APA Research Paper (Mirano)
Supply: Diana Hacker (Boston: Bedford/St. Martin’s, 2006).
This paper follows the model pointers within the Publication Guide of the American Psychological Affiliation, sixth ed.
(2010).
Weight problems in Kids i
Can Remedy Remedy Weight problems in Kids?
A Overview of the Literature
Luisa Mirano
Psychology 107, Part B
Professor Kang
October 31, 2004
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Weight problems in Kids 1
Author’s identify,
course, part
quantity, teacher’s
identify, and date
(all centered).
Supply: Diana Hacker (Boston: Bedford/St. Martin’s, 2006).
Summary seems on
a separate web page.
Weight problems in Kids 2
Summary
Lately, policymakers and medical consultants have
expressed alarm concerning the rising drawback of childhood weight problems
in america. Whereas most agree that the problem deserves
consideration, consensus dissolves round how to reply to the
drawback. This literature Assessment examines one strategy to treating
childhood weight problems: medicine. The paper compares the
effectiveness for adolescents of the one two medicine accepted by
the Meals and Drug Administration (FDA) for longterm remedy
of weight problems, sibutramine and orlistat. This examination of
pharmacological therapies for weight problems factors out the constraints
of medicine and suggests the necessity for a complete answer
that mixes medical, social, behavioral, and political approaches
to this advanced drawback.
Supply: Diana Hacker (Boston: Bedford/St. Martin’s, 2006).
Full title, centered.
The author makes use of a
footnote to outline
an important time period
that might be cumbersome to outline
throughout the textual content.
The author units
up her group by posing 4
questions.
The author states
her thesis.
Weight problems in Kids three
Can Remedy Remedy Weight problems in Kids?
A Overview of the Literature
In March 2004, U.S. Surgeon Basic Richard Carmona
known as consideration to a well being drawback in america that,
till lately, has been ignored: childhood weight problems. Carmona
mentioned that the “astounding” 15% baby weight problems charge constitutes
an “epidemic.” For the reason that early 1980s, that charge has “doubled in
kids and tripled in adolescents.” Now greater than 9 million
kids are labeled as overweight.1 Whereas the standard response
to a medical epidemic is to hunt for a vaccine or a cure-all tablet,
childhood weight problems has confirmed extra elusive. The dearth of success
of current initiatives means that medicine may not be the
reply for the escalating drawback. This literature Assessment considers
whether or not the usage of medicine is a promising strategy for fixing
the childhood weight problems drawback by responding to the next
questions:
1. What are the implications of childhood weight problems?
2. Is medicine efficient at treating childhood weight problems?
three. Is medicine protected for kids?
four. Is medicine one of the best answer?
Understanding the constraints of medical therapies for
kids highlights the complexity of the childhood weight problems
drawback in america and underscores the necessity for
1Obesity is measured by way of body-mass index (BMI):
weight in kilograms divided by sq. of peak in meters. A toddler
or an adolescent with a BMI within the 95th percentile for his or her
age and gender is taken into account overweight.
Supply: Diana Hacker (Boston: Bedford/St. Martin’s, 2006).
Headings, centered,
Help readers comply with
the group.
In a sign phrase,
the phrase “and”
hyperlinks the names of
two authors; the
date is given in
parentheses.
As a result of the
creator (Carmona)
will not be named in
the sign phrase,
his identify and the
date seem in
parentheses.
Weight problems in Kids four
physicians, advocacy teams, and policymakers to seek for
different options.
What Are the Implications of Childhood Weight problems?
Weight problems is usually a devastating drawback from each an
particular person and a societal perspective. Weight problems places kids in danger
for quite a few medical problems, together with kind 2 diabetes,
hypertension, sleep apnea, and orthopedic issues (Henry J.
Kaiser Household Basis, 2004, p. 1). Researchers Hoppin and
Taveras (2004) have famous that weight problems is commonly related to
psychological points corresponding to melancholy, anxiousness, and binge consuming
(Desk four).
Weight problems additionally poses severe issues for a society
struggling to deal with rising well being care prices. The price of
treating weight problems presently totals $117 billion per 12 months—a worth,
in keeping with the surgeon normal, “second solely to the price of
[treating] tobacco use” (Carmona, 2004). And because the variety of
kids who are suffering from weight problems grows, long-term prices will
solely enhance.
Is Remedy Efficient at Treating Childhood Weight problems?
