September 24, 2007
The Johns Hopkins Children Center
When his mother and doctor told him that his weight was unhealthy and that, from here on, his life was going to change, 11-year-old Christopher Ricks saw the writing on the wall.
"I was like, Oh my God, I'm going on a diet!" But Christopher's pediatrician referred him to Weigh Smart, a pilot program that takes a no-fault, family approach to weight loss and emphasizes health over diet.
"Weight loss for children is a family affair," says Kenneth Gelfand, the psychologist for the program provided by clinicians from the Johns Hopkins Children's Center and the Mt. Washington Pediatric Hospital, where Weigh Smart is based. "We take the stance that it's not the kids' fault, but it has to be treated - and the consequences of not treating it will be to their detriment."
Indeed, between 1980 and 2000, the number of children three to five years of age and teens over the 95th percentile for weight and height has doubled. For children ages six to eleven, the rate has tripled. Since 2000, these rates have increased another five percent to 17 percent.
The consequences for children? Higher blood pressure, insulin and cholesterol concentrations, all of which point to higher mortality.
"If childhood obesity stays at its current level, for the first time in more than a century, the present generation of children will live shorter lives than their parents," says Children's Center gastroenterologist Ann Scheimann, a member of the Weigh Smart team.
Over the course of its 10 weekly sessions, Weigh Smart aims to reduce the risks of being overweight through education, exercise and nutrition. Christopher began reading food labels and keeping a food diary to understand what and when he ate. Realizing that watching TV made him want to eat, he turned off the tube and replaced it with exercise. Today, he's several sizes smaller, and, after years of not being able to keep up with his friends, he now plays football and rides a bike with them. His mother, Wanda, who has shed some pounds herself, changed not only Christopher's home life, but the rest of the family's, too. "I prepare food now for everyone to have just one serving," she says. "Today, we all eat together, and we all go to the mall to walk together."
What can pediatricians do? "Address obesity factors before they're fully entrenched," says Lutherville pediatrician Dr. Alan Lake. "Identify kids at risk - those with a BMI (body mass index) over 85 percent, and refer them for early and aggressive intervention."
Obese children, those with BMI above the 95th percentile, should be further evaluated with blood work to check cholesterol, blood sugar and liver enzymes, Scheimann recommends.