Childhood Obesity

Although I was trained at a pediatric physician assistant program, I cannot recall a single lecture on the topic of child obesity because the epidemic was just beginning in the US at the time of my training.  Child obesity has tripled in our country since the 1980s, and a multitude of health problems are developing in kids in America because of this trend. Currently the rate of children that are overweight or obese is 33 percent in the US, and based on the most recent data collected in New Hanover County, the rate in our community mirrors this.  

Obesity trends

Carrying extra weight is linked to diabetes, heart disease, orthopedic problems, asthma, some cancers, as well as a negative self-image for children. How did this happen? How can the US triple obesity rates in children in just one generation of kids?! I am a health care provider as well as a mother of four and am highly concerned about the health of the kids of this generation! Based on the obesity trends in children in the United States, it is predicted that this generation will be the first to have shorter lifespans than their parents due to earlier death from diseases linked to their obesity. This in itself a travesty!

A surprising study

A surprising study that came in 2011 showed that 75% of parents of children who are overweight or obese reported that their primary care provider had never discussed the problem their child’s weight with them. This shows that even those parents that bring their children to office visits regularly can leave a visit clueless about what is likely the biggest risk to their child’s health. When I heard about this study, it motivated me to create The Family Fitness Challenge at my office at Wilmington Health. The first step to finding a solution to a problem is to recognize the problem! What good am I doing if I check a blood pressure on my patients every visit, but never mention it to them when it is running too high? How are they supposed to make lifestyle changes and make an impact on their disease?

Why weight problems in kids are overlooked

I know that part of why we fail to mention to a patient that they have a weight problem, is because the problem is so complex and takes a great deal of time. Another reason that weight problems in kids are being missed by health care providers is because our vision has become a bit skewed. As humans we subconsciously are always making comparisons to draw conclusions about what we see. As parents and as health care providers, with so many children falling into the category of overweight or obese, it is easy to become desensitized to seeing children who are an unhealthy weight because it becomes our “new normal.”  Without taking the time to do the height and weight at every office visit (and not just at the well child checks, which has been the tradition) and plotting a child on the body mass index (BMI) growth chart, it may be easy to overlook that there is actually an overweight child sitting in front of you.  This oversight is because the child in the office looks the same as so many other kids in your child’s classroom, your next door neighbor, or maybe even your own child!

Do you know your child's BMI?

The evidence is indisputable that children who are overweight or obese have more health risks than normal weight children.  But, before you can heed a warning, you need to have adequate information! The Center for Disease Control (CDC) classifies a child on the BMI percentile curve above 85th percentile, as being overweight. Children who are above the 95th percentile are considered obese. BMI is a value based on height and weight and does not actually measure the percentage of body fat. The challenge for you today is to determine what BMI percentile your child is in.

How do you know what BMI percentile your child is in? You may be able to obtain a copy of their BMI growth chart simply by contacting their primary care provider if they have been seen in the office recently. If you are unable to, you can easily gather this information on your own!  The first step is to weigh your child with a digital bathroom scale and make a note of their weight in pounds (make sure you have them remove heavy articles of clothing and shoes).  Next you need to measure their height with a tape measure in inches. You can then calculate where your child’s BMI lies at www.cdc.gov/healthyweight/assessing/bmi/.   At this website the CDC has a BMI calculator option for adults, as well as children.  You may want to take this time to assess the BMI of the adults in the household as well.  If you find your child is at an unhealthy weight, you can start making some steps to change the course of their health today! 

There are some great ideas on the CDC website where the BMI calculations are done, and I will be sharing some tips monthly on simple lifestyle changes that can make your entire family healthier!

Source: 1. Olshansky SJ, Passaro  DJ, et al “A Potential Decline in the Life Expectancy in the United States in the 21st Century”, New England Journal of Medicine, 352 (11):1138-1145,2005

J'nelle Ruscetti, PA-C, has initiated an evidence-based approach to addressing the childhood weight problem and has begun using it in her practice. It is an eight-week family plan, designed to not only treat children who are currently at an unhealthy weight but also to help prevent children from becoming an unhealthy weight.

The class meets weekly for presentations on various topics relating to childhood obesity. The program involves playing interactive games with the families, exercising as a group, and giving different challenges to the families for the upcoming week. Each week the exercises and the challenges become a little more difficult. We hope that by offering this program to the community, Wilmington Health can begin to make a change for the children in the Wilmington-area by reversing the trend in the childhood obesity epidemic that is plaguing our nation.