The widening scope of the weight problems drawback has prompted
medical professionals to rethink outdated conceptions of the dysfunction
and its causes. As researchers Yanovski and Yanovski (2002) have
defined, weight problems was as soon as thought-about “both an ethical failing or
proof of underlying psychopathology” (p. 592). However this view
has shifted: Many medical professionals now contemplate weight problems a
biomedical somewhat than an ethical situation, influenced by each
genetic and environmental elements. Yanovski and Yanovski have
Supply: Diana Hacker (Boston: Bedford/St. Martin’s, 2006).
Ellipsis mark
signifies omitted
phrases.
An ampersand
hyperlinks the names of
two authors in
parentheses.
The author attracts
consideration to an
essential article.
Weight problems in Kids 5
additional famous that the event of weight-loss drugs in
the early 1990s confirmed that “weight problems must be handled within the
identical method as some other continual illness . . . by means of the
long-term use of medicine” (p. 592).
The seek for the fitting long-term medicine has been
difficult. Lots of the medicine approved by the Meals and
Drug Administration (FDA) within the early 1990s proved to be a
disappointment. Two of the drugs—fenfluramine and
dexfenfluramine—have been withdrawn from the market due to
extreme unwanted side effects (Yanovski & Yanovski, 2002, p. 592), and
a number of others have been labeled by the Drug Enforcement
Administration as having the “potential for abuse” (Hoppin &
Taveras, 2004, Weight-Loss Medicine part, para. 6). At present solely
two drugs have been accepted by the FDA for long-term
remedy of weight problems: sibutramine (marketed as Meridia) and
orlistat (marketed as Xenical). This part compares research on
the effectiveness of every.
Sibutramine suppresses urge for food by blocking the reuptake
of the neurotransmitters serotonin and norepinephrine within the
mind. Although the drug received FDA approval in 1998, experiments
to check its effectiveness for youthful sufferers got here significantly
later. In 2003, College of Pennsylvania researchers
Berkowitz, Wadden, Tershakovec, and Cronquist launched the
first double-blind placebo research testing the impact of sibutramine
on adolescents, aged 13-17, over a 12-month interval. Their
findings are summarized in Desk 1.
After 6 mos.:
lack of three.2 kg
(7 lb)
After 12 mos.:
lack of four.5 kg
(9.9 lb)
After 6 mos.:
lack of 7.Eight
kg (17.2 lb)
After 12 mos.:
lack of 7.Zero
kg (15.four lb)
Achieve of Zero.67
kg (1.5 lb)
Lack of 1.three
kg (2.9 lb)
Desk 1
Effectiveness of Sibutramine and Orlistat in Adolescents
Common
weight
Remedy Topics Treatmenta Unwanted effects loss/acquire
Sibutramine
Orlistat
Management
Medicated
Management
Medicated
Zero-6 mos.:
placebo
6-12 mos.:
sibutramine
Zero-12 mos.:
sibutramine
Zero-12 mos.:
placebo
Zero-12 mos.:
orlistat
Mos. 6-12:
elevated
blood stress;
elevated pulse
charge
Elevated
blood stress;
elevated pulse
charge
None
Oily recognizing;
flatulence;
belly
discomfort
Supply: Diana Hacker (Boston: Bedford/St. Martin’s, 2006).
The author makes use of a
desk to summarize the findings
introduced in two
sources.
A word offers the
supply of the information.
A content material word
explains information
frequent to
all topics.
Be aware. The information on sibutramine are tailored from “Habits Remedy and
Sibutramine for the Therapy of Adolescent Weight problems,” by R. I. Berkowitz,
T. A. Wadden, A. M. Tershakovec, & J. L. Cronquist, 2003, Journal of
the American Medical Affiliation, 289, pp. 1807-1809. The information on
orlistat are tailored from Xenical (Orlistat) Capsules: Full Product
Info, by Roche Laboratories, December 2003, retrieved from
http://www.rocheusa.com/merchandise/xenical/pi.pdf
aThe medicine and/or placebo have been mixed with behavioral remedy
in all teams over all time intervals.
Weight problems in Kids 6
Supply: Diana Hacker (Boston: Bedford/St. Martin’s, 2006).
When this text
was first cited, all
4 authors have been
named. In subsequent citations of
a piece with three
to 5 authors,
“et al.” is used
after the primary
creator’s identify.
Weight problems in Kids 7
After 6 months, the group receiving medicine had misplaced
four.6 kg (about 10 kilos) greater than the management group. However
throughout the second half of the research, when each teams obtained
sibutramine, the outcomes have been extra ambiguous. In months 6-12,
the group that continued to take sibutramine gained a mean
of Zero.Eight kg, or roughly 2 kilos; the management group, which switched
from placebo to sibutramine, misplaced 1.three kg, or roughly three kilos
(p. 1808). Each teams obtained behavioral remedy masking weight loss plan,
train, and psychological well being.
