This month marks the launching of the first formal pediatric obesity clinic in Western Canada.
What makes it newsworthy? Why should families and doctors in other parts of North America care about this? Is it not perhaps too provincial; too local; too narrow?
Not at all!!
The challenge currently is that there are very few clinics anywhere in North America that help children lose weight. Many doctors and families are frustrated by the lack of resources to help these patients appropriately maintain a healthy lifestyle.
Following is an article I recently submitted to the local health care authority. It was written to raise awareness about the clinic.
Promoting awareness at an early age:
One of the foremost goals of wellness promotion is to help patients stay as healthy as possible, well into old age.
Unfortunately, according to experts such as the US Surgeon General and other respected epidemiologists, the current generation of children and youth will be the first generation who will have a shorter life-expectancy than their parents.
One of the main reasons for this gloomy public health statistic is the current epidemic of obese children. Presently there is no indication that the epidemic of obese children is under control. The numbers continue to climb year after year at an alarming rate – worldwide.
In some cases the rate of obese and overweight children and youth has increased by 3 times over the past 20 years, according to recent Health Canada data.
Obese pre-school children are a particular concern. Not only are these children more obese than ever before but they also start their overweight pattern at an earlier age than ever before.
Some say that the costs associated with this problem will ultimately exceed the cost of managing disease induced by tobacco use (see www.paguide.com and www.cps.ca ).
The good news is that prevention of childhood obesity has already taken shape. Across Canada a number of health groups have been orchestrating efforts between local and national government organizations, schools, parents, public health nurses, other stakeholders and interested parties.
Unfortunately, this has not been the case for children who are currently overweight or obese. Until now there has been no organized, medically-supervised, and team-oriented approach to treating these children.
Calgary will be the first Western Canadian city to go beyond prevention of childhood obesity when the only obesity clinic in Western Canada for pediatric patients opens in September 2004.
The clinic is modeled after the successful Weigh of Life Program, which is based out of Texas Children’s Hospital at Baylor College of Medicine in Houston. To get more detail on the specific methods used in the Weigh of Life program see www.pediatricobesityclinic.com and click on the Weigh of Life Program link.
The major thrust of this unique and highly successful program is its behavior modification approach. The 15-session program involves the child, the family and a team of dedicated, expert clinicians. These include a pediatrician, dietician, trainer and, perhaps most importantly, a psychologist who is highly skilled in behavior modification (See www.pediatricobesityclinic.com for more information on the credentials of the clinical team).
Although weight control remains one of the top priorities in stemming an increasing tide of Type II Diabetes (formerly called Adult Onset Diabetes), the focus will go beyond achieving a gradual, safe, medically controlled decrease of BMI. It will also help the patient and the family to become more aware of the importance of making small, but consistent lifestyle changes. This awareness is achieved through specific educational and hands-on sessions in the clinic (located in North West Calgary, close to the new Alberta Children’s Hospital).
Enrollment in the program is based on 3 factors. Patients must be between the ages of 5 and 16 to participate. They must have a Body Mass Index (BMI) that’s over the 95 th percentile (obese) or between the 95 th percentile and the 85 th percentile (overweight). And, they must be ready to engage in weight management efforts that involve long-lasting lifestyle changes.
The clinic will operate independently and some fees will be covered by Alberta Health Care. The main reason for the clinic’s independent format is that the administrators of the Calgary Health Region have not decided to endorse a publicly funded clinic for treating obese children and youth. However, the Calgary Health Region supports efforts to prevent childhood obesity.
(See www.calgaryhealthregion.ca)
The drawback, of doing one-on-one therapy for 15 weeks or more and following up regularly with graduates, is that it makes this program labor intensive. As a result, some skeptics have indicated that the cost may be excessively high.
This may be true, but offering no formal clinic may lead to even higher expenses for our publicly funded health care system. For instance, it will overburden the system if there’s an increase in children being hospitalized due to Type II Diabetes, upper airway obstruction and apnea, and reflux. Costs will also skyrocket if more kids have to visit clinicians in ambulatory care to monitor their lipid levels, elevated insulin levels and their hypertension. It’s not a pretty picture but it’s all too likely if we don’t do something about this disturbing trend now.
Increasingly, physicians are becoming aware that adult cardiovascular diseases have their roots in childhood. A superb summary of pediatric precursors of adult atherosclerosis can be found in “Pediatrics in Review”, Vol. 25, No. 1, pp 4-15, January 2004(A CHE publication by the American Academy of Pediatrics).
Hopefully, more physicians will make it a regular habit to follow their patient’s BMI longitudinally. That way, patients in need of intervention can be identified at an early enough age to make meaningful and long-lasting lifestyle changes and they can be helped in a timely fashion.
One thing’s for certain, this pediatric obesity clinic will mark a historic moment in Western Canada’s efforts to curb the complications of obesity in children and youth.
Referrals are now welcomed from anywhere in Western Canada.
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An informed parent is ... an empowered parent.