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Active Children Excel: A New Program Makes Pediatric Weight Management a Family Affair

As the trend toward childhood obesity continues unabated, physicians are treating more children for conditions long associated with adulthood – hypertension, high triglycerides, high cholesterol, fatty liver and insulin resistance. In 2012, more than one-third of children and adolescents in the United States were overweight or obese, according to the most recent figures reported by the Centers for Disease Control and Prevention.1 The percentage of obese children age 6 to 11 years increased from 7 percent in 1980 to nearly 18 percent in 2012. Similarly, the percentage of adolescents age 12 to 19 with obesity increased from 5 percent to nearly 21 percent over the same period.1,2

“Today more children are being referred to specialists with one or more of these traditionally adult diagnoses,” says Faustino Ramos, M.D., a pediatric cardiologist affiliated with Memorial Hermann The Woodlands Hospital and on the faculty of McGovern Medical School at UTHealth. “These conditions are complications of obesity. If we don’t address the underlying weight issue, we’re only putting a Band-Aid on the problem. The life expectancy for obese children is lower, in some cases less than that of their parents. We want our young patients to live long and healthy lives.”

Toward that end, Dr. Ramos is working with pediatric rehabilitation professionals at TIRR Memorial Hermann-The Woodlands and with other physicians to create a unique pediatric weight management program focused on the health and wellness of children in Montgomery County. Called Active Children Excel (ACE), the program combines education with a supervised exercise program led by skilled pediatric therapists and a personalized nutrition plan created by a registered dietitian. Working together with children and families as a team, they develop individually tailored programs to determine the appropriate activity level based on age, condition and degree of fitness.

“Obesity is the tie that binds a multitude of diseases together,” says physical therapist Lauren Semple, PT, D.P.T., who works with children and their families to develop customized weight management programs. “Childhood obesity requires a family intervention. When parents prepare healthy meals for themselves, their kids follow. If weight management becomes a family affair, everyone wins. It’s like creating a support group within the family itself.”

The ACE program is physician approved and monitored, and families are encouraged to schedule regular follow-up visits with their referring physicians for the appropriate medical tests. Therapists, fitness trainers, nutritionists and social workers offer expertise and encouragement. Monthly support groups provide access to expert speakers and an opportunity for networking between kids and families.

“Our ability to have a long-lasting impact on the family is limited when we see children and parents in an occasional 30-minute office visit,” Dr. Ramos says. “Convincing them to change their lifestyle is difficult when many come in only once a year for their annual physical. In some cases a referral to a pediatric cardiologist, endocrinologist or gastroenterologist is a wake-up call for the family, but in others, families with overweight children remain in denial. Facing that challenge led us to reach out to TIRR Memorial Hermann’s experts to develop a program especially for children who are overweight or obese. Now we’re working together to develop personalized recipes for health.”

The program provides families with a list of community resources to encourage long-term lifestyle changes. Goals for participants include maintaining appropriate weight and reducing risk factors for adverse medical conditions.

“This is not about quick weight loss. It’s about gaining the confidence to make a lifestyle change,” says Mikael Simpson, OTR, director of rehabilitation services and director of hospital operations at TIRR Memorial Hermann-The Woodlands. “We’re creating an environment in which children and their families can succeed and flourish – and become more engaged in healthy activities in the community.”

1Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of childhood and adult obesity in the United States, 2011-2012. Journal of the American Medical Association 2014;311(8):806-814.

2National Center for Health Statistics. Health, United States, 2011: With Special Features on Socioeconomic Status and Health. Hyattsville, MD; U.S. Department of Health and Human Services; 2012.