Jennifer DerasmoNutrition Sciences Student

Weight Management in Pediatrics

• More than one-third (34.9% or 78.6 million) of U.S. adults are obese. (2) One-third of youths are overweight or obese. (1)

• The term “obese” describes children and adolescents who have a body mass index (BMI) at or above the 95th percentile for their gender and age, while “overweight” describes those with a BMI at or above the 85th but below the 95th percentile. (1)

• Obesity-related conditions include heart disease, stroke, type 2 diabetes and certain types of cancer, some of the leading causes of preventable death. (2)

PathophysiologyObesity prevalence differs among racial/ethnic

groups and also varies by age, sex, and adult head of

household’s and education level (3)

According to the National Sleep Foundation (NSF),

extra pounds on children can put them at risk for

Obstructive Sleep Apnea (OSA) which affects mood,

difficulty in concentrating at school, headaches and

changes in performance (4)

The main causes of excess weight in youth are

similar to those in adults, including individual causes

such as behavior and genetics (5)

• Adipex-anorexiant, CNS stimulant, may cause dry mouth and an unpleasant taste

• Alli- fat malabsorption,peripherally acting antiobesity agent, may cause diarrhea, loss of appetite, nausea, sore throat, vomiting, tooth problems, swelling of lips, tongue, throat, and abdominal pain.

• Belviq- Anorexiants, CNS stimulants, may cause increased and painful urination, sore throat, dry mouth, increased hunger, rapid weight gain, unusual weight

1. NCCOR Childhood Obesity in the United States. (n.d.). Retrieved February 10, 2016, from http://www.nccor.org/

2. Adult Obesity Facts. (2015). Retrieved March 09, 2016, from http://www.cdc.gov/obesity/data/adult.html

3. Childhood Obesity Facts. (2015). Retrieved March 09, 2016, from http://www.cdc.gov/obesity/data/childhood.html

4. Children and Sleep. (n.d.). Retrieved March 07, 2016, from https://sleepfoundation.org/sleep-topics/children-and-sleep

5. Childhood Obesity Causes & Consequences. (2015). Retrieved March 02, 2016, from http://www.cdc.gov/obesity/childhood/causes.html

Background

Drugs & Supplements

Financial Impact• The annual nationwide productive costs of obesity

obesity-related absenteeism range between $3.38 billion

• Childhood obesity comes with an estimated price tag of $19,000 per child (2)

• Childhood obesity alone is responsible for $14 billion in direct medical costs (2)

References

ADIME

• Total energy intake ,sugar, fat, nutrition quality of life, level of knowledge & physical activity

• BMI, height & weight• FBG, HbA1C, HDL-C, LDL-C, Serum TG• Family history of Type 2 DM, High Stress

Levels, OSA , difficulty in concentrating

D

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M-E

• Excessive fat intake related to frequent consumption of high-fat foods as evidenced by 24 hour recall exceeding RDI for TG and cholesterol intakes.

• Excessive carbohydrate intake related to high intakes of carbohydrates as evidenced by 24 hour recall.

• Physical inactivity related to sedentary lifestyle as evidenced by self-reported video game use and physical activity class discontinued at school.

Nutrition Education (Content)•Describe the relationship of overweight/obesity & dietary fat intake with diabetes and cardiovascular disease to child as well as parent education•Reduce energy & fat intake as noted in the prescription, replace soda with water and whole milk with low fat milk, reduce total fat and saturated fat, teach portion sizes, teach meal prepping , teach food labels to parents and provide a grocery store tourNutrition Education (Application)•Short term goals: Read and understand 4 food labels each week for 2 weeks with child and parent. Add 5 servings of fruits and vegetables for meals and snacks per day. Long-term goal: Read over all food labels and understand and select food options based on knowledge of food labels. Incorporate a fruit and/or vegetable for each meal and snack. Have parents buy correct groceries for the child as the gatekeeper.

• Physical Activity to encourage self-esteem and improve mood• Ensure patient and parents are getting proper nutrition support and education

to prevent DM and weight gain• Ensure patient continues to attend nutrition follow-up meetings• Serum TG, HDL-C, LDL-C, FBG, total energy intake, physical activity• BMI, weight changes, overall Mood

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