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Community Rx (old)

Battling Childhood Obesity With Fitness And Diet

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http://media.soundmedicine.org/segments/030214_1.mp3

The obesity epidemic is beginning to turn around

According to a recent study by the Center for Disease Control and Prevention, there's been a significant decline in obesity among children who are 2 to 5 years old.

The facts

A recent study published in the New England Journal of Medicine found that a third of school-age children in the U.S. are overweight or obese. The study also showed that overweight 5-year-olds are likely to be overweight or obese as eighth-graders.

Acknowledge the problem; strategize a diet-and-exercise plan

Parents of overweight children should avoid thinking "they will grow out of it," according to David Creel, Ph.D, a registered dietician and clinical psychologist at Peyton Manning Children's Hospital. They, instead, should make meal-time fun; engage children with preparing means; make sure children are eating lunch at school, rather than skipping breakfast and lunch, and binging on unhealthy snacks all night; and encourage discussion of exercise and how to become healthier. Dr. Creel says he often begins an assessment of a patient with a food journal, or a pedometer, to meet them where they are.

"We need to engage the adolescence in the program, otherwise we won't be successful at all," says Dr. Creel on why engaging teens in the process of becoming healthier is more important than with younger children, whose parents provides their environment. 

Teens are typically more motivated to lose weight, often because of how it's affected their personal and social life, according to Dr. Creel.

"Sometimes they [adolescents] have chosen to be in an environment where there is less pressure. Sometimes they've chosen to be around other kids that have the same struggles and have given up," says Dr. Creel. "We aren't making this all about the weight. We're looking at the weight and their perspective of the rest of their life and their personality."

Surgery as an alternative to diet and exercise

For teens with a BMI of over 40, whose many attempts at diets and exercise have failed, surgery is an effective "intervention" for their downward spiral, according to Samer Mattar, M.D., a bariatric surgeon at Oregon Health and Science University. Teens who undergo the surgery should be doing well in school; have stable home environments; and should be psychologically stable; are assessed with much greater detail than adults are.

"When I see these patients a year, two years, five years down the line, you can see how they blossomed; you can see how their personality shines; how they are performing much better in school; how their social circles enlarge; and also, how they are much healthier," says Dr. Mattar. "Also, from a surgical point of view, I like operating on adolescents, because their tissues are much healthier than adults."

Of his ten years performing bariatric surgery on adolescents, there isn't one he regrets, according to Dr. Mattar, as his patients have only experienced successful results.