Consequences of Childhood Obesity: Prepare to Treat a Growing Problem Isabel Cristina Lau, MD Mountainstar Ogden Pediatrics

Childhood Obesity I have not disclosures

IS IT OK FOR BABIES TO BE OBESE?

One in five children in the US is overweight More children are becoming overweight, the heaviest children are getting even heavier Childhood obesity is one of the most common problems seen by pediatricians

Prevalence of overweight among children and adolescents ages 6-19 years

Consequences of Childhood Overweight Potential negative psychological outcomes: Depressive symptoms Poor Body Image Low Self-Esteem Risk for Disordered Eating Behavior

Negative health consequences: Insulin Resistance Type 2 Diabetes Hypertension

Continuation… High total and LDL cholesterol and triglyceride levels in the blood Low HDL cholesterol levels in the blood Sleep apnea GERD

Continuation… Early puberty Orthopedic problems such as Blount's disease and slipped capital femoral epiphysis Non-alcoholic steatohepatitis (fatty infiltration and inflammation of the liver) NASH. Non- alcoholic fatty liver disease(NAFDL).

Guidance on coding for obesity Obesity is complex and multi-factorial condition, private and public insurance carriers often limit reimbursement and coverage for overweight /obesity services Use time as a key element for coding. Use consultation code is someone other than a family member request a visit Coding one of the co- morbidities of obesity as the primary dx and the obesity

Treatment Regular Physical activity. –Be active and set a good example. –Track your individual physical activity at Medications Does Metformin works for kids?

SCREEN TIME Limited screen time to maximum 2 hours daily

References www. Mypiramid.gov/kids. Do obese children become obese adults? A review of the literature. Prev Med 1993;22:167–177 Serdula MK, Ivery D, Coates RJ, Freedman DS. Williamson DF. Byers T. Household Routines and Obesity in US preschool-Age Children. Pediatrics 2010;125; Sarah E. Anderson and Robert C. Whitaker. Obesity and Psychiatric Disorder: Developmental Trajectories. Pediatrics Vol 111 April Sarah Mustillo, Carol Worthman, Alaattin Erkanli, Gordon Keeler, Adrian Angold, E. Jane Costello Overweight, Obesity and Health-Related Quality of Life Among Adolescents: The National Longitudinal Study of Adolescent Health. Pediatrics vol 115 No2 February 2005pp Karen C. Swallen, Eric N. Reither, Steven A. Haas, Ann M. Meier Weight Teasing and Disordered Eating Behaviors in Adolescents: Longitudinal Findings From Project EAT(Eating Among Teens). Pediatrics 2006;117; e 209-e215. Jess Haines, Dianne Neumark- Sztainer, Marla E. Eisenberg and PeterJ. Hannan

Isabel Cristina Lau, MD Mountainstar Ogden Pediatrics 5495 S 500 E suit 120, Ogden UT