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Dealing with Childhood and Adolescent Obesity

Parents are a big factor in helping children learn healthy eating habits

The obesity epidemic in the United States doesn’t affect adults alone. Children and adolescents – and their parents, doctors and nutritionists – are dealing with the alarming situation as well.

“We definitely are seeing a lot more not only of adolescent but also childhood obesity,” said Dr. Jibel Gullo with Baptist Physicians Lexington. “We are seeing a lot more hyperlipidemia and diabetes in children. That’s something that 10 years ago you really didn’t think about as much, and now you have to check for that sort of thing. I’ve even just started a child on medication because their cholesterol levels are so high. We’re seeing a lot more of that in children.”

The problem – and its cure – begins in the home. That’s where Gullo first tries to make inroads and to educate.

“A lot of it is starting with parents, trying to talk to children about eating healthy and parents about making sure they eat healthy,” she said. “It’s a change the whole family needs to make.”

Gullo said parents are often reluctant to give up all the unhealthy “stuff” in the house that they like to eat, too. “That’s the biggest problem we have,” she said. “I send children and adults for nutritional counseling and if you can get them to go it’s usually very helpful.”

Numerous tool are used in diagnosing adolescent obesity. A body mass index (BMI) above 25 is an indication of obesity, Gullo said. She also uses a growth chart to see what percentile the child is in.

“We typically want to make sure they’re following their projected curve, that they’re not gaining weight at a faster rate than they’re growing,” she said. “It doesn’t really matter what percentage they are as long as they’re proportionate. You don’t want a child that’s in the 50th percentile for height and the 90th in percentile for weight. You want those measurements to be proportionate and around the same curve.”

As she designs a treatment plan, Gullo does not put a big emphasis on dieting. “I tell kids they really shouldn’t diet because they’re trying to grow,” she said. “I approach it more as a healthy lifestyle and try to make them understand that this is a lifelong change, that they need to eat healthy their whole lives.”

Instead of dieting, Gullo encourages her young patients to make good food exchanges, such as having a salad instead of a hamburger if they’re at a fast-food restaurant. Other healthy replacements Gullo recommends include drinking skim or 1-percent milk, juice and water instead of soda. Snacks should be fruit or something similarly good for them.

Exercise also is important for weight loss. Today’s kids are sometimes dangerously inactive.

“We do have an issue with kids coming home and spending hours with television or computer games and now with Facebook,” Gullo said. “There are a lot of sedentary lifestyles among children and teenagers. So we need to educate parents about that. Even if they’re not overweight, they shouldn’t be doing that.”

Gullo usually sends her overweight adolescent patients to a nutritionist, who will go into more details about what the child and his or her parents can do to help him or her lose weight.

“I don’t have a cutoff BMI, but if they are moderately obese even, I’ll usually refer them to a nutritionist,” she said. “A lot of times I’ll talk to the family and see them back in three months, and if there is no progress made, I’ll refer at that point.”

Working with a nutritionist often teaches the family things they didn’t know. “Some of them don’t realize they are eating things that are high calorie. They just don’t have any idea,” Gullo said. “One nutritionist said in one of the consults the mom was surprised at the portion sizes we recommended for the child. She had no idea that what she was plopping on a plate was too much for the kid.”

Ultimately, the best results are gained when the entire family follows the recommendations Gullo and the nutritionist give them.

“If the family is willing and motivated, that can be very helpful and they can all make changes,” she said. “But you have to have everybody on board.”

By Tanya J. Tyler, Associate Editor

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