Over the past two decades, the prevalence of children who are obese has doubled, while the number of adolescents who are obese has tripled. According to the National Health and Nutrition Examination Survey (NHANES) 31.9% of children and adolescents were overweight (BMI at or above the 85th percentile) and 16.3% were obese (BMI at or above 95th percentile).
Obesity impedes a child’s ability to learn and grow. It is no secret that overweight or obese children and adolescents are at risk for many health problems. Some of the negative health outcomes that may be more obvious to children and their parents are asthma, sleep apnea, skin infections, and joint pain. There are other serious health risks associated with obesity that may be less obvious to the child or parent, such as high blood pressure (hypertension) and Type 2 Diabetes. These conditions can have serious long-term health effects and may require ongoing medical treatment and management.
Our Efforts
The MN-AAP Obesity Taskforce, co-chaired Dr. Sarah Jane Schwarzenberg, director of Pediatric Gastroenterology at the University of Minnesota, and Dr. Jessica Larson, pediatrician at Fairview Elk River Clinic, is discussing ways to support the national initiative Let's Move by addressing the barriers that stand in the way with calculating and plotting BMI. The taskforce is also collecting practical tools, resources and links for Minnesota pediatricians to use in their practice to help assess, prevent and treat childhood obesity. For more information about this taskforce, or to join our efforts, contact debilzan@mnaap.org
If your school or community group would like a pediatrician to speak about obesity-related issues, please email debilzan@mnaap.org
Resources For Pediatricians
The AAP recommends the following approach to assessing, preventing and treating pediatric obesity:
Assess
Conduct thorough history including family history, eating and physical activity with all patients. Review selected behaviors (including screen time, sweetened beverages, eating out and fruits and vegetables).
For each patient, consider patients risk by virtue of family history, height and weight gain pattern, socioeconomic, ethnic, cultural, presence of co-morbidities and/ or environmental factors.
Beginning at age 2, calculate and plot BMI for all patients on a yearly basis.
Prevention is for all patients and should include promotion and support for breastfeeding, family meals, limited screen time, regular physical activity and yearly BMI monitoring.
Prevention Plus is for children between the 85th - 94th percentiles BMI. Specifically encourage 5 servings of fruits and vegetables/day, 2 hours or less of screen time, 1 hour or more of physical activity and 0 sugared drinks. Also discuss the importance of family meal time, limiting eating out, consuming a healthy breakfast, preparing your own foods, and promotion of breastfeeding.
Structured Weight Management is used if prevention plus has not been effective and BMI is between 95th - 98th percentiles. This approach combines more frequent follow-up with written diet and exercise plans.
Comprehensive Multidisciplinary Intervention is used when 3 - 6 months of structured weight management has failed to achieve targets. This approach combines more frequent visits with an MD and a dietician and could also include exercise and behavioral specialists.
Tertiary Care Intervention is for patients with BMI 99th percentile or greater and with associated co-morbidities or for those who structured weight management and comprehensive multidisciplinary intervention were not effective. This approach consists of all that is contained in the previous delivered interventions plus consideration of more aggressive therapies including meal replacements, pharmacotherapy, and even bariatric surgery in selected adolescents.
Child Nutrition Bill: Urge Members of Congress to Pass it This Summer
If a child nutrition bill is not passed this summer, millions of children will miss out on improved access to the nutritious food they need to learn and grow. Your voice is needed to demonstrate national support for completing a strong child nutrition bill this year.
Visit the AAP Adovacy Center for background information on this important bill and links to your members of congress.
September 14 Webinar: Childhood Obesity in Minnesota
Learn what MN-AAP's pediatric obesity taskforce is doing to help pediatricians assess, treat and prevent this epidemic in Minnesota. Dr. Sarah Jane Schwarzenberg, co-chair of the taskforce and director of the pediatric weight management program at the University of Minnesota, will share tools, strategies and success stories that physicians can take back to their practice as well as their community.
