caring for adolescents with obesity in an urban clinic
TRANSCRIPT
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
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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
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.