MHLbannersmallThe value of a medically
supervised program

By Felice E. Haake, DO

Editor's Note: Dr. Haake is a Family Medicine physician and medical bariatrician. Her practice at the Riverside Medical & Surgical Weight Loss Center focuses on non-surgical, medically- supervised programs for weight loss, complementing the work of David Salzberg, MD, a Riverside bariatric surgeon who offers weight loss surgery including gastric bypass, gastric banding and sleeve gastrectomy.

Dr. Felice HaakeOver the past two decades, the obesity rate among children and teens has tripled according to a federal study sponsored by the U.S. Department of Education. It's estimated that at least one in five children (other estimates are as high as one in three children) exceed the normal range for their age, height and body type by between 10% to 20% or more, a number that generally meets the definition of being overweight or obese. The numbers are often even higher among African-American and Hispanic children. Because overweight kids often become overweight adults with higher risk for heart disease, diabetes, certain types of cancer and other health issues, the costs to society could be staggering. At the same time, the psychological costs to children and adolescents, in terms of impaired self-esteem, stress and depression can be profound.

Recognizing this negative impact and what it means to children and families throughout our region, the Riverside Medical & Surgical Weight Loss Center recently initiated a pediatric medical weight loss program in addition to the existing medical and surgical programs for adults. Being able to provide an early intervention is critical and, like the medically-supervised adult programs, the strategies for children and teens take a multidisciplinary approach that includes medical, dietary, exercise, behavioral and psychological components.

Although there are a number of similarities in the programs – for example, all are exceptionally personalized and avoid the one-size-fits-all approach that characterizes most commercial programs – there are also some important differences. One of the most basic is the fact that children rely on their parents for a wide range of needs. For younger children particularly, those needs include what shows up on the dinner table, what goes into their school lunches or what kinds of snacks are available around the house, as well as encouragement and support for non-sedentary activities.

donutIn a number of cases, the children are simply mirroring some of the same poor eating and exercise habits as their parents, some of whom are also overweight or obese. In those instances we may see parents who are in denial about their own weight issues. Or they might tell us that they may be too far gone to lose weight themselves but want to get help for their children.

Either way, we have to work with each child and adolescent within the context of the overall family unit. And of course, beyond the family situation, they're also exposed to potentially unhealthy eating and activity behaviors through peer groups, school, child care settings and social networks.

kids at playAnother important distinction within the pediatric program is motivation. With adults we talk a lot about health and they are generally motivated toward improving their health and quality of life. While we provide the children and teens with education related to health issues, their real interest tends to lie in the social area. With the younger children particularly, we take a lot of time in finding out what they care about, and then use that interest as part of their personalized weight loss and weight management plan. I think that kind of intense focus on each child and each specific circumstance is something that other care givers just don't have the time or the specialized team to accomplish.

What we know for certain about childhood obesity is that it can be related to a wide range and combination of medical, behavioral, emotional, environmental, hereditary and psychological reasons. What we also know is that even when the reasons are determined and evaluated, obesity is not a problem that can be resolved overnight or in a few weeks. The quick fixes, in fact, are likely to be hazardous to a child's health. And no program, regardless of its quality and approach can guarantee a successful outcome.

What I feel positive about, however, and what I'm very gratified to be part of, is an approach that's closely coordinated, medically-supervised, evidence-based and multidisciplinary in order to offer children and adolescents the best chance for safe and long-term weight-loss.

For more information on the Riverside Medical & Surgical Weight Loss Center, please call (757) 637-7637 or visit their website.