The Challenge of Childhood Obesity

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One can hardly pick up a newspaper or listen to a newscast without hearing about one of the deadliest of all health problems among children: obesity. Just as taking a child to the doctor on a regular basis, keeping a child's immunizations up to date, or providing adequate safety measures can have significant effects on a child, so can ignoring the factors that contribute to the incidence of obesity. Because the choices that caregivers make often are influenced by ignorance or fiscal limitations, it is essential that healthcare providers inquire at each visit about factors in a person's life that reveal a need for assistance. Food choices, food preparation, exercise needs, and other issues that often surround and can compound the issue of obesity need to be revisited on each visit.

We know that obesity has widespread repercussions for children and can affect them for years to come. No longer is there a 500-pound gorilla in the room that no one will talk about; rather, there is an obvious and growing problem among children who are overweight, and all now acknowledge that this problem is significant. Obesity can lead to a host of other problems, including heart, bone, endocrine, joint, skin, psychological, and respiratory problems. Since 1963 there has been a 10% to 30% increase in the incidence of type 2 diabetes among children (depending on which statistics you read). We know that type 2 diabetes is directly related to the incidence of obesity; as the latter grows, so will cases of the former. In 2007, 22 million children under the age of 5 were obese, and this number continues to increase every day.

Because the problems that accompany obesity can have such devastating effects, it is critical that healthcare providers become more proactive in our approach to all children. In the office setting, the approach should start by obtaining height, weight, and an accurate calculation of body mass index for every child. Performing a dietary evaluation is also important, as this can reveal a pattern that ultimately might lead to obesity. Discussing these findings with both the child and the parent and providing useful information that they can use to modify behaviors and help correct problems when necessary should also be part of every visit.

Preventing the complications of obesity is every healthcare provider's responsibility. It is essential that we be mindful of the steps we need to take to accomplish this goal. We need to take on the fight against these burgeoning problems as advocates for our patients. We need to become proactive in our responses and interactions with children and parents so that we can change behaviors, beliefs, and attitudes toward obesity before it is too late—and that 500-pound gorilla stampedes us all.