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September 11, 2005
What weight problem?

Recently I had to go see a 2 year-old for a WCC. Before going into the room I want to plot this girl on a flow chart, when I realized that the highest weight on the y-axis is 40 lb, while she was 47lb 12 oz!!!!

While seeing this child, me and the resident I was working with, noticed some developmental delays, strabismus, and of course her weight problem. Keeping a somewhat broad differential in the back of our minds (Hunter's syndrome, Hurler's syndrome, and Prader-Willi syndrome to name a few) we began questioning this girl's diet and talking about it with her parents. I should note here that they were suprised that we thought something was wrong with their daughter's weight.

"She doesn't really like friuts and vegetables, but she loves to drink whole milk a lot, and she loves potato chips, fried chicken, and french fries" said her mom, who was a bit overweight herself. This child also does not play outside, but instread watches lots of TV. When we told them that she really needs to cut back on potato chips, her dad jumped in and said "these really aren't bad for you- see it says here- 0 trans fat!" Oh yeah- they had a bag of chips with them in the office, in case this child gets hungry!

I'm sorry but to me this is child abuse!

We ended up spending a good half hour educating them on diet. From what we said, I believe that DASH diet is the best for her, although there is a question of compliance.

Finally, we also sent her to a develpmental phychologist, and decided to get a few test to make sure her thyroid is working properly.

Posted At : 7:51 AM. | Link | Rotation 1 05-06 | Comments (7)

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Comments

It is frustrating to see obese children. Education is key to helping parents teach their children healthy habits.

Posted By Kate Fawcett / Posted At 9/12/05 9:06 AM

I have seen this scenario multiple times at this point and it always seems as though the parents believe that allowing their child to eat fatty food is "healthy" so that they can "grow". Yes some fat is helpful but not to this extent. I am not so sure if the DASH diet is the best choice seeing that it was made for Adults with hypertension and thus it would be a stretch for a two year-old. I would recommend on supplementing more fruits and vegetables and cutting out fried food to start with.

Posted By Anil Gupta / Posted At 9/12/05 9:17 AM

It is very sad to see that the parents of children such as this 2 year old do not realize that by "loving" their kids they way they do (feeding them the fatty foods that taste so good), they are just shortening the life of that child. I wish they were able to read the journal articles that have shown that 7 year old kids have been shown to have coronary artery disease! These poor children are getting slowly killed by ignorant parents...but what more can we do but try to educate the patients? I don't think CPS responds to "obesity abuse."

Posted By Jackcy Jacob / Posted At 9/12/05 3:26 PM

Lets not just say children are obese. Many patient i have seen does not understand how to read the panels behind every food product. All they see most of the time are the BIG WORDS saying "no fat or low sodium". They dont understand carbs play a large role in causing weight gain.

Posted By Ivan Ngai / Posted At 9/13/05 9:39 PM

Diet is only half the battle. I see exercise as a HUGE problem in children these days. Parents no longer push their kids to go outside and be active like they used to with us, and schools across the country are cutting back on gym. I think the childhood obesity epidemic is the most serious health problem in the US today.

Posted By Michael Loosemore / Posted At 9/14/05 7:23 PM

I have also seen a large number of obese children. However most parents, let alone the children are not willing to completely overhaul their diets. Maybe it would be better recommend cutting back on the fried foods and junk food (including no trans fat potato chips) and supplementing at least one extra vegatable or fruit per meal. Because lack of exercise is also contributing to obesity, parents should be told to cut down on the amount of tv their kids watch and that if they are watching tv, they shouldn't be eating snacks (suggest drinking water instead). Regular exercise should also become a part of their lives.

Posted By Amy Pound / Posted At 9/15/05 10:46 PM

I think that this is one of the saddest things to see in the clinical setting. I really don't know what can be done to help correct the problem. While dietary education is a must, I also agree with Mike that the lack of exercise seems to be a huge problem in the youth today. I think parents need to take charge and make their kids go run around outside or get involved in sports instead of letting them sit inside and play video games all day.

Posted By Keith Bartolomei / Posted At 9/17/05 1:07 PM