity and impulsivity, in the disorders of the development of coordination, in
the oppositional defiant alterations, in the aftermath of behaviour, in depression and
in anxiety. From attention deficits with hyperactivity and impulsivity (ADHD), we find
that only 20% are pure, with 80% of overlaps of two, three or more disorders of the
seven indicated above. Furthermore, for difficulties with reading, 48.4% would be
"pure" with an overlap of 51.6% with two, three or more disorders of the previous
ones (Cortese et al., 2013).
As per Heller et al. (2011), a habit is any learned behaviour that is repeated
regularly, and that requires little or no reasoning. Children's eating habits are
acquired according to what they learn daily in their home, that is, the parents pass
them on to their children. However, before the epidemic of overweightness and
obesity was observed in the population of almost everyone, including children, the
question is how elementary schools can participate in the search to acquire healthy
lifestyles or sustainable changes for health care. The answer is complex, because
the habits of food and exercise have strong sociocultural and economic influences;
there are also, being very different conditions in rural or urban areas or if the mother
works outside the home or not.
(Paragraph 1)
According to Doherty et al., (2018) preparing to go to school should begin
with breakfast that consists of healthy and culturally accepted foods. Although there

is not much information regarding school feeding habits, there are reports that 7% to
34% of children do not eat breakfast at home before going to school. In this regard,
working group of authors of the study in 2006 found in a sample of 2,532 school
children that only 72.2% of the children had had breakfast, while 27.8% attended the
school on an empty stomach. Of all of the children, 59.5% took food to school, and
60.7% took money to buy food; 17% of the children who had breakfast also brought
food and money to buy food, while 3% of school children did not eat breakfast, nor
did they bring food to eat at school or take money to buy something (Spanos et al.,
2014).
Awareness of parents and teachers
This information coincides with that reported in other surveys, and there is a
concern that parents and teachers are not aware of the potential risks that children's
eating habits have on health, learning and school performance. It has been observed
that the omission of breakfast in poorly nourished children can affect their attention
capacity and short-term memory, as well as their school performance, and it would
be expected that providing breakfast to children would have great benefits;
unfortunately, controlled clinical trials have not demonstrated these benefits reliably.
On the other hand, an inverse relationship between breakfast and body weight has
been observed in a paradoxical manner, that is, children who do not eat breakfast
have higher rates of overweightness and obesity than those who eat breakfast. This
is probably because when one eats with irregularity, one is hungrier when eating and

therefore eats more food; it has been demonstrated that children who eat little or no
energy food at breakfast eat more at dinner (Spanos et al., 2014). In this regard,
working group of researchers found that the combined prevalence of overweightness
and obesity in schoolchildren who skip breakfast is 44.3%, a higher percentage than
that of children who eat breakfast, which is 24.5%. Furthermore, the association is
more evident in boys than in girls (Robertson, Emerson, Baines and Hatton, 2014).
These results show the importance of communicating with the parents of the children
in order to achieve two objectives: a) that their children eat breakfast at home and, b)
that they compulsorily attend school with a healthy lunch or snack (Doherty et al.,
2018).
Availability of food in schools
According to Sailer et al., (2006) excepting some private schools, in public
schools there are no establishments where food can be purchased i.e. food vending
machines or spaces where they can be consumed. However, at recess children can
buy food sold by the school cooperative. By this name is known organisations that
integrate teachers and students, employees or parents, as allowed by the
regulations in force, whose function is that students learn the processes of
production and consumption. These cooperatives are not new and the first regulation
dates from 1934, and the following one was issued in 1937; in 1962 a new one
appeared, which was updated in 1982, which theoretically is still in force. The
educational objectives are of an administrative nature with socio-economic nuances
(Khalife et al., 2014).
Food and beverages are among the products authorised for sale in consumer
cooperatives, but there is no regulation related to the type of these products or the
formation of eating habits and health. In practice, the cooperative is an outlet
attended by students of the school itself, which at recess time sells food and

