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Pediatric Weight Management In Canada



Around the world, management of childhood obesity is posing increasing challenges for already overburdened health care systems.

While prevention efforts may eventually halt or even reverse the obesity epidemic, for children already living with excess weight, prevention efforts are similar to locking the barn door after the horse has bolted – these kids need help now.

So how does the landscape for pediatric weight management in Canada look today?

This question was addressed by Geoff Ball (University of Alberta) and colleagues in a paper just published in the International Journal of Pediatric Obesity.

With support from the Canadian Obesity Network Ball and colleagues conducted a national environmental scan of pediatric weight management programs in Canada.

Using an online survey, the researchers identified 18 pediatric obesity programs from across Canada.

These programs were generally accessed through physician referral and all included multidisciplinary teams that take a family-centred, lifestyle/behavioural therapeutic approach.

Most programs were launched in the past five years with public funding and enrolled approximately 125 clients/year into one-on-one and/or group-based weight management care. However, as the researchers note, the total capacity of all 18 weight management programs is three orders of magnitude smaller than the number of boys and girls eligible for weight management care in Canada.

Although many programs were affiliated with academic institutions, most did not systematically evaluate their obesity-related programming due to lack of funding to support evaluation and research. Furthermore, the variability in intervention models and treatment outcomes make it challenging to make comparisons across centres.

As in other countries, Ball and colleagues recognise that there is a clear need to translate obesity-related health services from specialized centres (i.e., children’s hospitals) to the primary care environment (i.e., family physician offices) where most families access care.

Till then, most Canadian children with excess weight and their families will likely have to fend for themselves or fall back on the rather limited (if any) resources currently available in their communities.

AMS
Edmonton, Alberta

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Ball GD, Ambler KA, & Chanoine JP (2010). Pediatric weight management programs in Canada: Where, What and How? International journal of pediatric obesity : IJPO : an official journal of the International Association for the Study of Obesity PMID: 20799914

2 Comments

  1. How fat does a child have to be before the doctors pay attention?

    My toddler was out of a normal range for weight / height according to the percentile charts given to me by my family doctor. Too much weight, but “healthy”. 90 percentile fatness.

    My doctor said don’t worry, it doesn’t matter, kids grow out of this.

    !!!!!! No wonder kids get to be obese. Nobody cares until they need a bariatric specialist.

    If doctors use height / weight / age charts they should PAY ATTENTION when a child is overweight, not wait for obesity become disabling.

    This is like taking a child with a broken arm to a doctor and having him say “don’t worry, it’ll heal. Come back if the bones come out though the skin, we have special orthopedic centers to treat that.”

    There will be plenty of kids who suffer from obesity related to disease or drug treatments or hormonal disorders to keep the bariatric specialists busy, even if obesity due to eating the wrong food isn’t a problem.

    The other kids who are “healthy” but overweight are in danger, and family doctors (and doctor’s office nurses and public health nurses) who brush off that danger should be reprimanded. Bad doc!!

    True, prevention efforts are like locking the barn door after the horse has bolted as far as children who are obese are concerned,
    however what I see now is that some horses have bolted, but the family doctors have still left the barn door wide open.

    Post a Reply
    • Thank you so much for your comment. From how I felt reading it, the thoughts are so succinct and “ain’t that the truth”. I so very much agree. At what point isn’t it a problem? When will there be proactive help by doctors. It would be great to be able to self-refer. I have been asking about my daughter’s weight to both pediatrician and doctor for at least 3 years. I too was told she’d outgrow it and we’d monitor it. Have to say, both my husband and I are morbidly obese, so I think it’s assumed that “the apple does not fall far from the tree” and it’s our fault our 10-year-old daughter is obese. At about 4′ something she just weighed 121.6 lbs. But big deal, if we’re not able or going to change our habits and likewise the families, at least she should have the health weight start we had before arriving in this state. Now, I know to some health-conscious fold, they’d probably consider allowing a child to become obese is part-and-parcel the equivalent of child abuse.

      I saw the switch in my daughter in Grade 3 — it was like night and day; this healthy looking average girl became round. I love her, but my own self-consciousness hurts for her. Not only that … to believe it or not … she was born at a mere 1 lb. 3 oz (3 months early).

      So, what’s being pieced together? Was there any blood work done regarding the sudden change in the weight pattern I noticed. At 6 she was developing and her breasts were quite “fatty” — that was worked up and found to be 2 years ahead of her age in development. Hmm. Height’s short. Again, to be blamed on genetics. I’m 5′.

      I guess because she was born micro-preemie, and I suffer with all unpleasant signs of PCOS – I’d be getting her to an endocrinologist ASAP and check hormones. I don’t think any of the doctors since have checked any of this out: growth, thyroid, etc. She’s also taking anti-anxiety medication, but that was started after the noticeable (to me anyway) weight change. She’s also constantly complaining she’s hungry, but then counselled she’s probably just bored and wants to eat.

      I am not a doctor, but have been through investigations throughout my life so I do suggest some blame on obesity might be medical in nature. Not all. Regardless, I don’t want for my daughter to have to wait until so late that things, lifestyle and her awareness get changed. Sure, it may turn out that it is our fault in our choice of meals in the end, but I do wonder of the preemie to health weight ratio. I know some preemies lean to the low side of the scale. Only one thing in her history sticks out being mentioned to me and that was during one phase as an infant, whatever formula combination she was being fed (and she was also a breastfed baby as best could be done), she put on a load of weight looking like she was on steroids — I guess they had increased her caloric intake too much and then weaned it back. So, when as a new mom reading about adult weight being established in childhood and possibly set by the amount taken in in infancy and the development of fat cells, I’m curious to research more into this and wonder if it could not have been somehow prevented.

      Long and short of it all … for me, I would like to take a few steps back and take a look at the overall picture, and patterns and not just at the problem at the moment when it’s already too late.

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