In 2011, a mother lost custody of her 200lb 3rd grade son for medical neglect. When enrollment into “Healthy Kids, Healthy Weight” program was unsuccessful and his weight kept rising, authorities got involved.  The Department of Children and Family Services (DCF) took the mother to court and won, after which the boy was placed in the foster care system. 

As a physician, I have seen the effects of obesity on health.  Obesity is a risk factor for many life-threatening diseases such as, high blood pressure, diabetes, strokes, arrhythmias and heart attacks.  During my Masters of Public Health here at the University of Miami, I’ve learned that although the lifespan of the average American is increasing, the quality of life is not.  In fact, chronic diseases, such as diabetes and high blood pressure, are now the most prevalent.

 

Obesity is not only a physical burden; there is also the risk of bullying and its psychological aftereffects. 

The Florida Department of health found that among bullied high school students, 52.4% were for weight, size and physical appearance.  Being bullied also increased their risk of violence, drug and alcohol use, risky sexual behavior, depression, self-harm and suicide ideation.  A quick solution to preventing childhood obesity is needed. However, reporting it as medical neglect would cause additional psychological harm. If not genetically predisposed, obesity is preventable with lifestyle modifications such as balanced meals, regular exercise, and adequate sleep. I suggest we start there at school and at home.

In Florida, the average obesity rates for 2-18 year olds is approximately 13%. Although a study by the Center for Disease Control (CDC) implemented efforts at state, local and community levels to lower childhood obesity, results were modest and the study was limited to 2-4 year old participants of Women, Infants and Children nutritional supplementation program (WIC). 

Other studies have shown that eating habits are acquired in the first years of life and even if healthier choices were provided at school, the kids won’t eat them.

In addition, a study showed that kids who had school lunch had a more balanced meal than those who brought lunch from home.  This proves that interventions targeting both school and home must work together to affect change. Therefore, interventions at home must not only start early in the child’s life but with support of the school and guidance from their doctors. Initial intervention should involve a team of doctors from multiple specialties to reinforce healthy habits and to provide instructions and explanations as to why healthy choices are important. This should be done before conception if possible, but throughout pregnancy and throughout the child’s life.

In terms of exercise, schools are increasing physical activity opportunities, but it needs to be extended to afterschool and the home.  All kids should be enrolled in a mandatory afterschool physical education program. The program should include sports for at least 45 minutes with only healthy snacks and water provided.  Healthy snacks should include fruits, and veggies.

Studies have show that the more exposure to healthy food a child has, the more likely they are to continue eating them. Physical activity at home may have some limitations such as: access to a park, safe neighborhoods to play in, and involvement of the family.  Therefore, home games should be created to help children and their families exercise together and improve bonding opportunities.  In addition, T.V time should be decreased as it has been found to correlate with higher body fat. 

Education about this must be given to parents by the schools and their doctors.

Lastly, studies have shown that sleep deprivation negatively affects metabolism and weight maintenance. Physicians should educate the parents on the adverse effects of sleep deprivation through a school sponsored Sleep Orientation Program. Instructions on how to create a good bedtime routine must also be provided.  School counselors should keep track of school performance and in class behaviors to identify kids who may be sleep deprived.  This will facilitate personalized counseling to the children and their parents.

Although the court ruling shows the severity of childhood obesity and possible parental consequences, the better way to affect change is not by instilling fear but through education.

Explanations and guidance are needed to help parents understand why healthier behaviors are so important for the health of their children.  By increasing exercise, balanced meals with fruits and veggies, decreasing time spent watching T.V., and improving sleeping routine, we might be able to ‘bend the curve’ on the rising prevalence of childhood obesity in Florida. 

Such efforts might even decrease the prevalence of obesity in adulthood.

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