Wednesday, January 14, 2009

What's Up Doc? The Kid's Weight!

Seems kiddie docs don't tell parents their kids need to lay off the treats and get moving. A new study out of my hometown, Cleveland, finds docs have been diagnosing weight problems among only 10% of overweight kids, 54% of obese ones, and 76% of the severely obese. We're talking kids aged 2 to 18. Researchers at Case Western Reserve School of Medicine (Hi, Dr. Teresa, my most fave alum) calculated body mass index from each child's height and weight.

I can understand the docs not mentioning anything in writing for the overweight. Maybe some of these kids were borderline, maybe slightly overweight. Okay. But it's the obese kids and the severely obese ones that worry me. I'm hoping the pediatricians/family doctors discussed their weight with their parents. Maybe they simply didn't want to label the kids. I have to admit I paused before placing "children" after the word "obese" above. It's painful to write those two words together.

Another observation - these kids had all gone through a "health care system" in Cleveland. Now I haven't looked at the study but I'm wondering if this is a representative sample. In other words, how many of these children have actual weight problems. We know they're more common in lower SES families. And so I must ask if pediatricians are under diagnosing weight issues in more affluent families as well.

Yeah, yeah, sometimes SOME of us parents might worry about our children's weight and more likely eating habits MORE than we should. You know who you are. Okay, sometimes me. But here's evidence some of us, including pediatricians, might need to worry a bit more, or at least express some concern.

Just like so many parenting issues...the people who are concerned are the ones who needn't be... and those who are not should be.

4 comments:

therextras said...

Weeelll, do you mean that because your children are not overweight, that means you worry about what they eat unnecessarily?

Weeelll, if all the physicians were concerned, how would you measure that concern? - Surely not on the basis of one research report...ahem.

Barbara

Dr. Polly said...

Hi Barbara! Great questions. No, I don't mean to suggest parents shouldn't put some thought into what their kids eat and drink, but I do think there are parents out there (and maybe I'm hanging in an unrepresentative social circle) that seem to obsess over their kid's diets too much. Like buying everything whole grain and organic and not letting their kids eat pizza, goldfish or the occassional sugary treat. I think there's a fine line, especially with girls (who we know are more at risk of eating disorders), between ensuring a quality diet and being too controlling. Having seen so many young girls and women with bulimia and anorexia I worry about the control issue.


Yes, the doctors' concern. Not easily measured, but I'm sure there are researchers out there who could find some interesting measures. And thanks for the reminder that one study is simply one among many. But we do have other studies suggesting obesity is under diagnosed in children. Probably part due to changing attitudes about what is or isn't obesity versus "baby fat". What do you think?

Love your website. Will add it to my page. Where'd you do your graduate work? Just curious, I went the social psychology route for my Ph.D. but did social/cognitive developmental stuff for my master's. Thought many times of a doctorate in developmental psych...

therextras said...

Thanks, Dr. Polly! I will return the favor - putting a link to mammadata under my list called Brain Food. All about my education is listed in the middle column, too - just before sleep reading, so have your pj's on. Thanks for leaving a comment on my research page, too.

Not exactly what I meant with my questions...I was thinking that the parents who DO pay attention to their children's diet DON'T have obese children. Ahem. But, you bring up an important extreme at that end of the behavior scale (over-control). What I do habitually is try to get parents to take ownership of the decisions they make for their children. To help them be more mindful and feel responsible for the evidence in their children's lives. (As opposed to the feeling of having no control in their lives as parents.) Final note on this is that diet recommendations are not my specialty - I avoid opinion on this on my site.

Regarding doctors...I go to different place with them, too. If obesity is underdiagnosed - you mean to say obesity is a diagnosis. I don't think anyone needs a physician to tell them if they are overweight. Might help if the physician notes it, as MDs are revered. Ahem.

The problem with MDs being a part of the chain is that obesity is a behavioral problem and MDs are woefully bad at addressing behavioral problems. (They do well with pharmaceuticals and surgery, er, medicine. Ahem.)

A physician does not have the role of effectively influencing a parent to change the child's diet, or lifestyle to include more activity aka exercise. THAT'S my specialty, and I work at influencing parents to get the children more active - all children and esp children with diagnoses.

I also think that when an MD is facing an obese parent with an obese child, he/she knows a few sentences about weight are futile. That's what I think! Thank you for asking, and I look forward to more e-conversations between us. Barbara

Bobby said...

Thank you for your concern. Childhood obesity is a growing problem in the United States. With the rise of video game popularity, less outdoor activity and processed foods it is easy to understand why kids with weight issues are becoming more common. The good news is that schools are becoming aware of the need for nutritional lunch programs and even fast food restaurants are adding healthier choices to their menu.