Childhood Obesity In Epidemic Proportions

"This is not as much a childhood problem as a societal problem." — Caughman Taylor, M.D.

Thirty years later the fabric of childhood looks dramatically different. After-school entertainment is more likely to involve the glitzy graphics of a computer game or an endless array of channels on cable TV. The rich scents wafting from the kitchen have been replaced by a bucket of Kentucky Fried Chicken tucked under mom’s arm as she returns from another long day at work.

The by-product of a vastly changed society is that today’s children are not only less active, but are eating far too much of the wrong types of foods. The frightening result has become an epidemic of children that are obese. In the past 20 years the number of obese children in the United States has doubled. In 1999, this meant 13 percent of children ages 6 to 11 and 14 percent of adolescents ages 12 to 19.

Thanks to an innovative program introduced a year ago by the Department of Pediatrics, obese children are learning how to lose weight and turn their lives around. “The main problem today is the popularity of sedentary activities. Television is directly linked to obesity,” said Dr. Caughman Taylor, a professor in the Department of Pediatrics and medical director of the Healthy Lifestyles program. “With all the kids we see, it is very rare that any of them spend less than two hours with TV or computer a day,” he said.

As inactivity and an abundance of snack foods add on the pounds, a whole host of health complications can be brought on by obesity, including orthopaedic problems, liver disorders, kidney disorders, hypertension, pulmonary disorders and menstrual irregularities. The incidence of Type 2 diabetes, which is closely linked with obesity, has increased dramatically in children. Obese children also suffer socially, and depression is not an uncommon affliction. “They are left out and ostracized, probably more than they will even admit to,” said Dr. Taylor.

Healthy Lifestyles incorporates a comprehensive approach to weight loss. “Our objective is to present a healthier way of living that affects the whole family,” said Amy Richburg, R.N., Nurse Manager, Children’s Hospital Outpatient Center, and Clinic Coordinator for Healthy Lifestyles. Children and parents are provided with extensive nutritional counseling, along with instruction on how to incorporate exercise into their normal routine. Structured exercise options are offered in conjunction with a local health club and the Goodbodies Program at the University of South Carolina.

The program's social worker sets behavioral goals for each child, and helps parents devise a reward system to reinforce children when they follow nutritional guidelines and increase their activity by exercising. Family involvement is also an important part of the program. "The parents need to be good role models in terms of eating and nutrition. We believe in stressing healthy living, not diets.  Kids cannot see their parents eating ice cream and drinking two cokes a day. They also need to see their parents being active. This is not as much a childhood problem as a societal problem," said Dr. Taylor.

When children enter the program, they spend an initial session with each of the Healthy Lifestyle team members, including a pharmacist who explains any medications that are needed to manage specific complications. Recommendations are then sent to the child's pediatrician, who will follow his or her progress on a monthly basis. Follow-up is done on a periodic basis by Healthy Lifestyles, and consultations are available with pediatricians as needed.

With the addition of Dr. Katie Stephenson to the staff, Dr. Taylor hopes to shorten the time children remain on Healthy Lifestyles' waiting list.  He's excited about a new home exercise program that will be introduced, while Richburg looks forward to the development of an eight to twelve-week course that will provide parents with additional education and direction. "Right now we can't spend nearly the time we want to with these kids," Richburg said.

A year after Healthy Lifestyles was established Dr. Taylor is pleased that over 50 percent of the patients who are compliant with the program have not only shed pounds but made significant improvement with weight-related medical conditions. "It's nothing that we do," he insisted. "If the family eats healthy and the child does something active five days a week for more than 30 minutes, then he or she will lose weight." As the pounds drop, the children’s confidence soars.  "As shy as some of them may be, they come in here with big grins on their faces. They've become a lot more comfortable in their own skin," Richburg said.  

Reprinted from Connections newsletter, November 2002

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