Moving into the second decade of management
Childhood obesity has been identified as a serious health concern for more than a decade and yet we continue to struggle with both, proper early identification and appropriate long term prevention and management. We’ve come to understand that although obesity is a patient-specific problem, its solution and implications are cultural and public health based. Where do we stand now – what do we know – where are we going?
Childhood obesity has climbed to the # 1 health concern of parents, surpassing drugs, smoking and safety. We clearly understand the medical and non-medical implications of obesity and its direct link to adult obesity and its complications, not the least of which is a shortened life expectancy! Obesity’s financial and psychological toll is profound.
Clearly prevention is key to both controlling and curtailing the long term medical complications of obesity. Unfortunately, studies have shown that pediatricians are not clear or accurate in both: a) identifying young patients early in life that are at risk for obesity and b) being clear to parents that a potential problem exists and offering early intervention strategies. Why? Differentiating a trend in weight gain (from a growth chart) can be tricky. Does the child simply have a “big build” or is the child growing genetically similar to his parents? Pediatricians are hesitant to discuss or “prescribe” diets and conversations with parents can quickly progress to a numbers game – “how much should he weigh? How much weight loss are we talking about?”
The point is, prevention is more than a number or a diet. It’s ultimately a life style change that involves a relatively complex discussion of a family’s (note family, not just the patient!) life style – their eating and exercise habits in addition to a whole host of outside (but critical factors) such as TV watching and video game use, school foods and after school snacks, sleep patterns, etc.
Fortunately, schools, health professionals plus public health and civic leaders are understanding these interrelationships and are developing workable, practical teaching plans. Schools and communities have become more committed to developing meal plans and outdoor amenities that support these goals and concepts. And nationally, obesity trends appear to have peaked and leveled off. But ultimately the solutions (and motivation) must come from inside – the family and patient to make a change. Food choices, exercise habits and healthy lifestyles are parenting practices. Food purchases, setting guidelines for TV and video time, encouraging and promoting (and participating in) exercise and outdoor activities are parental decisions and determinants that must be established and adhered to. This may be daunting and seemingly impossible but arguably the single most important responsibility (and legacy) that you will pass on to your children.
We understand. Addressing obesity in pediatric care is the new age of Pediatrics. It requires a partnership of health professionals and parents (and schools and communities) to understand lifestyles at both the personal and community level in order to institute long term and sustained benefit. Let’s work together – for the good of the next generation.