industrialised beverages, and sweets of all kinds including products that have little
benefit for the food and health of students. As these organisations lack infrastructure
in most schools, in reality, it is not possible to sell fresh fruits and vegetables or
products that require refrigeration. On the other hand, the almost universal lack of
drinkers of fountains of drinking water in schools, indirectly favours the consumption
of industrialised beverages, almost all sweetened. As can be seen, the activities of
these cooperatives have little to do with the formation of healthy eating habits in
children, which would be one of the objectives of school education; but it could be
said that the mass media advertising of food products for children and those sold in
the cooperative are very congruent. Food vendors located in the vicinity of the school
complement the menu that being tailored to taste of kids, selling to the children at
recess and at the end of the school day food that does not guarantee their quality in
terms of hygiene or in terms of their composition of nutrients (Khalife et al., 2014).
According to Sailer et al. (2006), for the school to be part of a favourable
environment for children's health, a total transformation is required in terms of the
philosophical principles that justify these organisations (vision, mission and
objectives), and the promotion of healthy habits should be incorporated, among them
habits regarding food. The school cooperative can stop being part of the obesogenic
environment and become a selling point for healthy products. The regulations must
specify what products, food and beverages meet their nutritional requirements, so
that fresh fruits and vegetables, natural water and other dairy products without or

with little fat can be sold. At the same time regulations must specify which products,
food and beverages cannot be sold, that is, they will be prohibited because they are
considered as a risk to the health of children.
Implementation of Interventions in School
Khalife et al. (2014), studied the use of interventions and general or specific
strategies or specific to help people with development and learning difficulties and
their families. They implemented interventions and general strategies such as those
based on advice, design and development of case management or in social support
networks. The case of advice and advice is very useful for students with medium
disabilities, such as people with problems of learning problems, psychosocial
problems of lack of self-directivity arise (blaming of failure and external attribution of
success), social immaturity and social inadequacy problems (interaction between
peers and teachers, vocational placement), or personality problems (low self-
concept, anxiety, no participation, poor self-confidence, depression). The study
looked at the roles of identification and referral, consultation with schools and school
personnel, provides individual and group advice to parents (Barak and Golan, 2000;
Bowen, 1998). Case management, within the paradigm of design and development
(D & D), pursues case management focused on tasks (e.g. school failure),
connecting research and improving services through intervention technology. A
"case management team" with consultation functions is created, supervision,
interdisciplinary participation and several agencies. Khalife et al. (2014) present a
new approach psycho-pedagogica, and emphasise the need to consider the
financial, political, ethical and contextual factors.
Many of the programs or interventions for the promotion of healthy dietary
practices implemented in developed countries have been evaluated to define their

strengths, weaknesses and areas of opportunity. For example, the investigation of
McDermott et al. (2012) presents a systematic review of several cases of
interventions carried out in European schools. The authors analysed interventions
with multiple components (combination of availability of healthy food with education
in nutrition and involvement of the parents); twenty-nine of them focused on children
and thirteen in adolescents, and they all reported on research articles published
between 1990 and 2007.
From the review carried out, the authors established that in the case of
interventions with children, the effectiveness of programs that are exclusively
educational and implemented only by the teachers is limited. Also, the effectiveness
of programs oriented solely to the creation of a healthy environment in the schools
was also questionable. The multicomponent interventions that include activities of
learning were the most recommended. In the case of focused interventions in
adolescents, evidence found a moderate effect on food behaviour when only working
with the educational component. However, more studies are required that involved
adolescents to determine how the family, social, economic and cultural factors
influence the eating habits of this age segment.
Another review on the effectiveness of interventions is the one reported
(Heller et al., 2011). The authors analysed interventions carried out between the
years 1996-2009 with the intention to prevent obesity or to treat a problem among
teenagers between twelve and eighteen years of age. The study establishes that

