Pediatric nurse practitioner Emily Hollenkamp, APRN-CNP, works with young patients suffering from obesity and their families as part of SSM Health Cardinal Glennon Hospital’s Healthy First program.
It's been widely reported that childhood obesity is on the rise. What percentage of children are now affected and are we able to pinpoint the causes?
Many people think that obesity is simply “overeating.” In reality, obesity is a progressive, life-threatening, costly metabolic disease of excess fat storage. It has become a dangerous epidemic that can result in serious health complications, even in teens and young adults.
According to the Centers for Disease Control and Prevention, from 2017 to 2020 the prevalence of obesity among US children and adolescents was 19.7% with approximately 14.7 million youths affected. It’s a complicated condition with multiple causes, including:
- Genetics: Genetic make-up can lead to morbid obesity by determining how our body accumulates fat, how many fat cells we have, and how big they are.
- Environment: Lifestyle choices play an important role, such as how much physical activity we get, what and how much we eat, and the amount of time we sleep.
- Biochemical: Hormones can impact our body’s ability to manage stress and other hormones, which in turn can affect how we burn fat.
- Culture: Our family, friends, and work environment all impact our consumption of foods and beverages.
- Neurologic/psychologic factors: Depression, low self-esteem, and poor stress management are all associated with severe obesity.
What does the Healthy First Weight Management Program involve?
The Healthy First program’s mission focuses on learning lifelong habits to support nutrition and physical activity the entire family can enjoy. The program includes an in-depth first appointment, monthly dietician-only visits, and follow-up multidisciplinary appointments. The multidisciplinary team consists of a Healthy First pediatrician, advanced practice nurse practitioners, registered dietitians, social worker, and a psychologist.
The first appointment with our team lasts approximately two hours and features a program introduction, nutrition counseling assessment, discussion of medical history, psychological evaluation, and thorough physical exam. The patient and family will return to the clinic every four months to revisit goals and meet with the medical provider. They also meet with our Healthy First registered dietitian every four to six weeks.
Are there BMI (body mass index) requirements for children to participate in Healthy First?
Yes, we require a BMI greater than the 95th percentile to enroll into the program.
What is the average age of program participants? Do you recommend starting as soon as weight becomes an issue, or only after family-led efforts have failed?
We accept children ages 4-18 into the program and we do recommend starting in the program as soon as weight increases above the 95th percentile. By the time weight has increased above 85%, the primary care provider and family should be using family-led tactics at home.
How long do patients typically stay in the program? Are most of them able to meet (and keep) their weight management goals?
Patients usually stay in our program for one to two years. We work together with the patient and family to establish SMART* goals to work toward, not necessarily pounds to lose. Patients who follow up regularly with our dieticians have been able to reach their SMART goals.
If you could give families just one tip for maintaining a child's healthy weight, what would it be?
Small changes can make a big difference in the life of our patients – and their families.
Learn more about the Healthy First program at SSM Health Cardinal Glennon Children’s Hospital which features both weight management and bariatric surgery options.
*Specific, Measurable, Achievable, Realistic, and Time-bound
