Pediatric Obesity: Health Implications Flashcards Preview

Dems Unit 2 Part 2 YAAAY > Pediatric Obesity: Health Implications > Flashcards

Flashcards in Pediatric Obesity: Health Implications Deck (18)
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1

Body Mass Index for Age charts

1. 2-20 years
2. correlates with body fat strongly above 95th percentile, modestly 85-95 percentile
3. identification of excessive weight gain relative to linear growth

2

5 categories Body mass index in children

1. Overweight: 85-94%
2. Obese: >95%
3. Severe obesity
a. >99th
b. > 120th of the 95th percentile: corresponds to adult class II

3

BMI association with co-morbidities

>95th association
>99th greatly increased co-morbidities

4

current pediatric overweight & obesity status

-Obese: 18% US age 2-19 (BMI?95)
- Overweight/ obese: 30%

- income difference accounts for most ethnic variation

5

common health effects of childhood obesity

-obstructive sleep apnea
-metabolic syndrome: insulin resistance + hyperlipidemia + HTN
-hepatic: NAFLD
-Decreased QOL: mood/ anxiety

6

less common health effects of childhood obesity

-endocrine: T2DM, PCOS
-Orthopedic

7

persistence of overweight into adulthood

related to: parent's weight, age of onset, severity

8

childhood obesity and risk of heart disease and T2DM

reversible if obesity resolves by young adulthood

9

what infant factor correlates strongly with later obesity?

early infant weight gain: highest quartile

10

physical activity
-daily goal
-sleep at 2-5yrs, 6-12 yrs, 13-18yrs

>1hr active play/day

Sleep:
-2-5yrs: 11hrs
-6-12yrs: 10hrs
-13-18yrs: 9hrs

11

physical exam

HTN
acanthosis nigricans
acne/ hirsustism
striae
organomegaly
joint pain
stigmata of genetic syndromes
neurologic function

12

labs

Start: age 10 or tanner 2; or age 2-9 if severely obese BMI >99%

-fasting lipids
-ALT
-fasting glucose +/- HgA1c q1-2yrs

13

4 APP Stages of Interventions

1. Prevention Plus: primary care
2. structured weight management: PCP + dietician/ psych
3. comprehensive, multidisciplinary weight management: diet, exercise, behavior
4. tertiary care: controlled/ supervised diets, meds, surgery

14

Prevention Plus weight loss plan

5210+:
5 fruits
2 hours tv or less
1 hour activity
0 SSB
+others

15

motivational interviewing

-identify family's motivating values
-Use QARrrrS: open ended questions, affirmations, reflections, rolling with resistance, reframing, summaries

16

principles of treatment for overweight child

1. motivational interviewing
2. family involvement
3. Environment cleanup
4. collaborative management: joint decision making (MD gives menu of changes)
5. cognitive behavioral techniques: self monitoring & accountability

17

collaborative management

-change both diet and PA
-joint prioritizing and decision making
-MD does not dictate but gives menu of changes

18

CBT

1. self-monitoring: if you can't count it, you can't change it
2. Accountability: reinforcement/rewards for behavior change