most successful preventive strategies include both regulatory policies and
modifications to the environment, considering both environmental and social factors;
they include nutritional education, but they use the school as a space to promote a
healthy diet. Regarding the programs for the treatment of obesity, the most effective
ones are multidisciplinary (they attend to educational and health aspects, but also
consider psychological, economic and social factors) and include the participation of
family. The authors of the review suggest a guide for the design of effective
interventions to prevent/reduce obesity among adolescents, in which genetic factors,
barriers to personal expenses, the cost and availability of healthy foods and the
influence of means are considered, among other elements (Cavadini, Siega-Ris and
Popkin, 2000).
According to an investigation by Chapman et al. (2005) based on an
economic analysis, the demand for food is highly elastic, which is why it is expected
that the quality of food in Peruvian households will get progressively worse (i.e. the
consumption of fats and carbohydrates will increase) as income grows. This study
identifies advertising as one of the most influential factors for the consumption of
unhealthy foods and also establishes the need to increase the availability of fruits
and vegetables in schools, by establishing healthy school kiosks.
According to Chapman et al. (2005), although school is just one more element
in the ecological context of this problem, the education setting can contribute to the
prevention of this health problem. The national system of textbooks that Mexico has
can be the lever for change as textbooks in Mexico can be used as a model for a
similar program in the UK. It is, of course, necessary to incorporate some
modifications; the first is the structuring of a curricular content for each degree
prepared by a multidisciplinary group of experts from universities and institutes, as
well as international organisations, coordinated by officials of the Ministry of Public

Education, covering primary school until the baccalaureate. This has to consider the
problems that exist in terms of food and exercise-sedentary lifestyle, respecting at
the same time the cultural norms of each region, but it has to teach students useful
concepts as well as to help them form healthy habits for life, both based on scientific
evidence. The group of experts has to be multidisciplinary, consisting of medical,
neurological, sociological and economic fields. Then, pedagogues and other design
professionals have to be added to elaborate the contents and materials that will be
integrated into the textbooks of the national system. A fundamental task is the
preparation of guides for the training of teachers and, finally, the construction of the
evaluation model. Although all topics are important, the teacher's training is vital,
because he or she is the one who has to transfer knowledge to the student. These
efforts, coupled with those made by researchers looking for evidence to improve
health, would help to combat overweightness and obesity in children (Jinks et al.,
2011)
Studies by Ells et al. (2006) assert that the seriousness of overweightness
and childhood obesity requires the need to search national and international
research from different disciplinary perspectives and a variety of proposals, from
which solutions can emerge. Hence, the present study is intended to support the
work of nurses in their effort to combat the problem of childhood obesity and
overweightness. Although it is true that this represents a vulnerable group, it is also a
group that is susceptible to influence with focused and innovative nursing

interventions. The intervention has to be designed to respond specifically to the
needs and resources of the group to which it is addressed, and to establish a
therapeutic relationship with the nurse. The purpose of this is to establish group
commitment and participation in such a way that the results of the same are
assumed by it as their own, and a greater impact is achieved.
The quasi-experimental research carried out by Rimmer et al., (2007) which
they called "Multidisciplinary program of attention to obese and overweight children"
was carried out in the IMSS and had the following objective: to determine if the
intervention with a multidisciplinary program (diet, exercise, psychology) reduces
weight and normalises metabolic parameters in obese and overweight children.
Three natural groups were formed, one of which was subjected to a balanced diet
program, exercise and psychological support; another received nutritional education
and the third was the control group. Anthropometric and metabolic parameters were
measured at the beginning and at 4 months of the intervention. The results show that
there was a statistically significant reduction in weight, BMI, abdominal perimeter,
systolic and diastolic blood pressure in the group that received the multidisciplinary
program, without statistically significant changes in the group that received nutrition
education or in the control group. Therefore, it can be recognised that nutritional
education without a change in physical activity does not lead to optimal results. The
researchers also point out the need for multidisciplinary work and the active
participation of society in general (Chapman, Craven and Chadwick, 2005).
Ells et al. (2006), in a study conducted to recognise the "Attitudes and
practices on diet and physical activity in obese schoolchildren and their mothers",
found that there is a high consumption of high energy foods and beverages with
sugar in kids. More than 55% of the children in the study did not perform physical
activity outside of school. The children showed little motivation and multiple barriers

