The Pediatric Obesity Problem: Our Role as Clinicians to Combat Childhood Obesity

by Wendy Scinta, MD, MS, FOMA, FAAFP

Dr. Scinta is the President of the Obesity Medicine Association (OMA) and is Clinical Assistant Professor of Family Medicine at SUNY Upstate.

Funding: No funding was provided

Disclosures: Wendy Scinta is the President of the Obesity Medicine Association (OMA).

Bariatric Times. 2019;16(10):17.

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For decades, the medical community has issued warnings of the growing obesity epidemic in the United States (US), and rightfully so. The number of adults with obesity in the US has increased more than 200 percent over the past 40 years, resulting in 70 percent of the population having obesity or overweight.¹ And today, on the heels of National Childhood Obesity Month, we are on the frontlines of an alarming parallel epidemic that is plunging our children into crisis.

According to the Centers for Disease Control (CDC), obesity now affects one in five children and adolescents in the US. Consider the adult medical problems that 20 percent of the nation’s children are now developing: diabetes, high blood pressure, fatty liver disease, sleep apnea, and more.² Now consider that childhood obesity typically continues into adulthood, further compounding these risk factors.³

As clinicians, we must treat obesity across the lifecycle, taking into account the diversity of patient age, sex, and socioeconomic background. And if we are sincere in our efforts to end the obesity epidemic, we must place children at the center of our intervention strategies.⁴

Obesity in childhood is one of the strongest predictors of adult obesity.⁵ If a child has obesity at four years of age and does not receive an intervention, there is a 40 percent chance he or she will have adult obesity; the odds increase to 80 percent for adolescents with obesity.

We must intervene early, and we must take it seriously. We cannot continue to ignore the condition in our youngest patients—children don’t outgrow obesity. And they don’t respond positively to blame or shame. Neither do their parents and other family members, whose support is essential to the treatment process.

Take a comprehensive approach to treating childhood obesity

Children with obesity suffer from adiposopathy (sick fat), as well as physical and psychological responses to increased adiposity, and they must, therefore, gain treatment for not only diet, but physical activity, behavior, and medication. This helps clinicians implement comprehensive treatment suggestions.⁶

In practice, successful treatment plans, such as the Behavior Opportunities Uniting Counseling and Education (BOUNCE) program, bring together effective obesity management techniques and center them around the family unit.⁷ Behavior modification, metabolic optimization, increased physical activity, and simple dietary changes can have transformative results when they are reinforced with family support. As an example, the elimination diet is effective because it encourages the adoption of healthier behaviors over time, making it easier for children and families to make lasting changes.

Pediatric obesity treatment begins with early familial intervention. The emotional and mental components of childhood obesity are critical to its management and best supported within the family unit. Clinicians can bolster that support through frequent follow-up visits focused on behaviors that resonate with patients and families.

Perhaps the most important way for clinicians to advance the effort to end childhood obesity is by staying on the cutting edge of childhood obesity medicine. The more information, interventions, and research we have in our arsenal, the better prepared we are to meet the individual medical needs of children and adolescents with obesity.

Pursue continuing medical education and other resources purpose-built for pediatric obesity

The Obesity Medicine Association (OMA)’s yearly Overcoming Obesity 2019 conference now includes a first-of-its-kind pediatric track that teaches best practices and advanced techniques for managing pediatric obesity, as well as the differences in evaluation, disease markers, and treatment tactics in pediatric patients versus adults.

Additionally, the OMA released the updated 2019 Pediatric Obesity Algorithm, which combines scientific evidence, medical literature, and clinical experience into one document to help clinicians make informed decisions about treating pediatric obesity. This comprehensive resource delves into factors that can specifically inform childhood obesity management, such as food insecurity, behavioral health problems, psychosocial consequences, pharmacology, comorbidities, and more.

Clinicians, such as primary care and family medicine doctors, in particular, are at the frontlines in the fight against the obesity epidemic. Together, we can create better health outcomes for more children living with obesity by continuing to educate ourselves and advocate for our patients.

For more pediatric obesity resources visit: https://obesitymedicine.org/clinician-resources/pediatric-obesity-resources/

References

1. Obesity and overweight. cdc.gov. https://www.cdc.gov/nchs/fastats/obesity-overweight.htm. Accessed Sept 25, 2019.
2. Weight loss for kids in Central New York. Medical Weight Loss of NY, PLLC. https://www.weightlosscny.com/medical-weight-loss-guide/bounce-program. Accessed Sept 25, 2019.
3. Why does childhood overweight and obesity matter? World Health Organization. https://www.who.int/dietphysicalactivity/childhood_consequences/en/. Accessed Sept 25, 2019.
4. Hoey H. Management of obesity in children differs from that of adults. Proc Nutr Soc. 2014;73(4):519–525.
5. Guo SS, Chumlea WC. Tracking of body mass index in children in relation to overweight in adulthood. Am J Clin Nutr. 1999;70(1):145S–148S.
6. Pediatric Obesity Algorithm: A Clinical Tool for Treating Childhood Obesity. Obesity Medicine Association. https://obesitymedicine.org/childhood-obesity/. Accessed Sept 25, 2019.
7. The Bounce Program: Effective Pediatric Dieting. Medical Weight Loss of NY, PLLC. https://www.weightlosscny.com/new-york-medical-weight-loss-programs/children-and-adolescents-program. Accessed Sept 25, 2019.

Tags: pediatric obesity

Category: Medical Methods in Obesity Treatment, Past Articles