Throughout this assignment,
critical discussions of the knowledge, skills and attitudes nurses require to
successfully implement health promotion within the adult field and chosen topic
of obesity will be considered, alongside with the different health promotion
models available.

According to the World Health Organisation, Health
Promotion is defined as the process of enabling
people to improve and take control of their health. It includes a wide range of
social and environmental interventions to ensure holistic care is instilled (WHO, 2017). The chosen
topic in relation to health promotion for this assignment is the effects of
obesity on adult sufferers. The reason this topic has been chosen is due to the
fact is it so becoming more and more prevalent in today’s society, there are
more sufferers than ever and action has started to be taken by the government
initiatives for example, sugar tax.

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There are various models that can be used in regard to
health promotion for example the Penders, Beatties and Chin and Bennes models
of health promotion are also some highly reputable models to use to analyse
evaluate health promotion.

For the purposes of this assignment the model the
Tannahill’s Model of Health Promotion 1985
REF will be chosen to demonstrate how health is promoted within a
population of people suffering from obesity. The Tannahill’s model of
Health Promotion is a very reliable academic model which consists of three
intersecting circles with components of health education, prevention and
protection, giving three dimensions of health promotion. The model will also be
critiqued throughout the assignment on its positives and negatives.

Adult Nurses play a vital role within health promotion. The
traditional focus of disease prevention and changing the behaviour of
individuals had been the traditional approach to health promotion from adult
nurses. Conversely, today an Adult Nurses’ role as a health promoter has
evolved and become more intricate than ever. Adult Nurses have broad
multi-disciplinary knowledge and a wide range of experience of health promotion
in their nursing practice which they can also reflect on (WHO, 2017).



It is paramount for nurses to be aware of the cause and
effects obesity can have on an individual’s health, along with knowing how
educate people on how to prevent weight gain or to recommend a change to
lifestyle choices to adult obesity sufferers (NICE, 2016).  Weight gain is the result of an
imbalance between energy intake and energy output. The pathogenesis is
multi-factorial and is the interplay of genetic predisposition and
environmental factors. The combination of our genetic propensity to store fat,
the ready availability of calorie dense foods, and sedentary lifestyle promotes

 There are a
considerable number of social determinants which contribute to obesity in adults
such as the following;

Diet A child’s
food environment plays a very important role. To start with, parents greatly
influence a child’s food choices and eating behavior.3 Parental
obesity is an important factor in predicting adult obesity, and offspring of
obese parents who themselves were obese in childhood may be at particular
risk.4 As the
child grows, aggressive advertising practices and relatively low cost of
energy-dense foods drive him towards foods high in saturated fat, refined
carbohydrates, and sweetened carbonated beverages. Students often have ready
access to high-calorie foods in school cafeteria and fast food shops located
nearby. Awareness about adverse effects of unhealthy nutrition is inadequate
amongst schoolchildren.


Physical activity Activity patterns within adults
can have changed due to changes in life for example, a new job, working long
shift patterns or  having a family.

In many developing countries, there
is acute dearth of open spaces and playgrounds in schools and communities.
Neighborhoods are often considered unsafe for walking and other outdoor
activities. An increasing pressure on academics and reduced emphasis on
physical activity in schools is another contributory factor to weight gain

Socio-economic Status (SES) The
relationship between SES and weight shows interesting dichotomy. Urban poor in
developed countries appear vulnerable due to poor diet and decreased physical
activity; urban rich in developing countries remain at risk due to an increased
affinity to the western type of lifestyle.5 Increased
prevalence of obesity in high SES private schools could be the result of
generous pocket money, availability of domestic help, and traveling to school
by car.

Tradition and culture A number of beliefs have been
passed down over generations, mostly in developing countries. A common myth is
that a fat child is a healthy child and that most of the obesity is baby fat,
which will eventually go away as the child grows. Oils, ghee, and butter are
believed to be essential to impart strength and increase growth. Leftovers on
plates are strongly discouraged. Adolescent girls have very low levels of
physical activity as they are expected to help out with household chores
instead of being involved in outdoor activities.6 Prenatal
exposure to maternal smoking and absence or short duration of breastfeeding in
infancy are some of the early-life determinants of overweight and obesity.7

Secondary causes Obesity due to endocrine disorders
(hypothyroidism, Cushing’s syndrome, GHD, pseudohypoparathyroidism) is far less
common than exogenous obesity. Genetic diseases either monogenic (leptin
deficiency, MC4R mutation) or pleiotropic genetic syndromes (Prader-Willi,
Bardet-Biedl) are extremely rare causes of childhood obesity. Hypothalamic
defects may rarely cause obesity.