Detect Childhood Obesity Early

By: Dr. Burris Duke Duncan Obesity very often begins in childhood. The more overweight your child is, the harder it is to lose weight. If obesity is caught early, you can prevent it from getting out of hand. Caring for children is a joint responsibility, a shared venture between you, the parent, and your childs doctor. At each doctors visit you bring your observations and the concerns you have about your child to the doctor. What you tell your doctor determines what is discussed. You can and should direct the conversation. Your doctor listens to your concerns and couples that with the medical knowledge and many years of experience he or she has in seeing children. Problems can then be approached together to find solutions. In order to bring any growth and developmental concerns to the attention of the doctor, parents need to know what normal growth and development is. At most well child visits, your doctor will weigh and measure your child but often doesnt have the time to discuss issues of overweight or obesity unless you bring them up. Even when your childs growth is plotted on a chart, the graphs are seldom shown to you and even less often explained. And your pediatrician may ask a few questions about your childs development but very few physicians take the time to actually evaluate a childs development. When you have normal growth and development information in your hands, you, the parent are in charge. With information to monitor both growth and development, you will know what is normal and what is not. You will know when your child is not growing as he or she should. And you will know if your child is acquiring the skills most children do at the age he or she is. If all is not going as it should, you can bring these issues up at the well child visit and your doctor will discuss them with you. Knowledge is power. It is no secret that we are experiencing an epidemic of obesity in this country and it very often starts early in life. Many children are already overweight or obese by the time they start preschool. Those who experience a rapid weight gain in the first year of life are 9 times more likely of becoming obese.1 These charts make it possible for the parent to recognize the problem as soon as it begins to develop and take action to stop it before it gets out of hand. A study in California found that from birth to 6 months of life, 40% of the infants had crossed two major percentile lines and between 6 and 12 months another 15% had crossed two major percentile lines.2 By one year of age, obesity has already begun in more than half of our children! However, its hard to recognize this trend without a chart to follow your childs weight. But if you see it, the problem becomes a concern. When you bring it your doctors attention he or she will use medical knowledge and together the two of you will work out a solution. By the time the child is two years old, the BMI (Body Mass Index) should be used to detect obesity, but only a few physicians use BMI charting. Wethington and colleagues found that only half of the pediatric office used the BMI to screen for obesity and less than one-quarter of general practitioner offices use it for children.3 Perrin and colleagues reported that only 22% of parents of children with a BMI 85th

percentile were told by their doctor that their child was overweight.4 The standup charts have the official BMI chart allowing you to follow your childs growth. As we know, an increase in weight can creep up on us without our realizing it. Then one day we step on a scale and wow! Infants and young children do not weight themselves and many parents do not recognize weight problems in their children. It is a lack of reference that stands in the way of the parent entering into the solution when their child is getting heavy Preventing your child from becoming obese can save him or her from embarrassment, isolation, and even bullying. Obesity must be recognized and corrected before it develops into a lifestyle pattern that initiates chronic life threatening conditions. Conditions like diabetes, muscle and joint problems, and even high blood pressure can begin early. Then if obesity continues, very serious problems develop later in life like heart attacks and stroke. All of this often begins in children. The time to halt the process is now!
References: 1. Goodell LS, Wakefield DB, Ferris AM. Rapid Weight Gain During the First Year of Life Predicts Obesity in 2-3 Year Olds from a Low-income, Minority Population. J Community Health 2009;34:370-375. 2. Mei ZG, Grummer-Strawn LM, Thompson D, Dietz WH. Shifts in percentiles of growth during early childhood: Analysis of longitudinal data from the California Child Health and Development Study. Pediatrics 2004;113:E617-E627. 3. Wethington HR, Sherry B, Polhamus B. Physician practices related to use of BMI-for-age and counseling for childhood obesity prevention: A cross-sectional study. BMC Fam Pract. 2011 Aug 3;12:80. doi: 10.1186/1471-2296-12-80. 4. Perrin EM, Skinner AC, Steiner MJ. Parental Recall of Doctor Communication of Weight Status National Trends From 1999 Through 2008. Arch Pediatr Adolescent Med. 2012;166:317-322.

About the Author Dr. Burris Duke Duncan completed his pediatric training in 1965 and has been monitoring the development, growth, and health of children for over 40 years. He was a member of the faculty of pediatrics at the University of Colorado for 10 years, the University of Rio Grande do North in NE, Brazil for 3 years, and the University of Arizona for over 30 years. Currently, he is Professor Emeritus and continues to teach at the College of Public Health at the University of Arizona. He has published 64 scientific articles and 22 chapters in medical textbooks and has given countless lectures. Dr. Duncan has worked in over a dozen different countries on five different continents. Dr. Duncan served as the Chair of the American Academy of Pediatrics Section on International Child Health and currently is the Co-editor of their Newsletter and creator of the popular Smart Growth Charts for parents to monitor their childrens development. In addition to helping parents care for children in his practice, Dr. Duncan and his wife Nancy have three children and seven grandchildren. Hence, he has both first-hand and second-hand experience with raising children and watching them grow. Smart Growth Charts were developed based on his interaction with parents and feeling the joy parents have in watching their child grow and develop. He firmly believes that doctors should not direct but be partners with parents and that any problems should be solved jointly. Putting a growth monitoring tool

such as Smart Growth Charts into the hands of parents is an important step in empowering a parent to be a more informed partner. Visit Smart Growth Charts to learn more.