caring for adolescents with obesity in an urban clinic

Caring for Adolescents with Obesity in an

Urban Clinic

Julia Joseph-Di Caprio, M.D., M.P.H.

HCMC Chief of Pediatrics

I have nothing to disclose.

Objectives

Upon completion of this session, participants should be better able to:

• Discuss an adolescent’s obesity with them and their parent.

• Develop plans with adolescents from diverse backgrounds and their parents for the management of the adolescents’ obesity (plans that have a chance of working).

Clinical Pearls• Clinicians should talk about an adolescent’s weight with

them, but the focus should be on healthy living, not dieting.

• Parents should not talk about weight with their adolescent, but modeling healthy behaviors is recommended.

• Most youth will not take part in intensive weight loss programs, but clinicians can use diet and exercise recommendations, community programs, and new media technologies to manage an adolescent’s obesity with them and their parents.

Adolescent Obesity in the U.S.

Percentage of high school students who were obese* — selected U.S. states, Youth Risk Behavior Survey, 2003

Adolescent Obesity in the U.S.

Percentage of high school students who were obese* — selected U.S. states, Youth Risk Behavior Survey, 2005

Adolescent Obesity in the U.S.

Percentage of high school students who were obese* — selected U.S. states, Youth Risk Behavior Survey, 2007

Adolescent Obesity in the U.S.

Percentage of high school students who were obese* — selected U.S. states, Youth Risk Behavior Survey, 2009

Adolescent Obesity in the U.S.

Percentage of high school students who were obese* — selected U.S. states, Youth Risk Behavior Survey, 2011

Adolescent Obesity in the U.S.

American Heart Association. Circulation, 2011

Adolescent Obesity in the U.S.

Ogden CL, et al. JAMA. 2012

Prevalence of Obesity and Trends in Body Mass Index Among US Children and Adolescents, 1999-2010

Adolescent Obesity in the U.S.

Ogden CL, et al. JAMA. 2012

Adolescent Obesity in Minnesota

Minnesota Student Survey Trends Report 2010

Adolescent Obesity in Minnesota

Minnesota Student Survey Trends Report 2010

Adolescent Obesity in Minnesota

Minnesota Student Survey Trends Report 2010

Adolescent Obesity in Hennepin County

Adolescent Obesity in Hennepin County

Mental health and overweight

BeLue, et al. Pediatrics, 2008

Objectives

Upon completion of this session, participants should be better able to:

• Discuss an adolescent’s obesity with them and their parent.

• Develop plans with adolescents from diverse backgrounds and their parents for the management of the adolescents’ obesity (plans that have a chance of working).

How to talk about weight

Puhl, et al, Pediatrics 2011

How to talk about weight

Puhl, et al, Pediatrics 2011

Neumark-Sztainer, et al. Pediatrics, 2008

Objectives

Upon completion of this session, participants should be better able to:

• Discuss an adolescent’s obesity with them and their parent.

• Develop plans with adolescents from diverse backgrounds and their parents for the management of the adolescents’ obesity (plans that have a chance of working).

The twenty minute office visit

evaluation/intervention

• Labs, family history-the “hook”?

• Diet review with recommendations

• Exercise and media review with recommendations

[wpvideo mReQjjZY]

You need to drop a few pounds

• Nutrition• Psychology• Medications• Bariatric surgery• Community programs

Taking Steps TogetherYouth Determined to Succeed

• Apps and other new technology solutions

You need to drop a few pounds

Chanoine, et al. JAMA, 2005

You need to drop a few pounds

Srinivasan, et al. J Clin Endocrinol Metab, 2006

You need to drop a few pounds

O’Brien PE, et al. JAMA, 2010

You need to drop a few pounds

• Nutrition• Psychology• Medications• Bariatric surgery• Community programs

Taking Steps TogetherYouth Determined to Succeed

• Apps and other new technology solutions

YDS focus groups

• 6 males and 8 females• 13-18 years• Grades: 8th to college• Social media used:Instagram, Twitter, Snap Chat, Tumblr,

Facebook, You Tube, Pinterest, Gmail, Facetime, Skype, text messages

• To get YDS message out: Facebook and Twitter• Twitter: must be inspiring tweets, don’t retweet, don’t

recycle tweets, no more than 3-12 tweets per day• Use Instagram for before and after pictures• Use You Tube for training videos, PSAs

You need to drop a few pounds

You need to drop a few pounds

www.drj4teenhealth.com

@DrJ4TeenHealth

Clinical Pearls• Clinicians should talk about an adolescent’s weight with

them, but the focus should be on healthy living, not dieting.

• Parents should not talk about weight with their adolescent, but modeling healthy behaviors is recommended.

• Most youth will not take part in intensive weight loss programs, but clinicians can use diet and exercise recommendations, community programs, and new media technologies to manage an adolescent’s obesity with them and their parents.