These outcomes paint a murky image of the effectiveness
of the medicine: Whereas preliminary information appeared promising,
the outcomes after one 12 months raised questions on whether or not
medicationinduced weight reduction may very well be sustained over time.
As Berkowitz et al. (2003) suggested, “Till extra intensive
security and efficacy information can be found, . . . weight-loss
drugs must be used solely on an experimental foundation
for adolescents” (p. 1811).
A research testing the effectiveness of orlistat in adolescents
confirmed equally ambiguous outcomes. The FDA accepted orlistat
in 1999 however didn’t authorize it for adolescents till December
2003. Roche Laboratories (2003), maker of orlistat, launched
outcomes of a one-year research testing the drug on 539 overweight
adolescents, aged 12-16. The drug, which promotes weight reduction by
blocking fats absorption within the giant gut, confirmed some
effectiveness in adolescents: a mean lack of 1.three kg, or
roughly three kilos, for topics taking orlistat for one 12 months, as
against a mean acquire of Zero.67 kg, or 1.5 kilos, for the
management group (pp. Eight-9). See Desk 1.
Supply: Diana Hacker (Boston: Bedford/St. Martin’s, 2006).
For a supply with
six or extra
authors, the primary
creator’s identify
adopted by “et al.”
is used for the primary
and subsequent
references.
Weight problems in Kids Eight
Quick-term research of orlistat have proven barely extra
dramatic outcomes. Researchers on the Nationwide Institute of Baby
Well being and Human Improvement examined 20 adolescents, aged
12-16, over a three-month interval and located that orlistat,
mixed with behavioral remedy, produced a mean weight
lack of four.four kg, or 9.7 kilos (McDuffie et al., 2002, p. 646).
The research was not managed in opposition to a placebo group; due to this fact,
the relative effectiveness of orlistat on this case stays
unclear.
Is Remedy Secure for Kids?
Whereas modest weight reduction has been documented for each
drugs, every carries dangers of sure unwanted side effects.
Sibutramine has been noticed to extend blood stress and
pulse charge. In 2002, a client group claimed that the
medicine was associated to the deaths of 19 folks and filed a
petition with the Division of Well being and Human Companies to
ban the medicine (Hilts, 2002). The sibutramine research by
Berkowitz et al. (2003) famous elevated blood stress as a aspect
impact, and dosages needed to be lowered or the medicine
discontinued in 19 of the 43 topics within the first six months
(p. 1809).
The principle unwanted side effects related to orlistat have been
belly discomfort, oily recognizing, fecal incontinence, and
nausea (Roche Laboratories, 2003, p. 13). Extra severe for
long-term well being is the priority that orlistat, being a fatblocker, would have an effect on absorption of fat-soluble nutritional vitamins, such
as vitamin D. Nevertheless, the research discovered that this aspect impact
could be minimized or eradicated if sufferers take vitamin
Supply: Diana Hacker (Boston: Bedford/St. Martin’s, 2006).
The author
develops the
paper’s thesis.
Weight problems in Kids 9
dietary supplements two hours earlier than or after administration of orlistat
(p. 10). With shut monitoring of sufferers taking the medicine,
most of the dangers could be lowered.
Is Remedy the Greatest Answer?
The information on the protection and efficacy of pharmacological
therapies of childhood weight problems increase the Question Assignment of whether or not
medicine is one of the best answer for the issue. The
therapies have clear prices for particular person sufferers, together with
disagreeable unwanted side effects, little details about long-term use,
and uncertainty that they may yield vital weight reduction.
In purely monetary phrases, the medicine value greater than $three a
day on common (Duenwald, 2004). In every of the scientific trials,
use of medicine was accompanied by an costly regime
of behavioral therapies, together with counseling, dietary
schooling, health advising, and monitoring. As journalist Greg
Critser (2003) famous in his e-book Fats Land, use of weight-loss
medicine is unlikely to have an impact with out the right “help
system”—one that features docs, amenities, time, and
cash (p. three). For some, this degree of care is prohibitively
costly.
A 3rd complication is that the research targeted on
adolescents aged 12-16, however weight problems can start at a a lot youthful
age. Little information exist to ascertain the protection or efficacy of
medicine for treating very younger kids.
Whereas the scientific information on the concrete results of those
drugs in kids stay considerably unclear, medicine
will not be the one avenue for addressing the disaster. Each medical
consultants and policymakers acknowledge that options would possibly come
Supply: Diana Hacker (Boston: Bedford/St. Martin’s, 2006).
