When Children Are Overweight: Real and Lasting Solutions

Woodall-RuffDenise C. Woodall-Ruff, MD, FAAP
Director, Healthy Weight & Wellness Center
Stony Brook Children’s Hospital
Morelli Peter Morelli, MD
Pediatric Cardiologist
Medical Director, Fit Kids for Life
Stony Brook Children's Hospital

March is National Nutrition Month. Because COVID has caused many children to limit their activities this winter, overweight and obesity in children has become a greater concern. Our physicians from Stony Brook Children’s Healthy Weight and Wellness Center, pediatrician Denise C. Woodall-Ruff, MD, FAAP, and pediatric cardiologist Peter Morelli, MD, share their best advice for helping children and teens deal with obesity and the subsequent health problems it can cause.

How severe are the problems of overweight and obesity with children and teens?
Very severe. The prevalence of obesity has reached epidemic proportions. During the past 30 years, childhood obesity rates have more than tripled. About one third of children and adolescents between 6 and 19 years of age meet criteria for overweight or obesity. The problem with obesity is not just weight; it is the associated health problems, including high blood pressure, high cholesterol, type 2 diabetes, joint pain, sleep apnea, depression and anxiety. Children with obesity are at risk for poor self-esteem and can experience stigmatization among their peers.

What are the best ways to address this problem?
There are many approaches, but often the most effective are lifestyle-based, medically supervised programs that help children change behaviors over time. Programs must be positive, highly individualized, multidisciplinary and family friendly. Research shows that programs have a higher success rate when one or more parents remain involved.

What is the approach of Stony Brook’s Healthy Weight and Wellness Center?
Our program is evidence-based, comprehensive and multidisciplinary, drawing on all the factors that will help a child successfully take and keep weight off. It starts with a medical assessment and monitoring, and continues with ongoing assessments. Our team is led by a board-certified pediatrician and includes a registered dietitian. If additional medical conditions are suspected, we bring in the appropriate pediatric subspecialists at Stony Brook Children’s for support. At the heart of the program are nutrition, behavior and activity level changes. Most patients require at least six months to a year of intervention including meeting with a dietitian to review current diet and develop an individualized eating plan. We also work to educate the family on meal planning, label reading, food choices and recipe modifications.

How do you handle exercise?
We work with families on creating strategies to improve the patient’s overall fitness level and calorie burning activities.  Some of our kids are enrolled in Fit Kids for Life. This program includes instruction on how to make gradual changes in lifestyle habits, safe aerobic exercise and strength training under the supervision of personal trainers. It also includes nutrition counseling, dietary assessments and food demonstrations because nutrition and activity are so entwined in the weight loss process. This program is currently under modification due to the current COVID-19 pandemic and social distancing restrictions.   

Are there other options?
Our program also collaborates with the Krasner Psychological Center to offer child and family virtual group sessions to focus on behavior modification skills that promote healthy lifestyle changes. They assess the patient’s and family’s readiness to change, and offer counseling that supports behavior and lifestyle modifications. In addition, Stony Brook offers bariatric surgical options for children ages 10 years and older who qualify. The bariatric program is accredited at the highest level by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) to work with adolescents as well as adults. We are ranked among the top centers nationally for bariatric surgery patient outcomes reported to the MBSAQIP.

What’s the bottom line?
The bottom line is that when children with obesity become adults with obesity, they can develop a long list of life-threatening illnesses or conditions that severely impair quality of life. When you address weight problems early, healthy children can grow into healthy adults. At Stony Brook, we provide a highly individualized approach that can help children develop a healthy lifestyle. A physician referral is required to enter the program. If you don’t have a physician, we are happy to refer you to one.

For more information about the Healthy Weight and Wellness Center, click here.

For more information about Stony Brook Children’s, call (631) 444-KIDS.