Each September, the Center for Disease Control (CDC) and the American Association of Pediatrics (AAP) work to draw attention to a disease that affects nearly 1 in 5 children.
Childhood obesity is a condition in which a child is well above the healthy weight for their age and height. According to the National Institutes of Health, it is connected with an increased risk of health problems including type 2 diabetes, heart disease, stroke, psychosocial problems, depression, and certain types of cancer later in life.
Dr. Rushika Conroy, director of Baystate Health’s Comprehensive Pediatric Weight Management Program, answers questions about the condition and discusses what parents can do to help their kids stay healthy.
What are the main causes of childhood obesity?
In 95% of cases, obesity is polygenic in origin – meaning it is from a combination of a strong family history of being overweight or obese, and an imbalance between how much they are taking in and putting out.
When we don’t get enough exercise our risk of obesity rises. In addition, when we don’t have access to healthy and affordable food, our chances of becoming obese increase. Often, cheaper food is less healthy and the foods that are easier to get tend to be energy dense and nutrient poor. We see more people impacted by “food deserts”, which are low-income areas where there is limited access to grocery stores. (You can learn more about food deserts and other health disparities in Baystate Health's Community Health Needs Assessment reports.)
Who is most at risk?
All children are at risk of developing obesity, but those at highest risk include those with at least one parent who suffers from obesity, those with limited ability to be active and have access to healthy food choices, and those with certain disease states and conditions.
Has the pandemic contributed to childhood obesity?
While the pandemic has had a positive impact on some families' eating habits and health, for most, COVID-19 has had a negative impact on the rates of childhood obesity.
Many people are less active and burning fewer calories both because they are moving less during the day (as they are not leaving their homes) and because of decreased access to places where they can be active. In addition, the significant stress that COVID-19 has caused emotional disturbances in both adults and children, which in many leads to emotional eating.
In the beginning of the lockdown recommendations, many stocked up on non-perishable food items, which are often processed, nutrient poor, and filled with calories. When you add that all together, you get a lot of kids developing obesity and its complications, including type 2 diabetes.
We are also learning that kids who are obese and develop COVID-19 have worse outcomes from the virus than those who do not suffer from obesity, which is worrisome.
What would you like people to know?
There is a lot of stigma around obesity. People often think that it is someone’s fault, that they lack will power and that all they have to do is stop eating so much. We need to remember that obesity is a disease and there are multiple components involved in developing it, just as there are multiple components involved in treating it.
It’s important to know that kids who are obese who are able to get down to a healthy weight for their height have the same low risk of health problems as adults who were not obese as kids. It’s equally important to know that kids who are obese who grow into adults who are obese have a higher risk of health problems than adults who were a healthy weight as kids and developed obesity later.
There is a lot at stake in childhood to make improvements that can do wonders for their health into adulthood. It is not just as easy as eating less and exercising more. It is a slow and steady process, and you can see success if you work at it.
Has COVID-19 changed how you work?
The MIGHTY program (an intensive six-month group program that emphasizes physical activity, nutrition, and change of habits for the entire family) did have to go virtual. The team has done a great job of putting together Zoom classes to interact with participants, and also sends them weekly emails with recipes and other exercise activities. They have been able to increase the number of people who can participate, which has been great.
Right now, the team is working on developing both hybrid programs as well as bringing back the in person program in a safe manner.
How else has virtual care worked for the program?
Dieticians have had a lot more success having virtual visits. It is a more feasible option than trying to come into the office every month as this would lead to a lot of missed school and work. We hope to continue following up through virtual visits going forward because it is less of a burden on patients and families.
Provider visits are more challenging, and we’re working to have some visits in person, even every few visits. Some patients can do measure height and weight at home, while others have been able to come in for those measurements when convenient for them, which has been helpful for the families and useful for the visits.
Learn More About the Baystate Health Comprehensive Weight Management Program
The Baystate Comprehensive Weight Management Program (CWMP), which includes the MIGHTY program and the bariatric surgery program, provides children and families struggling with childhood obesity with the resources, tools, and care needed to treat the disease.
In order to be treated, children must be between the ages of 2-22 and have a diagnosis of obesity, defined as a BMI (body mass index) greater or equal to the 95th percentile for their age and gender.
The program team is made up of pediatric endocrinologists, dietitians, pediatric gastroenterologists, behavioral health specialists, and pediatric surgeons.
Patients receive personalized care including an evaluation for conditions that often occur along with obesity—including type 2 diabetes, sleep apnea, fatty liver disease, high blood pressure, mental health disorders, and high cholesterol. Treatment plans include dietary changes, medical management of related conditions, weight loss medication, or bariatric surgery if appropriate.
In addition to clinical services, the CWMP also offers the MIGHTY Program (Moving, Improving, and Gaining Health Together at the YMCA). This is an intensive six-month group program that emphasizes physical activity, nutrition, and change of habits for the entire family.
Generously funded in part by Kohl’s department stores and Kohl’s Cares, this program offers a fitness evaluation, individual fitness prescription, group exercise sessions, individual and group nutritional counseling, and strategies for maintaining lifelong health.
The MIGHTY program is currently being offered virtually and both hybrid and in person programs are being developed as we speak.
Adolescent Bariatric Surgery
Following guidelines from the American Society for Metabolic and Bariatric Surgeries and the Obesity Society, the Adolescent Bariatric Surgery Program offers laparoscopic sleeve gastrectomy procedure to those 15-22 years of age who meet specific program requirements. Six months before surgery, patients are required to meet with a dietitian, behavioral health specialist, weight management doctor, and surgeon, as well as attend weight loss support groups and complete labs and other diagnostic tests.
Make an Appointment
If you’re looking to make healthy changes with your child, call 413-794-KIDS to learn more and make an appointment.