February 26, 2013
Parents with children diagnosed as “obese” based on body mass index, a measure of height and weight, are often largely on their own in figuring out what to do to help their child. To their credit, pediatricians have done a much better job of identifying children with obesity and sharing with parents the American Academy of Pediatric’s recommendation of 5-2-1-0 (five servings of fruits and vegetables, two or fewer hours of “screen time”, one hour of physical activity, and zero sugar-sweetened beverages). Unfortunately, time and resources rarely allow pediatricians and parents to take the next step and implement a structured weight-management program for children struggling with their weight. Over the past several years, however, programs for these children and their families have been developed, implemented and expanded to reach a larger number of families. Here are a few of the opportunities and where to look for more information.
The Alliance for a Healthier Generation – Healthier Generation Benefit
Founded in 2005, the Alliance for a Healthier Generation is a joint initiative of the American Heart Association and the William J. Clinton Foundation. The Alliance, which is committed to reducing rates of childhood obesity by 2015, has several programs and initiatives to help children and families. A program of high priority and relevance to an individual child struggling with weight is the “Healthier Generation Benefit.” It is a collaborative effort among the Alliance, national medical associations (including the American Academy of Pediatrics and the Academy of Nutrition and Dietetics, among others), health insurers (including Aetna, Humana, several Blue Cross and Blue Shield insurers, Wellpoint and several smaller insurers), and employers that provides the resources for families of an obese child to receive an intensive obesity intervention.
Specifically, the program provides insurance coverage to pay for several visits with both a physician and a registered dietitian, both of whom have been given scientific-based resources to maximize the efficacy of the intervention.
For more information, check out http://healthiergeneration.org/healthcareprofessionals.aspx?id=3287 and contact Allison Kwan at 954-415-7837 or firstname.lastname@example.org.
Mind, Exercise, Nutrition, Do It! (MEND)
MEND is a program for clinically obese children and their parents that is offered at several YMCAs across the country and, in many cases, paid for by health-insurance companies. (Different insurance plans cover different amounts. In states like Texas and Louisiana, where state laws require coverage for obesity, the program is fully covered, even for low-income children on Medicaid).
The MEND programs last 10 weeks and meet twice per week. Both the child and parent must attend. The program combines healthy eating, regular physical activity and behavior change. A study evaluating the program, published in the journal Pediatrics, showed that children who participated in the program experienced a 3.4% reduction in overweight at six months. The youngest kids (less than 13 years) had the greatest reduction in overweight (4.3%), while those older than 13 showed 1% reductions. Both children and their parents reported significant improvements in health-related quality of life.
For information about MEND and whether the MEND program is available near you, check out mendfoundation.org.
Obesity Treatmet Centers at Children’s Hospitals
Many children’s hospitals have weight-management programs for children who are obese, but who don’t have medical complications and treatment centers for children with the most severe obesity and/or with obesity-related health complications such as type 2 diabetes, high blood pressure, high cholesterol and other associated morbidities. Many of the weight-management programs for children who do not yet have medical complications are not covered by insurance.
Several examples of these types of centers include:
Additional programs exist throughout the country. Your pediatrician can help you to identify programs nearby or, if you live near a children’s hospital, do a quick search to see if that hospital offers weight-management programs for children and families.
While these programs provide examples of a “good start” to helping families access treatment for their children struggling with weight, the unfortunate reality is that far too many kids and families still have limited access to resources to help them successfully overcome their struggles with weight and achieve a healthy BMI by the time they enter adulthood. With the impending healthcare reforms mandated by the Affordable Care Act and the growing understanding of what works when helping children and families achieve a healthy weight, the types of available programs are likely to grow.
By Natalie Digate Muth
Natalie Digate Muth, MD, MPH, RD, FAAPNatalie Digate Muth, MD, MPH, RD, FAAP is the Healthcare Solutions Director for the American Council on Exercise, a board-certified pediatrician and Fellow of the American Academy of Pediatrics, a Diplomat of the American Board of Obesity Medicine, registered dietitian and board-certified specialist in sports dietetics, and ACE-certified health coach. She is the author of "Eat Your Vegetables" and Other Mistakes Parents Make: Redefining How to Raise Healthy Eaters" and the upcoming textbook "Sports Nutrition for Health Professionals". She has been ACE certified since 1998.