Episode 91: Managing Obesity In Children

Episode 91: Managing Obesity In Children

Pediatric obesity is a very important topic to talk about because we want to tackle these situations early on as it will likely lead to healthier adults. Dr. Angela Fitch joins me today to talk about how to manage obesity in children.

Dr. Angela Fitch is board certified in obesity medicine, internal medicine, and pediatrics. She is currently the Associate Director of the Massachusetts General Hospital Weight Center and a faculty at the Harvard Medical School. She currently is serving as President-Elect of the Obesity Medicine Association and previously served as Secretary/Treasurer and a trustee. She was the 2015-2016 chair of the clinical management section of The Obesity Society. Dr. Fitch is the winner of the 2017 Clinician of the Year Award from the Obesity Medicine Association.

She enjoys seeing patients of all ages to help them reach their weight and wellness goals. She enjoys cooking, traveling and outdoor activities with her husband and son, and looks forward to exploring New England.

Key Highlights: 

Tune in to my conversation with Dr. Angela Fitch and learn:

• The difference between management of obesity in children as compared to adults
• Can children outgrow obesity? 
• Treatment modalities used in the management of obesity in children
• Off-label medications approved and considered for management of obesity in the pediatric age group
• How to approach obesity in younger children aged lower than 6 years old
• Some challenges in getting oral medications approved for pediatric obesity 
• How she addresses the parental and personal blame most adults feel for their children’s obesity
• How Dr. Angela Fitch and her team manages the emotions, stress and anxiety that come along with the management of obesity in kids
• How the terminology we use in society adds to the stigma that puts the blame on children and adults with obesity

Recommendations for Diagnosing Overweight and Obesity according to AAP and Obesity Medicine Association Guidelines

1. Use body mass index (BMI) and the Centers for Disease Control and Prevention (CDC) normative BMI percentiles to diagnose overweight or obesity in children and adolescents ≥2 years of age.
2. Diagnose a child or adolescent >2 years of age as overweight if the BMI is ≥85th percentile but <95th percentile for age and sex, as obese if the BMI is ≥95th percentile, and as extremely obese if the BMI is ≥120% of the 95th percentile or ≥35 kg/m2.  Variations in BMI correlate differently to comorbidities according to race/ethnicity and that increased muscle mass increases BMI which also needs to be taken into account.

Modalities used for Management of Obesity in Children

• Lifestyle intervention
• Medications
• Surgical intervention

Quotes:

“The big issue for all of us is we live in a world that’s obesogenic.”  – Dr. Angela Fitch

“If we don’t do some intervention of some sort, it’s likely that the child will continue to have obesity, and not grow out of their weight.” – Dr. Angela Fitch

“The big differentiating factor sometimes for the younger kids is that their weight management is not always focused on weight loss, it can be focused on weight maintenance as well.” – Dr. Angela Fitch

“It definitely is stepwise, meaning we should layer the treatment, the treatment should be layered. But it doesn’t have to be always at the bottom that you start with that and go up. And that’s where people sometimes get a little too focused on that.” – Dr. Angela Fitch

“Obesity is a chronic disease. And I think everybody should understand. This needs to be treated as a chronic disease, really.” – Dr. Avishkar Sabharwal

Links:

• Dr. Angela Fitch on Linkedin: https://www.linkedin.com/in/angelafitchmd/

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