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

2. Childhood Obesity I have not disclosures

3. IS IT OK FOR BABIES TO BE OBESE?

4. 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

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

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

8. Negative health consequences: Insulin Resistance Type 2 Diabetes Hypertension

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

10. 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).

11. 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

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

15. SCREEN TIME Limited screen time to maximum 2 hours daily

16. References www.cdc.org www. Mypiramid.gov/kids. www.aap.gov.www.aap.gov 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;420-428. Sarah E. Anderson and Robert C. Whitaker. Obesity and Psychiatric Disorder: Developmental Trajectories. Pediatrics Vol 111 April 2003. 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 340-347. 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

17. Isabel Cristina Lau, MD Mountainstar Ogden Pediatrics 5495 S 500 E suit 120, Ogden UT 84405 801.479.0174