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NEW Kids ™ Nutrition, Exercise, and Weight Management for Kids. Brian Fidlin, PsyD Program Director of NEW Kids Assistant Professor of Gastroenterology. Obesity is a complex medical, social and psychological phenomenon. Has implications for business, law, health and public policy.

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New kids nutrition exercise and weight management for kids

NEW Kids™Nutrition, Exercise, and Weight Management for Kids

Brian Fidlin, PsyD

Program Director of NEW Kids

Assistant Professor of Gastroenterology


New kids nutrition exercise and weight management for kids

  • Obesity is a complex medical, social and psychological phenomenon.

  • Has implications for business, law, health and public policy.

  • Adult obesity affects health insurance, employee productivity, workforce development, public policy, litigation and legal precedent.

  • Pediatric obesity affects school performance, self esteem, medical health, mental health and our nation’s future.


Pediatric obesity a growing problem
Pediatric Obesity phenomenon. A Growing Problem

  • Since 1970, childhood obesity has almost quadrupled among children aged 6-11 and more than doubled among adolescents aged 12-19.

  • As of 2003-04, 17.1% of children aged 2-19 are clinically overweight

    • This is more than three times greater than the Healthy People 2010 goal of 5%.


Consequences of pediatric obesity
Consequences of Pediatric Obesity phenomenon.

  • Pediatric obesity impacts:

    • Physical health

    • Mental health

      • Obese children were found to have a poor quality of life, comparable to that of pediatric chemotherapy patients

    • Medical care costs

    • Mortality

www.obesityhelp.com


Today obese children tomorrow
Today Obese Children, Tomorrow… phenomenon.

  • Obese youth are likely to become obese adults

    • In a study following children for an average of 17 years, 77% of those who were overweight as children remained obese as adults, compared with 7% who were “normal” weight as children became obese in adulthood.


Costs of obesity
Costs of Obesity phenomenon.

  • Severe overweight children miss 4x as much school as normal weight kids.

  • Obesity associated annual hospital costs for children increased more than threefold from $35 million during 1979-1981 to $127 million during 1997-1999.

  • National health expenditures related to adult obesity range from $98-129 billion annually.

  • No one can predict what the cost will be in the future with the increased number of medical co-morbidities that we are seeing in our current pediatric population.


Who s problem is it
Who’s Problem Is It? phenomenon.

Prevention and Treatment of Pediatric Obesity

HEALTHCARE

COMMUNITY

FAMILY

SCHOOL

ENVIRONMENT

GOVERNMENT


Where is wisconsin
Where is Wisconsin? phenomenon.

  • University of Baltimore – US Obesity Report Card based on efforts to pass obesity control measures at the state level


Types of legislation introduced and in some states passed
Types of Legislation Introduced and in Some States Passed phenomenon.

  • Nutrition Standards: Controlling types of foods and beverages offered during school hours

  • Vending Machine Usage: Prohibiting types of foods and beverages sold in school and prohibiting access to vending machines at certain times

  • BMI Measured in the Schools

  • Recess and Physical Education: State mandated additional recess and physical education time


Types of legislation introduced and in some states passed cont
Types of Legislation Introduced and in Some States Passed (Cont.)

  • Obesity Programs and Education: Programs established as part of curriculum

  • Obesity Research: Legislative support for other institutions or groups to study obesity

  • Obesity Treatment in Health Insurance: Expanding health insurance to cover obesity treatment

  • Obesity Commissions: legislature established commissions designed to study obesity


What is new kids
What is NEW Kids? (Cont.)

Multidisciplinary Clinic

  • Medical, Psychologist, Dietitian, Physical Therapist

  • Physician referred

  • Need secondary co-morbidity to be seen

  • Hospital based clinic

  • Individualized treatment

  • Family based

Nutrition, Exercise, & Weight management for Kids

NEW Kids at the Y

  • 12 week educational curriculum

  • Physician referred

  • Overweight but no co-morbidity

  • Offered at 4 YMCA locations

3-2-1-0 Blast Off to a Healthier Family!

  • PMD Toolkit for use in office

  • Teaching for residents

Web Based Programs

  • Parents and caregivers

  • Teens and school age children


Current barriers
Current Barriers (Cont.)

  • INSURANCE REIMBURSEMENT FOR MEDICAL COMORBIDITY, BUT REIMBURSEMENT FOR OBESITY/OVERWEIGHT IS PROBLEMATIC

    • Excludes children who are “obese” but do not have a secondary complication YET

    • Willing to pay more money to treat versus prevent disease

  • MENTAL HEALTH INSURANCE COVERAGE

    • Lack of ideal mental health insurance coverage for families

    • Lack of universal coverage of Health & Behavior Codes

    • Lack of insurance copies taking on additional providers

      • Obese children have been shown to have a lower quality of life

      • Depression

      • Social Stigma

      • Bullying

  • LACK OF INSURANCE COVERAGE FOR PREVENTATIVE SERVICES BY REGISTERED DIETITIANS


Suggested solutions
Suggested Solutions (Cont.)

  • Medical reimbursement of preventive services for obesity

  • Medical reimbursement of treatment for obesity

  • Universal coverage of Health & Behavior Codes

  • Increased Medicare coverage of dietitians for preventive services…process has been started!


New kids nutrition exercise and weight management for kids

Multilevel (Cont.)Pyramid Model of

Stepped Care Interventions

Intensity / Cost

Reach

Lowest

Highest

Specialty

Primary Care

Health Systems

Community and Neighborhood

Media

Policies

Highest

Lowest

Source: Glasgow, Diabetes Care 2003; 26:2451


References
References (Cont.)

Action for Healthy Kids (2005). Childhood Obesity: The preventable threat to America’s youth, fact sheet. Retrieved from http://www.actionforhealthykids.org/newsroom_facts.php on 7/18/08..

Cawley, J & Liu, F. (2008). Correlates of state legislative action to prevent childhood obesity. Obesity 16(1):162-7.

Cotton, A, Stanton, KR, Acs, ZJ, & Lovegrove, M (2005). The UB obesity report card: An overview. Retrieved from http://www.ubalt.edu/experts/obesity/

McCauley, LA, Kempf, A, Morgan, J, Katcher, ML, Remington, P (2005). Overweight among high school children: How does Wisconsin rank? Wisconsin Medical Journal 104(5): 26-31.

Schwimmer, JB, Burwinkle, TM, & Varni, JW(2003). Health-related quality of life of severely obese children and adolescents. JAMA 289(14): 1813-9.

Wilensky, S, Whittington, R, Rosenbaum, S (2006). Policy Brief: Strategies for improving access to comprehensive obesity prevention and treatment services for medicaid enrolled children. Retrieved from http://www.gwumc.edu/sphhs/departments/healthpolicy/chsrp/downloads/RWJ%20Medicaid%20Obesity%20Policy%20Brief.pdf on 7/18/08.