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Physicians Update

Fall 2008

UCLA Program Helps Overweight Children


Child overweight measureWith an estimated 11 million overweight children and adolescents nationwide, and some 13 million more who are at risk for becoming overweight, excessive weight among children is characterized as the most serious and prevalent nutritional disorder in the United States. The problem of excessive weight can lead to problems in both childhood and adulthood. Pediatricians increasingly are diagnosing adult-onset, or type 2, diabetes in overweight youngsters, along with high blood pressure and elevated cholesterol. (Children are classified as overweight if their body mass index, BMI, a calculation based on height and weight, is at or above the 85th percentile but less than the 95th percentile in comparison to national statistics for children their age, and obese if their BMI is at or above the 95th percentile.) When overweight children become overweight adults, they are at significantly higher risk for such weight-related health problems as heart disease, hypertension, osteoarthritis, gallstones, kidney stones, sleep apnea, colon cancer and stroke, among others.

Multidisciplinary program

As part of the effort to combat this problem, UCLA has established a multidisciplinary program focusing on treatment of overweight children. “The goal of the UCLA Fit for Healthy Weight Program is to work with the doctors in the community to serve a group of children who traditionally have been challenging for general pediatricians to take care of,” says Wendy Slusser, M.D., an expert in childhood nutrition and one of the lead physicians for UCLA FIT. The program follows a four-tier system for managing overweight children. The first two tiers can be undertaken in a community pediatrician’s office and involve identification, assessment of risk factors, nutritional guidance and structured weight management, while the third and fourth tiers require a more specialized, multidisciplinary approach such as that offered by the UCLA program. A general pediatrician might not be comfortable, for example, managing a child with metabolic syndrome; in such a case, the UCLA program offers a multidisciplinary team that addresses the range of the child’s health issues. “Not only will we address children’s medical needs, but we can also work on their weight loss, which is very important to their overall treatment and will ultimately help to reverse their problems,” Dr. Slusser says. “We will work to find out the root of their weight problem that hasn’t responded to the less-intensive efforts in the primary-care setting. Based on our assessment, we will determine the needs for each individual child.” In addition to a general pediatrician whose professional focus is nutrition, the UCLA program includes an endocrinologist, gastroenterologist, psychologist, dietitian, exercise physiologist and a pediatric bariatric surgeon. “Only select patients who undergo a minimum six-month evaluation will be candidates for minimally invasive weight-loss and metabolic surgery,” says Daniel DeUgarte, M.D., surgical director of the program. Child Swimmer, Fit Program

Nutrition and exercise

The cornerstone of therapy to treat weight issues in children — as with adults — remains diet and increased physical activity. Sixty minutes or more of sustained exercise every day is recommended for children and adolescents, Dr. Slusser says. A diet that offers the full Recommended Daily Allowance of vitamins, minerals and proteins and is based on fruits, vegetables, whole grains, nonfat and low-fat dairy products, fish, lean meat and beans is preferable. Changes in diet seem to be most successful when preparation of familiar foods is modified rather than new foods being substituted.

Call (310) UCLA-FIT (310-825-2348) for more info, or:


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