Risk behavior for obesity: a conceptual analysis according to Walker and Avant

Oliveira, Vinícius Rodrigues de; Soares, Amanda; Vitor, Allyne Fortes; Fernandes, Maria Isabel da Conceição Dias; Souza, Francisca Marta de Lima Costa; Oliveira, Jonas Sâmi Albuquerque de

doi:10.1590/0034-7167-2024-0293

person Vinícius Rodrigues de Oliveira

final review · providing critical · intellectual input to the manuscript · data analysis and/or interpretation · study/research design

schoolUniversidade Federal do Rio Grande do Norte. Natal, Rio Grande do Norte, Brazil

0000-0002-9915-0062

person Amanda Soares

final review · providing critical · intellectual input to the manuscript · data analysis and/or interpretation

schoolUniversidade Federal do Rio Grande do Norte. Natal, Rio Grande do Norte, Brazil

0000-0001-8063-4131

person Allyne Fortes Vitor

final review · providing critical · intellectual input to the manuscript · study/research design

schoolUniversidade Federal do Rio Grande do Norte. Natal, Rio Grande do Norte, Brazil

0000-0002-4672-2303

person Maria Isabel da Conceição Dias Fernandes

final review · providing critical · intellectual input to the manuscript · study/research design

schoolUniversidade Federal do Rio Grande do Norte. Natal, Rio Grande do Norte, Brazil

0000-0003-0569-5027

person Francisca Marta de Lima Costa Souza

final review · providing critical · intellectual input to the manuscript · data analysis and/or interpretation

schoolUniversidade Federal do Rio Grande do Norte. Natal, Rio Grande do Norte, Brazil

0000-0002-2442-9499

person Jonas Sâmi Albuquerque de Oliveira

final review · providing critical · intellectual input to the manuscript · data analysis and/or interpretation

schoolUniversidade Federal do Rio Grande do Norte. Natal, Rio Grande do Norte, Brazil

0000-0003-0303-409X

Corresponding author: Vinícius Rodrigues de Oliveira, E-mail:
vinciusrodriguesvro@gmail.com

EDITOR IN CHIEF: Dulce Barbosa

ASSOCIATE EDITOR: Márcia Ferreira

Uses of the concept
Public Health(¹⁴,¹⁵,¹⁸-²⁰)
Nutrition(²-²⁴)
Medicine(¹⁷,²⁵,²⁶)
Physical Education(²⁷,²⁸)
Nursing(¹⁶,²⁹)
Defining attributes of the concept
Related to diet: -Consumption of sugary beverages(¹⁴,¹⁶,¹⁷,²⁰-²⁴,²⁸) -Diets high in carbohydrates and fat(¹⁴,¹⁹-²⁵,²⁸) -Low intake of fruits and/or vegetables(¹⁶,¹⁷,²⁰-²⁶) -Skipping breakfast(¹⁴-¹⁶,¹⁸,²⁰,²⁴,²⁵) -Frequent consumption of fast food and ultra-processed foods(¹⁵,¹⁶,¹⁹-²¹,²⁹)
Related to physical activity: -Physical inactivity(¹⁶-²⁶,²⁸) -Sedentary behavior(²⁰,²¹,²⁵,²⁸) -Lack of participation in physical education classes(²⁴)
Related to general habits: -Excessive screen time(¹⁴,¹⁵,¹⁷-²¹,²⁶,²⁹) -Smoking(¹⁶,²⁰,²¹,²⁶,²⁷) -Alcohol consumption(¹⁹-²¹,²⁸,²⁹) -Eating while watching television(¹⁵,²⁴,²⁹)

Model Case
Nurse Anna, while collecting anthropometric data from schoolchildren, attended to A.S.M., a 16-year-old Black adolescent weighing 74.7 kg, with a height of 162 cm and a Z-score BMI of +2, corresponding to a classification of obesity. After identifying the condition, the nurse initiated a conversation with the adolescent to discuss his health situation. During the initial approach, she completed a food consumption form and discussed lifestyle habits to identify risk behaviors for obesity and plan an intervention based on the findings.During the conversation, the adolescent reported that he did not consume fruits or vegetables, except for potatoes, which he mentioned liking, particularly “French fries with cheddar and bacon.” Additionally, he stated that he preferred soft drinks over fruit juices. A.S.M. also revealed that he skipped breakfast in the mornings because he often woke up late for school due to poor sleep quality at night. Throughout the day, he reported consuming quick snacks, such as stuffed cookies or fried savory snacks. For dinner, he mentioned frequently eating instant noodles because it was a more practical option, as his mother worked outside the home, leaving him responsible for preparing his meals. Finally, the adolescent stated that he did not engage in physical activities, not even during school physical education classes, and instead preferred watching series or playing video games.
Related Case
V.C.O., a 17-year-old female, visited the Basic Health Unit for a family planning consultation. The patient has Polycystic Ovary Syndrome (PCOS). Before the consultation, her anthropometric measurements were taken, revealing a Z-score BMI of +3, indicative of obesity. The nurse conducting the consultation began by addressing the patient’s nutritional status. V.C.O. reported being aware of her condition and believed that her situation was related to genetic factors, as obesity cases were frequent on her maternal side of the family. Additionally, she stated that her excess weight might be associated with PCOS and/or the use of antidepressants. The patient also disclosed that she did not engage in physical activity and spent a significant amount of time using her phone. In response, the nurse provided brief recommendations regarding physical activity and reducing excessive screen time. The consultation then continued, focusing on the patient’s family history and PCOS while emphasizing concerns related to the diagnosis of obesity.

Antecedents

Consequences

-Influence of gender and age group(¹⁶-¹⁸,²⁰,²²,²⁴,²⁷-²⁹)
-Unfavorable socioeconomic conditions(¹⁶-²¹,²³,²⁵,²⁶)
-Food insecurity(¹⁷,¹⁹,²¹,²³,²⁶)
-Obesogenic home or school environment(¹⁵,¹⁶,¹⁹,²²,²³)
-Sexual, racial, or ethnic minority groups(¹⁴,¹⁷,²⁶,²⁹)
-Lack of parental control/monitoring*(¹⁴,¹⁵,²⁹)
-Absence of support/encouragement to avoid the behavior(¹⁹-²¹)
-Need for social approval(¹⁶,¹⁹,²⁷)
-Influence of social media and advertisements for obesogenic foods(¹⁵,¹⁹,²⁴)
-Unfavorable environment for physical exercise**(¹⁷,¹⁹,²¹)
- Limited nutritional knowledge among caregivers*(²³)

-Greater susceptibility to overweight and obesity(¹⁴-²⁹)
-Increased risk of developing chronic endocrine and cardiovascular diseases and cancers(¹⁵,¹⁷,¹⁹-²²,²⁴,²⁵,²⁸,²⁹)
-Physical and mental health impairments in later life stages(¹⁴-¹⁶,²⁴,²⁹)
-Reduced sleep duration and quality(¹⁵,¹⁶,¹⁸)
-Premature death(²⁵,²⁸)
- Triggering of other risk behaviors (²⁰,²⁴)

[1] Legend: Specific to children and adolescents

[TFN1] ^**
Considerations include safety issues and limited physical spaces.

Risk behavior for obesity: a conceptual analysis according to Walker and Avant

Comportamiento de riesgo para la obesidad: análisis conceptual según Walker y Avant

ABSTRACT