First thing Sunday morning, Edgar van Mil presented on Overweight and Obesity in Children.
First Edgar explained what obesity is and why obesity is so prevalent. Obesity is due to an energy imbalance: our energy input (food) does not equal our energy (activity) output. It all comes back our genes. We are genetically wired to store extra calories as fat. This is because those of our ancestors who successfully stored fat to get them through leaner times survived, while those that did not store up fat did not survive. So we, their genetic inheritance, have the same genes.
Battling this disease is difficult for adults. Add in the challenge to children and we’ve got double trouble. And me must address this with children. Our environmental conditioning toward obesity begins before we’re even born and continues on until we are 2-3 years of age. Clinicians need to form a team with the child and the parents. The child isn’t the only patient either. The knowledge gaps of the parents need to be addressed as well. The children need education as well, but they need special education that they will understand using lots of pictures and using explanations using things that are familiar to them and relate to the educational theme such as, putting activity and food on a set of scales or a teeter totter to explain the balance relationship. The clinician network (physician, physical therapist, dietician, psychologist, school) is a tool to achieve goals, not the team leader. The parent needs to be the team leader, until the child is about 6, then the child can begin taking control of their own future. The network can assist the team to success by providing guidance on goal making and how to make steps toward those goals. This is how we get the patient and their families to self-manage, which is the ultimate goal of the network.
The main bits of education needed include:
— this is a lifestyle change journey and won’t happen over night. It also is flexible and changeable as the child grows.
— No one needs to suffer in the journey. Need to find a happy medium.
— obesity puts the child at increased risk for chronic health conditions.
— love does not mean giving the child everything they want.
— energy balance as discussed above.
— Instead of using food as a reward to make oneself feel good, try something else, like helping others, playin with the dog, etc.
— Other contributing factors need to addressed as well, such as psychological factors in the child, relationship factors in the family.
Don’t forget the overarching goal of empowering the family and patient to take their future into their own hands.
That concluded Edgar’s session.