Healthy Tomorrow

Healthy Tomorrow

The obesity epedemic has spared no one - not even our nation's youth. To build a brighter tomorrow, we must bring weight management to children today.

According to the American Dietetic Association, the number of children in the United States who are overweight or obese has more than doubled in the past 30 years. In fact, one in five U.S. children would be classified as "morbidly obese" if he or she were an adult.

Childhood obesity is a serious health threat to America's children. Action must be taken now to slow the increase in the number of obese children in the United States.

Physicians who provide health care for children can make a strong case against obesity and the potential life-changing health problems it can cause if not dealt with immediately. Currently, 60 percent of children who are overweight display at least one medical risk, such as high blood pressure or elevated cholesterol levels, triglycerides or insulin. Type II diabetes (formerly a disease affecting only older adults) is now becoming more prevalent in teen-agers and young adults. This alarming increase is shocking when one considers the high medical costs that will most likely be incurred later in life. The cost of treating teen-agers and young adults with Type II diabetes is high, mainly due to Type II's potential to cause blindness, limb amputations and kidney disease - among other debilitating conditions.

The Dallas branch of the Women, Infant and Children Federal Food Assistance Program (WIC) is extremely concerned about the increase in pediatric obesity. WIC assists families with young children (i.e., newborns to 6-year-olds). According to WIC's Cindy Wachtler, R.D., L.D., "We are now seeing kids who are 5 years old weighing over 100 pounds. They will not outgrow this weight, especially when they're drinking three or more sodas a day."

This information should come as no surprise since today's food and restaurant industry promotes and actively markets "super-sized meals," which create havoc with weight management - especially in children. The increased incidence of pediatric obesity and related health concerns has prompted the U.S. government to issue mandates dealing with this epidemic. Are "sin taxes" in our future? Wachtler thinks so.

"Several years ago, if I had heard about a `sin tax' on foods that are high in fat and/or sugar, I would have laughed and said, `Not in a million years,'" she notes. "I now believe that we may very well see a future tax on unhealthy, high-fat foods."

Poor nutrition isn't the only culprint responsible for childhood obesity. Lack of physical activity is another contributor, as many studies have proved. The average child spends 900 hours per year in a school setting, yet still manages to squeeze in 1,500-plus hours per year to watch television - and this doesn't even include the amount of hours dedicated to playing video games and/or surfing the Internet. An alarming statistic is that an estimated 50 percent of children (starting at age 5) have televisions in their bedrooms - enabling youngsters to watch television from the moment they wake up until they go to bed at night.

Because WIC interacts with young children on a daily basis, the organization is actively involved in the effort to slow the growing epidemic of childhood obesity. Federal statistics help strengthen the message that children of preschool age are not too young to learn how to prevent obesity. In fact, it has been shown to be easier to treat pediatric obesity when children are young than when they reach their teen-age years.

Puberty is an especially difficult period for children - a time of weight gain that can be hard to lose later in life. Studies have shown that an obese 12-year-old has a 75 percent chance of becoming an obese adult, whereas an obese 6-year-old only has a 25 percent risk of obesity in later life. That's why early intervention is so important to the health of child.

Fortunately, some health and fitness clubs are now starting to address the problem of pediatric obesity. For example, Pro Sports Club in Bellevue, Wash., has just started a program to assist obese children and their families.

"One of the barriers preventing fitness facilities from offering programs for obese children and adults is because many of the programs don't work," says Mark Dedomenico, M.D., owner of the Pro Sports Club. "People gain their weight back. For a program to work with obese children, it must be a multidisciplined approach that works with the family."

Indeed, family involvement is crucial to weight management for children. After all, overweight children often have overweight parents; therefore, weight management must require an effort from the entire family.

Pro Sports Club's new program will be directed by a psychologist who will work alongside dietitians and exercise specialists to assist overweight children. Dr. Dedomenico stresses the importance of staffing when developing a program for obese children.

"Staff must be qualified and able to deal with young children and their families," he says. "The family must be involved and committed for the behavior and lifestyle changes to occur. That takes commitment from all parties - parents, children and staff."

Why involve a psychologist in weight management for children? Several reasons. A psychologist may discover that a child's overeating stems from problems at home. Furthermore, a psychologist can help promote safe weight loss.

