For kids obesity is not just a phase

Main Category: Obesity / Weight Loss / Fitness
Article Date: 22 Dec 2003 - 0:00 PST

email to a friend   printer friendly   opinions  

Addressing weight issues with children and adolescents requires a multifaceted approach from physicians that often involves the entire family.

In the US and UK there is startling evidence that type 2 diabetes is occurring more frequently among younger patients -- a warning flare regarding the toll the obesity epidemic is taking on the nation's youth.

Such news is an urgent call for action, and one that the AMA (American Medical Association) is taking to heart.

The surgeon general has said the high incidence of overweight and obesity among young people is the greatest threat to public health today.

It foreshadows a maturing generation plagued by high blood pressure, heart disease, complications of diabetes and a range of other chronic conditions associated with extra pounds.

After all, data show that heavy children are more likely to grow up to be heavy adults. Think of what that means in terms of these Centers for Disease Control and Prevention statistics:

The percentage of children and adolescents defined as overweight has more than doubled since the early 1970s.

About 15% -- 9 million young people between the ages 6 and 19 -- are now overweight, having body mass index values at or above the 95th percentile of the sex-specific BMI growth charts.

More than 10% of preschool children ages 2 to 5 are overweight, up from 7% in 1994.

That's why the AMA convened in November its Working Group on Managing Childhood Obesity -- an initiative spun off from the organization's effort to develop a clinical roadmap for addressing adult obesity, which became available Dec. 1.

The working group's specialized mission focuses attention on the unique needs of pediatric patients struggling with weight. More information on the group's actions is available on the AMA's Web site (www.ama-assn.org/ama/pub/article/3216-8158.html).

And although the obesity epidemic is spreading rapidly among all children, it is at an even greater crisis point for those from minority communities.

According to the CDC, non-Hispanic black and Mexican-American adolescents ages 12 to 19 were more likely to be overweight (24%) than non-Hispanic white adolescents (13%).

Similarly, Mexican-American children ages 6-11 were more likely to be overweight (24%) than non-Hispanic black children (20%) and non-Hispanic white children (12%).

A big part of the quandary is that inner-city neighborhoods tend to offer fewer opportunities for activity and recreation, and fewer resources to help build healthy diets, bodies and lifestyles. Thus, one of the working group's highest priorities will be developing methods to reduce this racial and ethnic disparity.

The working group's overarching goal is to develop strategies to reverse the current trends. Crafting these approaches, however, will involve a range of practice-based, systemic and even policy-oriented issues.

But it also will require individual physicians to take steps of their own. Physicians can identify and educate overweight or at-risk pediatric patients and their families. After all, it is frequently a family problem.

Often, the best course in doing so is to distinguish between healthy and unhealthy weights at every visit. Experts suggest that doctors avoid using the 'O' words -- overweight and obesity -- instead focusing on a common, positive language that involves body mass index and well-being.

In addition, physicians can serve as an important connector between these kids, their families and community or school-based resources.

Physicians also have the power to encourage pediatric patients to become invested in their own progress. For instance, the whole family could work to increase their activity levels, using pedometers to track the number of steps they take toward the daily goal of 10,000.

Finally, physicians should schedule quarterly visits with overweight and obese patients to supervise their progress and regularly assess them for obesity-related complications.

For now, the take-home message for physicians -- and one that must be shared with the families of these young patients -- is that overweight and obesity in childhood is an acute health problem and must be treated as such.

It's not a phase of life kids will outgrow. Cracking that problem will require multi-faceted approaches combined with long-term management and attention. Failing to do so will have dire consequences.

• Additional
• References
• Citations