Childhood obesity: fighting the psychological burden

While obesity's physical toll on adults often takes the form of diabetes, heart disease, and other health risks, morbidly overweight children also carry the burden of mental anguish.

"Adult social restraints don't exist with younger people," notes Melissa Booth, director of Newton-Wellesley Hospital's Kids on the Move program. "So, kids don't hesitate to point fingers and laugh at peers struggling with weight problems."

Helping such children is becoming the focus of a national health agenda. According to the American Academy of Pediatrics, the number of overweight or obese children has doubled in the last two decades, with weight related diseases such as Childhood Type 2 Diabetes also seeing a corresponding increase.

Lifestyle training
One way of dealing with this issue are programs such as Kids on the Move, which helps obese children fight back against social stigma.

"In essence, we're trying to educate both parents and children about how to eat healthy and be active," says Booth about the hospital weight loss program.

Taking place over a 10-week period, each Kids on the Move session features one hour of nutritional education, followed by a second hour of physical activity.

Counselors begin by talking about healthy snacking."We suggest reaching for fruit instead of high calorie processed foods, for instance," says Booth. Afterwards, physical therapists teach parents and youngsters how to enjoy yoga, strength training, martial arts, and other activities that foster healthy lifestyles.

Periodically, field trips are also scheduled. "The group will travel to McDonald's, for example, and discuss right food choices-selecting a salad rather than a hamburger for lunch," says Booth.

Key to the program's success is the pairing of adults and children as participants. "Quite often, overweight kids come from overweight households," says Booth. "But by bringing youngsters and their parents together, and having them learn about living healthy lives, we're trying to break this generational cycle of obesity."

In addition to such behavioral approaches, surgical procedures are another option for a select group of chronically obese children."When you ask a 400-pound, 15-year-old boy what his life is like, you can understand why surgical options need to be examined," says Dr. Michael Tarnoff, director of the Tufts New England Medical Center's adolescent weight loss program.

When diet fails
"These are children who have constantly tried dieting without any real success," says Tarnoff."Virtually every other weight maintenance initiative has failed them." In such cases, gastric bypass and similar surgeries that dramatically limit the body's intake of food might be the only viable form of help.

While invasive procedures for adolescents should be carefully considered,Tarnoff says that, of the 150 teens who have benefited from his program's surgical weight loss operations, "none have gained back their weight." Nevertheless, medical specialists such as Dr. Lee Kaplan, director of Massachusetts General Hospital's Weight Loss Center, are quick to point out that reorienting approaches to food is often more successful with children than adults.

"Because a young person's brain is more open to learning than someone who is older, counseling to change a child's eating behaviors can be successful," says Kaplan. "As far as children are concerned, we always focus first on prevention when it comes to weight loss."