Long Term Effects

• Diabetes
• Three Important Points
• Risk Factors
• Long Term Risks and Immediate Complications
• Listening to Patients
   

Diabetes

A major health risk that we currently see is type 2 diabetes, which we now find in adolescents. Before, we didn’t see it until adulthood, but now we see it in adolescents too because we have such an epidemic of overweight in this country. Overweight can cause bone and joint problems as well, because if the body has to carry around that extra weight, that’s more pressure on the musculoskeletal system. Later on in life overweight can cause problems with the heart, because once again you’re carrying around extra weight, which can put pressure on the heart and cause clogging of the arteries. It can affect fertility later on in life, and in fact many teenage girls have something called PCOS, which causes a lack of menses or very irregular menses.

Sometimes I talk to families about the complications of diabetes. I’ll talk to kids about how unpleasant it might be to have to prick yourself several times a day to test your blood sugar, or in some cases, to have to take shots of insulin every day, and then later on in life have circulation problems. It’s not a very pretty picture, and sometimes it’s scary enough to get parents thinking about using healthy food as a medicine to prevent these diseases.

Colleen Kochman, RN, MSN, PNP

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Three Important Points

When parents come to the clinic I really like to emphasize three points:

1. I explain the importance of obesity in terms of related complications such as diabetes, cardiovascular disease, and psychosocial problems;
2. I explain to parents the most important causes of obesity at the present time: excessive caloric intake and lack of physical activity; and
3. I also emphasize that obesity can be prevented and that the parents play a crucial role in this regard.

Diego Botero, MD, Pediatric Endocrinologist

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Risk Factors

I explained to families that many clinical studies have shown a strong correlation between obesity and diabetes, cardiovascular disease, hypertension, dyslipidemia, gallbladder stones, musculoskeletal problems and psychosocial issues. I try to describe all of these medical conditions using lay terms. And I try to be very positive, telling them that all of these risk factors can be reduced significantly by losing weight and by making changes in lifestyle such as becoming more physically active.

Diego Botero, MD, Pediatric Endocrinologist

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Long Term Risks and Immediate Complications

Obesity in adults is known to cause many health problems, the most concerning of which are heart disease, diabetes and cancer. Among children, excessive weight increases the risk of becoming obese as an adult, but it also has numerous immediate complications. Excessive weight places stress on almost every organ system in a child’s body, including:

Heart: high blood pressure, high cholesterol, and other risk factors;

Hormones: type 2 diabetes (previously called “adult onset” diabetes), early puberty for girls, and delayed puberty for boys;

Lungs: asthma, shortness of breath, and sleep apnea;

Gastrointestinal tract: acid reflux, constipation, and fatty liver;
Muscles, bones and joints: flat feet, bowed legs, and disabling hip problems;

Central nervous system: increased cerebrospinal pressure, causing headaches and blurry vision; and

Psychological: depression, poor self-esteem, and eating disorders.

I will sometimes say to patients, “Imagine carrying a 50-pound backpack on a long hike. You would probably feel pretty tired and sore by the end of the day, and look forward to putting that pack down. Well, being overweight is like having to carry that pack around, day in and day out, never being able to put it down.”

David Ludwig, MD, PhD
Director, Obesity Program

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Listening to Patients

I like to listen to patients and families when they come in to the clinic. I think many times they haven’t had an opportunity to discuss just how it feels to be overweight in our society. I like to give them the opportunity to vent a little bit about that, if they want to, and to talk about the reasons they want to lose some weight and what differences it would make in their lives. Some kids want to be able to be more active; some kids are motivated to lose weight because teasing upsets them so much. Other kids would like to have more choice in clothes, or be able to make the football team, or have something like a prom coming up. So I like to hear why it is that they’re here. Whose idea was it? Are they here because someone made them come, or because they really want to lose some weight, and if so, why? So that’s the first thing. Then, because I’m a health care provider, I like to talk about the complications of being overweight, particularly later in life. We’re seeing so much diabetes now in kids who are overweight. I want to make sure that families know that in addition to feeling better about themselves and increasing their self-esteem, there really are some serious health consequences if they don’t take weight loss seriously.

Colleen Kochman, RN, MSN, PNP

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