"A psychologist must be involved to lessen the risk of obese children turning into bulimics and/or anorex-ics while involved in a weight-management program," Dr. Dedomenico claims. "Obesity is a complicated problem among youth that needs the supervision of a highly trained staff."

Although the weight-management program is new to the Pro Sports Club, Dr. Dedomenico doesn't anticipate any problems marketing the program to the club's 21,000 members. "We have already had inquiries into the program and word-of-mouth is already getting around the Belle-vue area," he says.

As evidenced by Pro Sports Club's new weight-management program, the fitness industry can do much to assist children and their families with the problem of obesity. How? "Fitness clubs can do many meaningful and educational projects with kids that support physical activity," says WIC's Wachtler. "The logic to prevent childhood obesity is to start early to teach families how to be active together. Health clubs can offer fitness classes for parents and their children to do together, with more comprehensive programming geared towards lifetime activity as the child grows."

Jen Keznor, children's program director at Pike Creek Fitness in Wilmington, Del., has been offering comprehensive children's fitness programs since 1997. "We offer a kids' fitness class for children ages 18 months to 8 years," she says. "We started our program because we saw an increase in childhood obesity within our community. We looked at our own childcare center and noticed that our kids were sedentary, so our goal became one of offering physical activity classes to children in a safe and noncompetitive environment."

How are the fitness programs doing now? "We have had an overwhelming response from our members," Keznor says. "We started our classes in a converted racquetball court and have now expanded to three courts. We recently started to offer our fitness classes at off-site preschools in the area as well."

Pike Creek Fitness provides 45-minute children's fitness classes for $6 per member and $8 for nonmembers. And nonmembers have responded favorably. "With our off-site pre-schools, we generally have over 100 kids in our program each week," Keznor claims.

While Pike Creek Fitness was able to create its own children's fitness program, some clubs may lack the resources required for that approach. Fortunately, pre-existing programs are available for clubs that want to help overweight children. Consider ShapeDown - a leading weight-management program for children and adolescents that health and fitness clubs can purchase.

Created by Laurel M. Mellin (as-sistant clinical professor of family and community medicine and pediatrics at the University of California-San Francisco), ShapeDown is a family-based, developmentally sensitive program that addresses underlying factors associated with pediatric obesity. The program's concept is to bring families together to foster improved communication skills and to make better health choices - from nutrition, to exercise, to relationship-building.

Linwood, N.J.-based Atlantic Coast Living Center - a small, for-profit fitness facility affiliated with a hospital - has implemented ShapeDown successfully at its location. Registered Dietitian Debbie Bourgoin facilitates the program and teams with a li-censed family therapist to address the needs of obese children. (Again, overeating may indicate troubles at home, and licensed therapists know how to make behavioral changes.)

"We offer ShapeDown sessions throughout the year, with a 10-week session that meets every Wednesday evening," Bourgoin says. The program costs $500, with an average of four to eight children in attendance at each session.

After children and their families have completed the 10-week course, they become eligible for an advanced program that meets once or twice per month, depending upon the needs of the child. The advanced program carries a fee of $60.

Does the program work? Bourgoin answers with a story about the Smith family (not the real name). Mom is a physician, dad is an attorney. They brought their 9-year-old son, Eric, to Atlantic Coast Living Center to ask Bourgoin for her assistance with Eric's weight problem. Eric's peers and older (athletic) siblings had been teasing him about his weight.

How did Eric progress in the ShapeDown program? "At first, he didn't want to come," Bourgoin ex-plains. "But by the time he finished the basic ShapeDown sessions, he was happy to be here."

Bourgoin shared that, since joining ShapeDown, Eric has started swimming and fishing. He has also grown a vegetable garden on his own - his pride and joy. "I saw an entire personality change in this child," Bourgoin enthuses. "He has become a confident and very positive boy."

Even clubs that lack the personnel necessary to offer a comprehensive, multidisciplined program like Shape-Down can still do plenty to prevent childhood obesity. According to a recent U.S. surgeon general's report, adults and children need at least 30 minutes of physical activity per day to achieve positive health benefits. Fit-ness clubs are encouraged to find ways to incorporate children's programs into their schedules. By starting now, health and fitness organizations can join many other facilities in getting children and their families started on the road to better health.

You realize that most children could use better diets and more activity in their lives. But how do you make them - and, more importantly, their parents - realize that as well? We can help. Go to for free handouts that will allow you to spread your fitness message to youngsters and their families.

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