Arkansas Children’s Hospital, childhood, obesity, Samiya Razzaq, fitness

Program Works with Overweight Children – and Their Parents

One year ago, 12-year-old Quinton Cordes weighed 200 pounds and was suffering from high blood pressure. Today, he is 151 pounds and still shrinking.

The difference between now and then is a new lifestyle formed with the help of the Arkansas Children’s Hospital Fitness Clinic.

“We just took their suggestions about the dietary changes, cut out pretty much most of the processed foods in the house, and we took out pop and stuff like that,” said his father, Daniel. “And he gets out every day now and plays outside, at least rides his bike for about 30 minutes after he gets home from school. So that’s pretty much all we’ve done. … It wasn’t that dramatic at all.”

Started in 2001, the program sees referrals ages 2 to 21 who have body mass indexes above the 85th percentile. Some children have been as heavy as 500 pounds. It is staffed by a physician, Samiya Razzaq, MD, along with a physical therapist, nutritionist and a psychologist. Most patients are on Medicaid, and most insurance companies pay for the program.

Children undergo a lengthy assessment during their initial visit to the clinic, starting with Razzaq. She assesses all medical aspects of their condition, including co-morbidities such as high cholesterol and low self-esteem. That opens the door for frank discussions with parents, some of whom may be resistant and some who may not be aware that their child is depressed or even that they have a weight problem.

“For example, yesterday we had a 16-year-old girl,” Razzaq said. “Both the parents yesterday said they did not think she had a weight problem. She was 70 pounds overweight. Mom thought she was going to grow into it. Dad said he was always a big person, so he never recognized that she was overweight or obese.”

Razzaq said most parents don’t understand how much their family’s lifestyle impacts their children’s weight. Most mistakenly believe that the child’s condition is a result of genetics (a factor, Razzaq says, but one that can be overcome), thyroid problems or reactions to asthma medication.

It takes a daily swing of 500 calories – through some combination of consuming less and burning more – in order to lose a pound per week. Working with Razzaq, the multidisciplinary team customizes goals and a fitness plan to help the child either to lose weight or maintain their weight as they age and their body grows.

Razzaq uses the word “tweak” as she describes the planning. A busy family won’t be asked to spend three hours cooking every night, but it will be encouraged to provide a healthier diet and limit the child’s sedentary activities – television, video games, etc. – to two hours a day. The team doesn’t try to deprive young people of their favorite foods. Instead, it asks for limits – two pieces of pizza, smaller cheeseburgers instead of Big Macs, and asking the child to throw away 10 french fries when they eat out. The one non-negotiable no-no is sugary drinks of any kind. “The easiest way to eliminate calories from your diet is by taking out the calories that you’re drinking,” Razzaq said.

According to Razzaq, a psychological assessment sometimes uncovers deeper problems that are contributing to the child’s weight gain, including problems with parents or abnormal eating. Some children have to be admitted for treatment because they are so depressed. Sometimes the team has to call in reports to the Arkansas Department of Human Services because there is neglect at home. One set of three siblings had been deprived of food and sexually abused by their mother and her boyfriend for four years until they were adopted by their grandmother. When they came to the clinic, they didn’t know how to use utensils.

Patients return about every three months for follow-up visits, unless the team believes greater frequency is needed.

The program is booked solidly for nine months. To help increase the patient load, the team started a Fit-to-go clinic for patients who are further along on the program. Those participants visit monthly with a specialty nurse and dietician. The main program sees 40 patients per week, while about 16-20 are participating in the Fit-to-go clinic. “All the patients who’ve been coming to the Fit-to-go clinic have actually lost weight or maintained weight,” Razzaq said.

Razzaq said that an overweight child almost always has at least one overweight parent, so the program benefits others in the family. One young person who started the program last February at age 14 weighed more than 400 pounds. His parents had divorced and his mother was depressed, so their bonding time was making a pot of spaghetti together and then eating it. Meanwhile, the child would eat two Subway footlong sandwiches in one sitting. The team asked him to limit his intake to one six-inch sandwich, start exercising, and cut out sugary drinks. In two months, he lost 40 pounds. Both his mother and he started water aerobics, and she lost 12 pounds.

Daniel Cordes said his own family has also seen positive results since Quinton got involved in the program. “The rest of us have been losing weight as well, which is a good thing,” he said. “The actual change of it really wasn’t as difficult as we thought it was going to be.”

Julius Ford from Pine Bluff is another success story. According to his mother, Tamara Gulley, Julius was 160 pounds when he started the program at age 9. Not only was he overweight, but he also was suffering from mood swings. Under the clinic’s guidance, Gulley said she changed his diet and got him involved in sports. He now weighs 128 pounds and is wearing clothes that are two sizes smaller than before.

“At first, he couldn’t even tie his shoes because his stomach would get in the way,” she said. “Now he’s happy. He can run more. He can play more without getting too exhausted, and he likes the fact that he’s lost a lot of weight. He can do a lot more in his sports activities without getting too tired, and the fact that he can bend down and tie his shoes and run up and down the court without getting tired after the first two runs – he really enjoys it.”

Tags:

Bookmark:

Facebook

Technorati

Newsvine

Google

Related: