There has certainly been a lot of media coverage recently about the fact that there is an obesity epidemic. The positive thing is that this makes people aware of what a big problem it is, and maybe points out the role that junk food has in society and the main factors associated with that. At least, it makes people question that. On the other hand, I think that media advertising isn’t particularly helpful; it makes kids want to go out and buy and eat that stuff. Also, since we live in a society that seems to be so thin conscious with models etc., that tends to make overweight children feel badly about themselves.

 

Colleen Kochman, RN, MSN, PNP

 

Obesity in the family
Parental weight history comes up initially when families meet with the medical providers; they have to determine whether there is a familial history of obesity, so the issue is inherently involved in the OWL clinic. But it is also interesting to talk to kids about their parents’ weights and the expectations that they have. Many of these parents have opted for some surgical intervention to lose weight, and in those cases I think it’s important to assess what kids’ understanding is of their parent’s weight management and when they lost weight. We sometimes hear from kids, “Well, I’m just going to do what my mom or dad did, because they had surgery to lose weight.” We don’t rule that out or anything, but children need to talk about their parents’ weights, because it is important to determine what their thoughts are, particularly when their parents have been overweight. On the other hand, if their parents are very lean, we talk with the child about what’s it’s like to be a little bit different from their parents

Allison Lauretti, PhD, Staff Psychologist

 

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

 

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