Targeting Childhood Obesity

By Michael Bilton and Katie Gesicki

By sharing ideas and implementing innovative programs, a learning collaborative is working to reduce overweight and obesity rates in children.


Michael Bilton	Katie Gesicki

As a health care professional, you are well aware that obesity rates among youth and adolescents are rising at an alarming rate. In the past three decades, the obesity rate for children ages 6 to 11 years has tripled, according to the Institute of Medicine.

Rising numbers of overweight and obese individuals among all age groups is now a widely acknowledged national health care and public health crisis. The media are covering this issue at an unprecedented level, and numerous stakeholders have committed resources—through research, prevention, treatment and advocacy—to help reduce the numbers. Many hospitals have taken up the effort, and many others are exploring how best to become involved.

An Opportunity for Hospitals

We frequently think first of families, schools, pediatricians and communities in turning the tide on youth obesity. The role of hospitals is often overlooked, even though hospitals are in a prime position to tackle this growing epidemic, given their wealth of medical expertise and their leadership position within communities.

Intervening successfully to prevent or treat youth obesity will generate returns by improving future health and reducing burdens on the health care system. Obesity is a significant contributor to rising health care costs. Many obese children develop numerous co-morbidities such as type 2 diabetes that may last into adulthood and throughout their lives. Committing resources to fight childhood obesity is an excellent investment in community health for hospital leaders.

And for nonprofit facilities, a childhood obesity program can help fulfill hospital community benefit requirements.

Making a Difference

To better understand and promote the contributions of hospitals, the Health Research & Educational Trust created the Youth Obesity Learning Collaborative, a three-year initiative funded by the Centers for Disease Control and Prevention and the American Hospital Association.

The learning collaborative includes 17 competitively selected hospitals and health systems from rural, suburban and urban communities who share program ideas, learn from each other and provide guidance to other hospitals. The participating hospitals run a variety of programs, illustrating several specific ways that hospitals can impact childhood obesity.

Primary prevention programs. Reaching children who are not yet overweight and instilling healthy behaviors while they are young can significantly impact rates of childhood obesity.

Clarian Health in Indiana uses school-based programming to educate children about healthy behaviors and targets those most at risk. It developed a classroom-based version of the “Committed to Kids” weight management program (originally developed in 1987 by Louisiana State University as a treatment program for youth obesity) and offers the program in health and physical education classes at elementary and middle schools in the Indianapolis region.

In San Pedro, Calif., Little Company of Mary Hospital leads Creating Opportunities for Physical Activity, an initiative focused primarily on motivating Latino children and expanding community access to recreation and activity sites. The hospital has partnered with four schools in the area and developed an after-school curriculum to increase the physical activity of children in elementary school. Little Company of Mary places a strong emphasis on family involvement in sustaining kids’ physical activity and good nutritional habits by hosting evening family workshops at convenient community locations.

Secondary prevention and treatment programs. Hospitals are also well positioned to offer outpatient weight management clinics for obese children. The Children’s Center for Weight Management at the Children’s Hospital of Alabama in Birmingham offers two group programs, “Let’s Eat Smart, Then Exercise Right” for ages 6 to 11 and “Healthier Weigh” [sic] for ages 12 to 18. Both 10-week programs focus on increasing activity levels and establishing healthier nutrition patterns in families through education and counseling.

In Kansas City, Mo., Children’s Mercy Hospital and Clinics’ Pediatric Care Center is home to the “Promoting Health in Teens and Kids” program for obese youth and their families. This initiative uses a multidisciplinary clinical approach based on motivational interviewing combined with intensive, long-term group education and follow-up for 2- to 17-year-old kids and their parents.

Most of these outpatient programs use multidisciplinary teams including, for example, physicians, health promotion specialists, registered dieticians, registered nurses and exercise physiologists. They also track patients’ body mass index and other key clinical indicators.

Community advocacy. Another role chosen by some hospitals is advocating for public policies that support healthier children. Hospitals can get behind a range of public policy levers, including healthier school food policies, better bicycle and pedestrian routes, and increased access to recreational areas.

Integris Health founded and supports the Oklahoma Fit Kids Coalition. Currently composed of 90 organizations signed on to combat childhood obesity, the coalition has advocated successfully for legislation on such issues as restricting school vending machines, implementing farm-to-school programs to provide locally grown foodstuffs to school cafeterias, and developing fitness assessment software programs to track student fitness.

A Call to Action

The value of hospital involvement is readily apparent, and action is needed now. As childhood obesity rates continue to rise, hospitals cannot afford to overlook this major community and population health issue. Moreover, hospitals are already equipped to act on their own and to collaborate with other community organizations. There are plenty of program examples for hospitals to follow, and many states and regions have active networks that would welcome hospitals’ participation.

Start a dialogue at your hospital and in your community, and decide how you can best make a difference to help reduce and prevent childhood obesity in your community.

Michael Bilton is vice president of education and Katie Gesicki is project coordinator for the Health Research & Educational Trust, Chicago.

To learn more about HRET’s youth obesity work and to read project summaries of the participating hospitals, visit www.communityhlth.org and select “Youth Obesity Learning Collaborative” from the “Projects & Affiliates” tab.

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This article 1st appeared on October 1, 2007 in HHN Magazine online site.

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