Today’s children are headed for the record books, but for all the wrong reasons.
“Pediatric obesity is a real threat to your children’s health and to their families’ health,” said Walter Larimore, MD, FAAP, a family physician in Monument, CO.
“Unless we intervene, the growing incidence of pediatric obesity means this generation of children may be the first in American history to have a shorter life expectancy than their parents.” He points to research showing that a high adolescent BMI is associated with a 30-40% higher adult mortality compared with medium BMI and it lowers life expectancy from eight to twenty years!
It’s not too late to act. Starting with a research project at Florida Hospital in Orlando, Dr. Larimore (and Sheri Flynt, MPH, RN, LD, the Manager of the Center of Nutritional Excellence at Florida Hospital) created an intervention that reduces body mass index and blood pressure for both overweight children and their overweight parents as it improves overall family health scores.
Dr. Larimore has already written a best-selling book for parents, Supersized Kids: How to protect your child from the obesity threat (with Sheri Flynt and Steve Halliday). Now he is taking the message to family physicians, including a simple, clinically proven, eight-week intervention.
“This whole program began when Florida Hospital in Orlando recognized a significant increase in admissions for medical problems related to childhood obesity,” Dr. Larimore said.
Pediatric wheelchairs had to be enlarged and strengthened, pediatric anesthesiology guidelines had to be revised, and almost every other pediatric service had to adjusted to accommodate supersized patients.
Outside the hospital setting, the mushrooming pediatric obesity epidemic is destroying children’s lives, draining family and government resources and pushing America dangerously close to a total health care collapse.
“For example,” Dr. Larimore points out, “in 2002, the Social Security Administration paid out $77 million per month to citizens whose disability is obesity-related.”
Extra lifetime medical costs attributed to obesity for 20-year-olds who are 30 to 69 pounds over a healthy weight add up to anywhere from $12,290 (for black men) to $21,550 (for white women).
Childhood obesity is complex and multifactoral, Dr. Larimore says.
Children today face nutritional challenges from unhealthy eating habits, calorie-laden fast food meals, oversized portions, a sedentary lifestyle at home and school, and lack of sleep. He pointed to the growing popularity of video games, television, and online entertainment as well as a lack of exercise and physical education at school as a result of the No Child Left Behind Act.
Many neighborhoods are less safe, which inhibits outdoor play time. Parents use TV to keep children occupied, which reduces their activity rate.
“There is nothing that produces a metabolic rater lower than watching TV,” he said. “You use more energy sleeping or reading than you do watching TV and kids are spending more and more time in front of a screen.”
One study revealed that for every two hours or more of TV per day a girl watches, the risk of becoming obese jumps 23%, while the risk of developing diabetes increases 14%.
“There are so many factors that work against controlling childhood obesity,” Dr. Larimore added. “It is very discouraging to healthcare professionals who care for children. The tack we took was finding small interventions that the family can make and ways the family physician can help.”
The most important step the family physician can take is to confront childhood obesity directly. If a child is obese or overweight, say it to the parents and say it to the child, he advised.
Confronting overweight/obesity and telling both child and parent that it’s time to deal with the issue may make a significant difference.
Hard to believe? Taking a moment to encourage a patient to stop smoking is all it takes to spur 20% of patients to quit. Advising parents to buckle up their children every time they get into a vehicle is enough to change behavior in 50% of families. Dr. Larimore believes childhood obesity intervention can be just as quick and just as effective.
The key is an eight-week, family-based action plan with a menu of small, easy steps, Dr. Larimore said. The plan can be easily recommended by the family physician and explained by a medical assistant. Options start as simply as turning off television during meals, cutting out a single fast food restaurant visit each week, or getting fifteen more minutes of sleep at night.
“It is highly healthy behaviors that we are after, not weight loss,” he explained.
“Once kids realize they have options, they tend to make healthier choices. They are already concerned about self- and body-image, they just don’t know they can do anything about it. That’s where the family physician can walk through an open door.”
