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Wednesday Feb 18, 2015

Curbing Childhood Obesity Requires Moving Beyond the Exam Room

A concerned parent recently brought her child to see me, worried that the child was underweight. A check of the patient's height and weight confirmed what I suspected -- the child's body mass index was normal. The problem likely is that so many of the child's peers are overweight or obese that the parent's sense of normal was skewed.

Our state, North Carolina, has the fifth-highest rate of childhood obesity(www.eatsmartmovemorenc.com) in the nation, affecting nearly 20 percent of children ages 10-17 years. Nationally, more than one-third of all children and adolescents(www.cdc.gov) are overweight or obese.

More than one-third of U.S. children and adolescents are overweight or obese.

The White House recently marked the fifth anniversary of the first lady's Let's Move campaign,  an ambitious national program to combat childhood obesity that the AAFP has supported. But efforts to address this epidemic have shown mixed results. In the first two years after the program launched, the obesity rate among children ages 2-5 years dropped nearly 4 percent, but the rate among those 12-19 increased more than 2 percent during the same period. Overall, the rate of childhood obesity(time.com) was steady at nearly 17 percent.

The Robert Wood Johnson Foundation recently doubled down on its investment in childhood obesity programs, matching the $500 million commitment it made in 2007 with a pledge for another $500 million(www.rwjf.org) during the next 10 years.

But what can we as family physicians do in our own communities? When I was president of the North Carolina AFP, our chapter partnered with the state agricultural extension agency to provide nutrition education in family medicine practices. We identified children who were overweight or obese and provided education for entire families in large-group visits. We also worked with the extension office to develop a Web-based resource that included the menus of the popular fast food restaurants in our region. The database allowed users to compare nutrition information of various menu items so that they could make healthier choices when they ate out.

Both of those programs were funded by the state's Health and Wellness Trust Fund, which provided grants with money from the Tobacco Master Settlement Agreement. Although those funds are long gone, family physicians can still find creative ways to help families eat better and increase physical activity. And we can help families beyond the work we do in our exam rooms.

For example, Tommy Newton, M.D., of Clinton, N.C., created a program that rewards elementary students(www.scpfhc.org) for achieving certain fitness goals. The 10-year-old program, used in schools across the county, has more than 3,500 students enrolled and has been shown to improve children's fitness and self-esteem.

One of the challenges many families face is the lack of a safe place for children to play. Gone are the days (in most communities) when parents felt comfortable allowing their kids to ride their bikes around town -- or even play outside in their own neighborhoods -- without supervision. One of our local communities has addressed that by completing a bike trail that stretches from one end of the city to the other, providing a safe place for families to exercise.

What is your community doing to address this crisis?

Mott Blair, M.D., is a member of the AAFP Board of Directors.

Posted at 11:44AM Feb 18, 2015 by Mott Blair, M.D.

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