Addressing Childhood Obesity

According to a new scientific statement by the American Heart Association, parents and caregivers should be involved in treatment programs for their obese children. The authors of the statement studied research that evaluated outcomes of behavioral change strategies. Some of the strategies that they looked at included high involvement by parents of obese children in the context of treatment programs. Most of the programs were multi-disciplinary, typically involving a team of psychologists, medical staff and dietitians and taking place in a university or hospital clinic setting.

From the research, the statement authors concluded that the following strategies were most effective:

• As a family, identify specific behaviors that should be changed.
• Set clearly-defined goals and monitor progress.
• Provide a home environment that encourages healthier choices.
• Parents should praise their children’s progress and, instead of criticizing, use “slips” as an opportunity to help children identify ways to make different choices if the same situation arises again.
• Food shouldn’t be a reward or withheld as punishment.
• Keep track of progress toward goals, using a written or online tracker.

There have been mixed results in previous research about the effectiveness of parental involvement in family-based treatment. The authors note that the inconsistent findings from other studies could be due to the fact that not all types of parental involvement are helpful. Dr. Jaime Ponce, bariatric surgeon at the Gastric Band Institute, commented that “when the home environment offers positive influences on the kids, improvements can be seen, but what is needed more is better education at all levels, better control of marketing strategies, and better stimulus for positive lifestyles.”

How to best treat childhood obesity is often a controversial and touchy subject. Over the past several months in Georgia, an anti-childhood obesity ad campaign has induced quite a debate. The state of Georgia has some of the highest obesity rates in the country, with 40 percent of its youth overweight or obese. Ads launched by the Children’s Healthcare of Atlanta told parents to “stop sugarcoating” the issue of childhood obesity.  In the ads, overweight Georgia children were featured, with messages such as “Fat prevention begins at home. And the buffet line” and “It’s hard to be a little girl when you’re not.” Critics of the ad campaign said that they could stimulate further stigmatizing of overweight children.

According to a CNN article about the issue, 75 percent of the parents of obese children in Georgia don’t see their child’s weight as a problem. A representative of the campaign explained that because of this denial, it was necessary to make people aware that this is a medical crisis, saying “We knew flowery ads don’t get people’s attention. We wanted to come up with something arresting and hard-hitting to grab people.” The goal of the campaign was to create awareness and to get people talking about childhood obesity, and that it did; Amongst all of the debate, the number of children enrolled in a multi-disciplinary program–the Health4Life Clinic–grew substantially from 2010 t0 2011.  In 2010 they had 350 patient visits and almost 600 patient visits in 2011, treating more than 100 children with fatty liver disease or cirrhosis, which are both conditions that are rarely seen among children who are not overweight.  The ads are currently being phased out, with critics maintaining they caused more negative effects than positive.

In 2011, a controversial editorial published in the Journal of the American Medical Association suggested that severely obese children are at such a great risk for life threatening complications, that treatment such as surgical weight loss or state-intervention should be considered.  You can read more about the editorial and view the responses of several of the country’s leading weight loss surgeons here.