Healthy Weight Program

A proactive approach

Childhood obesity and overweight have become an epidemic in America and a major threat to the health of children and adults. Over a third of children are overweight or obese, many of whom have health problems due to excess weight, including high cholesterol, hypertension, and diabetes. Experts predict that we will start to see a decline in the average adult life span due to obesity, especially the effects of developing obesity earlier in life than we have seen before. We really don’t know what the effects are going to be on adults after decades of unhealthy weight and the problems and complications associated with it.

We started aggressively treating overweight and obese children back in 2005, before the first guidelines were even published. We have continued to modify and improve our program as more research and recommendations have been published over the years. We also aggressively monitor children’s weight, attempt to identify trends early even before the child is overweight or obese, and prevent problems from ever developing in the first place. We take a very proactive approach to prevention and to maintaining a healthy weight and lifestyle. Weight problems are actually much easier to treat in children than in adults because children are still growing and they can simply grow into their weight rather than having to lose weight, once energy balance and metabolism are restored.

Primary prevention

Breastfeeding support

Breastfeeding has been shown to be associated with a decreased risk of obesity, but reasons are unclear. We encourage breastfeeding and support and assist mothers in their desired breastfeeding goals.

Prenatal nutrition

Hormones and gene expression that influence weight and appetite in children may be affected by the prenatal environment. We provide pregnant mothers with the latest research on healthy habits and diet while pregnant.

Best infant feeding practices

Over-feeding infants, especially from bottles, has been associated with an increased risk of overweight and obesity. We provide information on recommended feeding amounts and practices, and educate parents on when and how to start solid foods, including baby food and table food.

Healthy toddler feeding

Eating habits, both good and bad, often start at this age, as do healthy or unhealthy attitudes towards food. Overweight and obesity often starts during these years.

Preschool nutrition

Preschoolers overlap with toddlers and school-age kids. However, research shows that the greatest risk of developing obesity happens during the preschool years. We therefore make a particular effort during these years to teach both parents and children healthy eating habits, and start monitoring weight gain and body mass index (BMI) more carefully.

School-age children

We continue to teach parents and especially children healthy eating habits and attitudes, and to monitor weight gain and BMI.

Pre-teens and teens

Children at this age have more independence, make more choices themselves, and are more often unsupervised. We therefore focus most of our efforts on educating and encouraging teens on making healthy choices.

Young adults

As part of our program in caring for young adults and transitioning them to adult care, we provide information on making healthy choices for a lifetime.

Monitoring

At every age and stage we monitor children’s growth and weight gain, alerting parents even if body mass index (BMI) is normal but weight gain is faster than normal and out of proportion to overall growth. We try to catch unhealthy trends before they become a problem.

Treatment Program

We started our treatment program in 2005. When the first guidelines for obesity treatment in children were published in 2007, we were already following or exceeding most of them. Our treatment program includes the following:

Comprehensive history and physical exam

  • We look for any possible conditions that can cause obesity, as well as any effects of unhealthy weight, including hypertension, diabetes, pre-diabetes, puberty and hormone problems, sleep apnea and other sleep problems, hip and other bone and joint problems, cholesterol problems, and liver and heart damage.

Comprehensive laboratory evaluation

  • Lab test for any causes and associated conditions, especially high cholesterol, liver damage, diabetes, and pre-diabetes.

Treatment and monitoring plan

  • We diagnose and treat or do further testing for any problems.
  • We refer patients to endocrinologists, dietitians, psychologists, sleep doctors, orthopedists, cardiologists, GI (liver) specialists as needed, as well as surgeons for bariatric surgery when recommended.
  • We find out problems in energy balance, diet and activity levels, set small goals for improvement, and follow-up frequently, setting new goals at each visit and monitoring progress.
  • We refer patients to CHOA’s Strong4Life clinic, camps, and programs as necessary.
  • We emphasize developing healthy habits, not just weight loss or treating a number or fixing problems. We help children and often entire families achieve greater health and wellness.