to acquire habits of healthy eating and physical activity, as well as low self-esteem
and self-efficacy. Likewise, their mothers showed little motivation and low self-
efficacy to support their obese children. For the study in question, the results will
serve as the basis for the design of educational interventions focused on motivation
and self-care to prevent overweightness in children.
Cavadini, Siega-Ris and Popkin (2000), implemented a study called
"Educational intervention and physical activity in overweight or obese young people"
with the intention of modifying the level of physical activity and consumption of foods
rich in fat, in 18 adolescents (with an average age of 12 years) who were overweight
or obese. The planned design was pre-experimental with a pre and post-test and
one more measurement after the intervention, which lasted 9 weeks and included 4
educational sessions and 8 sessions of physical activity. The educational sessions
were focused on cardiovascular health. The information was collected through the
scales to measure Physical Activity and Weekly Feeding Habits, not reporting
significant statistical differences in each of the tests.
It is important to note that the results of the research show few interventive
studies (only those mentioned above) which are multidisciplinary, and the
participation of nursing professionals is not evident or specific, which speaks of the
need and the importance of carrying out, on the part of our discipline, these types of
studies that have a specific impact on the control of overweightness and obesity in
childhood. Studies have shown that most children with high blood pressure have no

symptoms. Target organs such as the brain, fundus, kidney, and heart vascular
damage may occur as the disease progresses. Children are undergoing a special
period of growth and development, and hypertension affects children's normal
growth and development, including future life, work, and study. With the
improvement of material life today, the nutritional status of children and adolescents
has been greatly improved, but unhealthy eating habits cause excess energy to be
stored in children and converted into fat, which seriously endangers children's health
(Creswell and Clark, 2007)
Lung capacity represents the strength of the respiratory muscles and the
respiratory organs and can be used as an indicator of pulmonary ventilation function
to some extent. From the analysis of the results of vital capacity indicators, the
absolute value of lung capacity in the obese group was greater than that in the
normal group, and the difference was not significant. From the results of the body
shape study of children in the obese group, it can be seen that the body shape of the
obese group develops laterally and the chest circumference is large (Hinckson and
Curtis 2013)

Chapter Five: Conclusion and Recommendations
4.1 Conclusion and Recommendations
Parents, schools, and society should attach great importance to improving
the current status of obese children with reasonable diet and physical exercise, and
also a healthy future for children. Overweight and obese school-age children
generally have mental health problems, low physical confidence, and social
adaptation disorders and behavioural disorders. Children who are obese are more
prone to mental health problems including learning disabilities & personality defects
and performance of three psychological problems of adaptation disorders is more
prominent. Children with simple obesity have no obvious learning disabilities, but
obesity has a certain impact on learning motivation. Effectively treating obesity
should improve their psychological status and strengthen the learning motivation that
is conducive to learning and progress.
Persons who are obese have obvious lateral development characteristics of
body shape, body weight, body mass index, body fat percentage, chest
circumference index, shoulder width index, pelvic width index and waist-to-hip ratio
that are higher than normal group; heart and lung function development is blocked,
blood pressure is high, and lung capacity and body mass index are low.
Furthermore, the development of strength, speed, endurance, sensitivity and
flexibility are below the development rate of normal children, apart from those
suffering from learning disabilities. Among the psychological scale test results, obese
children were higher than the normal group, and there were significant differences in
the three categories of learning disabilities, personality defects, and social adaptation
disorders.
Therefore, to improve children's health, the actions carried out in the schools
need to have the support of parents to be able to extend the healthy space to home.
The low self-efficacy and commitment of parents to encourage a change in eating

