Childhood obesity is a phrase heard often in media today. Our nation’s children are heavier than past generations. The epidemic of overweight and obese children plagues our nation. Those children from low-income families are particularly at risk due to unhealthy diets and consumption of higher calorie, high-fat foods and sweetened drinks with limited opportunities for daily physical activity.
Overweight and obese children in low-income households can meet or exceed the healthy recommendations when given access to a structured weight management program, according to a new study published in Academic Pediatrics. If left untreated, this obesity and lack of physical activity are likely to extend into adulthood, placing the child at higher risk for obesity-related diseases, including cardiovascular disease and type 2 diabetes.
The number of children in Pennsylvania struggling with obesity has risen since 2003. The Commonwealth is ranked 20th for child obesity in the 2007 National Children’s Health Survey (Rank 1st is best; 50th is worst). Over 25% of low-income children age two to five inclusively are overweight or obese in Pennsylvania, according to the 2008 Pediatric Nutrition Surveillance System (PedNSS).
Like Pennsylvania and many other states, Tennessee has struggled with this issue and in fact is ranked fifth highest for child obesity in the 2007 National Children’s Health Survey. The year before, Tennessee Medicaid (TennCare) partnered with the international commercial weight loss program, Weight Watchers, to help treat obesity. Through the TennCare Weight Watchers Partnership Program overweight and obese TennCare recipients under the age of 21 were able to participate with no out-of-pocket cost.
Researchers led by the University of Colorado School of Medicine in Aurora evaluated the weight change of 280 qualified participants aged 10 to 17 years old. The participants were referred by their health care providers to participate in the program.
“We hypothesized that individuals who participated in the program would have a reduction in body mass index (BMI) z score significantly greater than zero and that there would be no difference in the reduction in BMI z score between boys and girls,” says Nia S. Mitchell, MD, MPH, lead investigator and assistant professor of general internal medicine at CU School of Medicine and CU’s Anschutz Health and Wellness Center and Colorado Health Outcomes. “As secondary analyses, we also determined if there was a threshold of participation, in duration or number of meetings, which might be associated with clinically significant weight loss.”
The use of a BMI z score is the best way to measure weight change in children.
The team also compared weight change to the Expert Committee Recommendations Regarding the Prevention, Assessment, and Treatment of Childhood and Adolescent Overweight and Obesity.
By the end of their participation in the program, the weight change in 53 percent of the children either met or exceeded the recommendations of the Expert Committee. Participants who attended the program for more than 12 weeks and those who attended ten or more meetings saw a five percent decrease in BMI z score. More than half the participants attended eight or fewer weekly meetings, while nearly 30 percent attended ten or more.
While it is difficult to define significant weight loss in children because they are still growing, the study demonstrated that a clinically significant change in BMI z score was achieved by the 25 percent of those who participated in the program for more than 12 weeks.
“Our analysis suggests that the TennCare Weight Watchers Partnership Program was associated with a majority of participants meeting the recommendations of the Expert Committee. Providers should, therefore, consider referring their patients to similar structured programs,” said Dr. Mitchell.
The study team also points out that this type of partnership can give low-income families the opportunity to give their children a good chance for weight management success.
The BMI chart – read in percentiles – compares height, weight, and gender to determine if you are overweight or obese or healthy. A youth who is the 85th and 95th percentile on the growth chart is considered at risk of overweight, according to the National Institute of Health (NIH). The Center for Disease Control & Prevention (CDC) offers an online BMI calculator and points out that if your child has a high BMI, you should see your family physician.B
eing overweight does put a person at risk for developing diabetes, as well as other health concerns. However, a BMI percentile will not diagnose a problem. In other words ‘at risk’ does not mean ‘will definitely get’. Instead think of it as a wake up call or a time to change eating habits and physical activities. Again, if you child is overweight, see your physician for medical advice specific to your child.
This article was taken in part from a press release by Elsevier Health Sciences. It is not intended to replace the medical advice of your physician. If you are experiencing any of the symptoms of diabetes, make an appointment with your physician.
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