Brackets point out
a phrase not within the
authentic supply.
A citation longer
than 40 phrases is
indented with out
citation marks.
The author interprets the proof;
she doesn’t simply
report it.
The tone of the
conclusion is
goal.
Weight problems in Kids 10
not solely from a laboratory but in addition from coverage, schooling, and
advocacy. Certainly, a handbook designed to teach docs on
weight problems beneficial a notably nonmedical plan of action,
calling for “main modifications in some facets of western tradition”
(Hoppin & Taveras, 2004, Conclusion part, para. 1). Cultural
change will not be the standard realm of medical professionals,
however the handbook urged docs to be proactive and “focus
[their] vitality on public insurance policies and interventions” (Conclusion
part, para. 1).
The options proposed by quite a few advocacy teams
underscore this curiosity in political and cultural change. A report
by the Henry three. Kaiser Household Basis (2004) outlined tendencies
that will have contributed to the childhood weight problems disaster,
together with meals promoting for kids in addition to
a discount in bodily schooling courses and after-school
athletic packages, a rise within the availability of sodas
and snacks in public colleges, the expansion within the variety of
fast-food retailers . . . , and the growing variety of
extremely processed high-calorie and high-fat grocery
merchandise. (p. 1)
Addressing every of those areas requires greater than a health care provider
armed with a prescription pad; it requires a broad mobilization
not simply of docs and anxious mother and father however of educators,
meals business executives, advertisers, and media
representatives.
The barrage of potential approaches to combating childhood
weight problems—from scientific analysis to political lobbying—
signifies each the severity and the complexity of the issue.
Supply: Diana Hacker (Boston: Bedford/St. Martin’s, 2006).
Weight problems in Kids 11
Whereas not one of the drugs presently accessible is a miracle
drug for curing the nation’s 9 million overweight kids, analysis
has illuminated among the underlying elements that have an effect on
weight problems and has proven the necessity for a complete strategy
to the issue that features behavioral, medical, social, and
political change.
Supply: Diana Hacker (Boston: Bedford/St. Martin’s, 2006).
Record of references
begins on a brand new
web page. Heading is
centered.
Record is alphabetized by authors’
final names. All
authors’ names
are inverted.
The primary line of
an entry is at
the left margin;
subsequent
strains indent 1⁄2”.
Double-spacing is
used all through.
Weight problems in Kids 12
References
Berkowitz, R. I., Wadden, T. A., Tershakovec, A. M., & Cronquist,
J. L. (2003). Habits remedy and sibutramine for the
remedy of adolescent weight problems. Journal of the American
Medical Affiliation, 289, 1805-1812.
Carmona, R. H. (2004, March 2). The rising epidemic of
childhood weight problems. Testimony earlier than the Subcommittee on
Competitors, Overseas Commerce, and Infrastructure of
the U.S. Senate Committee on Commerce, Science, and
Transportation. Retrieved from http://www.hhs.gov/asl
/testify/t040302. html
Critser, G. (2003). Fats land. Boston, MA: Houghton Mifflin.
Duenwald, M. (2004, January 6). Slim pickings: Trying
past ephedra. The New York Occasions, p. F1. Retrieved from
http://nytimes.com/
Henry J. Kaiser Household Basis. (2004, February). The position
of media in childhood weight problems. Retrieved from http://www
.kff.org/entmedia/7030.cfm
Hilts, P. J. (2002, March 20). Petition asks for elimination of weight loss plan
drug from market. The New York Occasions, p. A26. Retrieved
from http://nytimes.com/
Hoppin, A. G., & Taveras, E. M. (2004, June 25). Assessment
and administration of childhood and adolescent weight problems.
Scientific Replace. Retrieved from http://www.medscape
.com/viewarticle/481633
McDuffie, J. R., Calis, Ok. A., Uwaifo, G. I., Sebring, N. G.,
Fallon, E. M., Hubbard, V. S., & Yanovski, J. A. (2002).
Three month tolerability of orlistat in adolescents with
Supply: Diana Hacker (Boston: Bedford/St. Martin’s, 2006).
Weight problems in Kids 13
obesity-related comorbid situations. Weight problems Research,
10, 642-650.
Roche Laboratories. (2003, December). Xenical (orlistat)
capsules: Full product info. Retrieved from
http://www.rocheusa.com/merchandise/xenical/pi.pdf
Yanovski, S. Z., & Yanovski, J. A. (2002). Drug remedy: Weight problems.
The New England Journal of Drugs, 346, 591-602.

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