Pediatric Obesity KAMU Kansas Association for the Medically
Underserved OBESITY MODULE 6
https://www.flickr.com/photos/joe_13/188297063/
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Module 1: Why is it so Hard to Lose Weight? Module 2: Assessing
and Documenting BMI Module 3: Brief Treatment: Assess, Advise and
Agree (AAA p ) Module 4: Intensive Treatment and Follow-up Module
5: Resources and the Office Environment Module 6: Pediatric Obesity
2 GOALS: WEIGHT MANAGEMENT TRAINING COMMUNITY HEALTH CLINICS Ann M.
Davis, PhD, MPH, ABPP
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What is it? How do we measure it? Who is most at risk? How
should you treat it? What else can you do? PEDIATRIC OBESITY
http://pixabay.com/en/child-kid-boy-snack- lollypops-164454/
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4 WHAT IS PEDIATRIC OBESITY?
http://www.letsmove.gov/obesity
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5 WHY USE BMI PERCENTILE? http://www.letsmove.gov/obesity
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Children are struggling with their weight 6 1 out of every 3
children is overweight or obese Ann M. Davis, PhD, MPH, ABPP
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7 PREVALENCE AMONG CHILDREN IN KANSAS Davis AM, Boles RE, James
RL, Sullivan DK, Donnelly JE, Swirczynski DL, Goetz J. Health
behaviors and weight status among urban and rural children. Rural
and Remote Health 8 (online), 2008: 810. Available from:
http://www.rrh.org.au.http://www.rrh.org.au
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8 HIGH RISK POPULATIONS
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9 WONT THEY OUTGROW IT? NO ! A child who is overweight or obese
at age 11 has already taxed their body to such an extent that they
are significantly more likely to suffer these health consequences,
even if they lose the weight as a teen.
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10 TREATING PEDIATRIC OBESITY Prevention Stage 1 = Prevention
Plus Stage 2 = Structured Weight Management Stage 3 = Comprehensive
Multidisciplinary Intervention Stage 4 = Tertiary Care Intervention
Treatment Expert Committee Recommendations Regarding the
Prevention, Assessment and Treatment of Child and Adolescent
Overweight and Obesity: Summary Report; Sarah E. Barlow and the
Expert Committee; Pediatrics 2007;120;S164-S192; DOI:
10.1542/peds.2007-2329C
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11 IDENTIFY/DOCUMENT THE PROBLEM 1.Get accurate height and
weight at EVERY visit 2.Measure height with recumbent or wall
stadiometer 3.Calculate BMI percentile on EVERY child 4.If
appropriate, make the weight diagnosis Weight Excess weight Body
mass index BMI Risk for diabetes & heart disease Use the term
overweight or obese as a medical diagnosis, and put the diagnosis
in their medical chart. Show them their growth chart. Stadiometer:
http://en.wikipedia.org/wiki/Height_gauge
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1.Limit sugar sweetened beverages 2.5 or more of fruits and
vegetables a day 3.60 minutes of activity per day 4.2 or fewer
hours of screen time per day 5.No TV in bedrooms** 6.Eat breakfast
daily 7.Limit eating out 8.Encourage family meals 9.Appropriate
portion sizes 12 STAGE 1 - PREVENTION PLUS ADVICE FOR EVERYONE: THE
9 HEALTHY BEHAVIORS
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13 ORDER TESTING Order labs BMI 85-94 th %ile with NO risk
factors Fasting Lipid Profile BMI 85-94 th %ile WITH risk factors
Fasting Lipid Profile ALT and AST Fasting Glucose BMI 95 th %ile
Age 10 years and older Fasting Lipid Profile ALT and AST Fasting
Glucose Other tests as indicated by health risks
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14 Weight Recommendations
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15 STAGE 2 - COUNSEL THE PATIENT Counsel the patient Empathize
Reflect What is your understanding? What do you want to know? How
ready are you to make a change (1-10 scale)? Provide Advice or
information Choices or options Elicit What do you make of that?
Where does that leave you? Commit What goal are you ready to
set?
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16 STAGE 2 - GOALS OF YOUR WORK Monthly family visits with
health professional (with training in pediatric weight
management/behavioral counseling) Health goal = Meet prevention
goals More focused attention to lifestyle changes DO NOT tell them
what changes to make Instead elicit change talk from them 3-6
months Goal = weight maintenance or a decrease in BMI velocity;
Long term goal = BMI < 85th %ile
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17 STAGE 2 - TOOLS
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18 INTERNET RESOURCES
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19 STAGES 3 AND 4 Stage 3: Family-Based Behavioral Groups
Healthy Hawks at KU Med Lasts 12 weeks Free Available in English
and Spanish Telemedicine-based, available throughout the state
Call: (913) 588-6300 Stage 4: Bariatric Surgery and Very Low
Calorie Diets Sometimes Stages 1 and 2 Dont Work
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As a healthcare team member. people listen when you talk! Join
the local school wellness committee Bring healthier foods to
potlucks that you attend Encourage that group outings focus on an
activity rather than food Start a healthy recipe exchange at work
Start a wellness effort at your local place of worship Put together
a healthy families resources packet for your area increase
awareness of programs/supports in your community 20 WHAT ELSE CAN
YOU DO?
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RECAP: PEDIATRIC OBESITY IS A PROBLEM AND YOU CAN HELP
1.Pediatric obesity is a significant problem 2.It needs to be
treated in childhood 3.Measuring/reporting/diagnosing using BMI
percentile at every pediatric visit is key 4.Recommend the 9
healthy behaviors for everyone (Slide 12) 5.Increase efforts for
those over the 85 th %ile 21
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Please click on the link below to take the quiz for this module
Ann M. Davis, PhD, MPH, ABPP Thank you! You may open the survey in
your web browser by clicking the link below: KAMU Obesity Module 6
Quiz If the link above does not work, try copying the link below
into your web browser:
https://redcap.kumc.edu/surveys/?s=Ss9XLSTarS KAMU Obesity Module 6
Quiz https://redcap.kumc.edu/surveys/?s=Ss9XLSTarS If you have
questions, please feel free to contact Leslie Sullivan, MS,
Department of Preventive Medicine and Public Health, KU Medical
Center [email protected]@kumc.edu or 913-588-2791 22 PLEASE
TAKE THE QUIZ TO COMPLETE THE MODULE