habits represents an important barrier which has also been observed in other
investigations. On the other hand, the activities that are carried out at school have to
move from being merely informative to generating competences of self-reflection,
self-efficacy and prevention. To develop these competencies, significant learning is
necessary, with a focus on relating knowledge of nutrition with health, with situations
everyday, with their own experience and from nearby social groups (i.e. family and
friends).
With the development of the UK's economy, UK's adolescent obesity has
entered a period of rapidly becoming an epidemic. If it is not prevented and
controlled in a timely manner, it will take less than 10 years to develop better health
of population by reducing obesity in developed countries. The fight against obesity
cannot be delayed. We should learn from previous experience and use the
prevention and treatment experience of developed countries to enable families,
schools, medical experts, governments, enterprises and the media to work together
to prevent obesity in children and adolescents, thereby improving the long-term
health and social productivity of the entire nation.
4.2 Limitation of research:-
There have been many limitations as most people do not want to share their
details and they do not want the researcher to gather their data. It has been found
that in current decades many researchers are going through different limitations in
terms of gathering the data. Moreover, most of the data has been utilised, and new
interventions have been used in order to manage the data and provide appropriate
treatment to obese people which helps them to overcome the issues they face.
4.3 Reflection
This report has consisted of an analysis of “Healthcare Management
Interventions of Obesity with Learning Disabilities”. It has been a great experience to

conduct research on the current or most trending area of concern which also
supported me in increasing my knowledge with this regard. In order to conduct this
research effectively, I decided to use a qualitative method of data collection as it
helps to evaluate the available information in a more detailed manner. In addition to
this, secondary sources have been used to collect the information for the literature
review.
This has helped me to analyse
the view points of several researchers in order to critically evaluate the topic and
developing a deeper understanding of it. Further, it has also helped to clear me of
my doubts regarding this topic by performing an evaluation of several different
authors' points of view. Hence, my focus throughout this research has been to gather
qualitative data and for this I have used an interpretivism research philosophy which
support in gathering data by connecting it with relevant theories and approaches.
This has assisted in collecting and presenting the information in a more
authenticated and reliable manner so that correct data can be presented in the
findings of the research.
Throughout the conducting of this research, I have been able to enhance my
knowledge in this particular area of study. In addition to this, I also became familiar
with the various numbers of methods or tactics that can be used to gather more
reliable and accurate information from secondary sources. Despite this, I also came
to learn about the major mistakes that can happen while collecting and presenting
information, all of which should be avoided as it may affect the research to a great
extent. This will further support me in performing future work more effectively, and if I
ever get the chance to research a related topic then I would be able to perform the
study in an even more effective manner. In addition, this knowledge will further help
me in creating a base for primary research which I would be able to expand and
present in a more effective manner.

4.4 Implications
While conducting research, there are a number of issues that can be faced by
researchers; for example, investigation may lead to another direction which can
affect the basic concept of the topic. This can in turn affect the understanding of
readers and professionals who are going to enter this area, or it may affect the
health of people who are dealing with obesity by providing the wrong information. So,
research must be conducted in an ethical manner by collecting information from only
relevant or authenticated sources to provide adequate data.
4.5 Recommendations
From the research presented above, it has been determined that obesity is
increasing at a rapid pace among people and specially in children, which is affecting
their future and capacity to learn. Therefore, in order to overcome these issues it is
recommended that their parents as well as teachers must focus on adding more
physical activities in children's routines. Furthermore, children should be given a
healthier and more nutritious diet by avoiding sugary or fatty foods, and this will
provide them better heath for a better life.
4.6 Recommendations for future research
The research of the current topic has been performed using the secondary data
collection method, which makes use of existing information that sometimes could be
outdated. Therefore, it is recommended that future research must also focus on
collecting primary data so that information presented can be more accurate and
current in order to help in providing the real and relevant information about obesity
how it can be overcome.

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Arianne N. Sweeting, Lan D. Caterson. 2017. Approaches to obesity management.
[Online] Available
through:<https://onlinelibrary.wiley.com/doi/full/10.1111/imj.13474>.