1. Jennifer Derasmo
Nutrition Sciences Student
Weight Management in Pediatrics
• More than one-third (34.9% or 78.6 million) of U.S.
adults are obese. (2) One-third of youths are
overweight or obese. (1)
• The term “obese” describes children and
adolescents who have a body mass index (BMI) at
or above the 95th percentile for their gender and
age, while “overweight” describes those with a
BMI at or above the 85th but below the 95th
percentile. (1)
• Obesity-related conditions include heart disease,
stroke, type 2 diabetes and certain types of cancer,
some of the leading causes of preventable death.
(2)
Pathophysiology
 Obesity prevalence differs among racial/ethnic
groups and also varies by age, sex, and adult head of
household’s and education level (3)
 According to the National Sleep Foundation (NSF),
extra pounds on children can put them at risk for
Obstructive Sleep Apnea (OSA) which affects mood,
difficulty in concentrating at school, headaches and
changes in performance (4)
 The main causes of excess weight in youth are
similar to those in adults, including individual causes
such as behavior and genetics (5)
• Adipex-anorexiant, CNS stimulant, may cause dry mouth
and an unpleasant taste
• Alli- fat malabsorption,peripherally acting antiobesity
agent, may cause diarrhea, loss of appetite, nausea, sore
throat, vomiting, tooth problems, swelling of lips,
tongue, throat, and abdominal pain.
• Belviq- Anorexiants, CNS stimulants, may cause
increased and painful urination, sore throat, dry mouth,
increased hunger, rapid weight gain, unusual weight
1. NCCOR Childhood Obesity in the United States. (n.d.).
Retrieved February 10, 2016, from http://www.nccor.org/
2. Adult Obesity Facts. (2015). Retrieved March 09, 2016, from
http://www.cdc.gov/obesity/data/adult.html
3. Childhood Obesity Facts. (2015). Retrieved March 09, 2016,
from http://www.cdc.gov/obesity/data/childhood.html
4. Children and Sleep. (n.d.). Retrieved March 07, 2016, from
https://sleepfoundation.org/sleep-topics/children-and-sleep
5. Childhood Obesity Causes & Consequences. (2015). Retrieved
March 02, 2016, from
http://www.cdc.gov/obesity/childhood/causes.html
Background
Drugs & Supplements
Financial Impact
• The annual nationwide productive costs of obesity
obesity-related absenteeism range between $3.38
billion
• Childhood obesity comes with an estimated price tag
of $19,000 per child (2)
• Childhood obesity alone is responsible for $14 billion
in direct medical costs (2)
References
ADIME
• Total energy intake ,sugar, fat, nutrition
quality of life, level of knowledge &
physical activity
• BMI, height & weight
• FBG, HbA1C, HDL-C, LDL-C, Serum TG
• Family history of Type 2 DM, High Stress
Levels, OSA , difficulty in concentrating
D
I
M-E
• Excessive fat intake related to frequent consumption
of high-fat foods as evidenced by 24 hour recall
exceeding RDI for TG and cholesterol intakes.
• Excessive carbohydrate intake related to high intakes
of carbohydrates as evidenced by 24 hour recall.
• Physical inactivity related to sedentary lifestyle as
evidenced by self-reported video game use and
physical activity class discontinued at school.
Nutrition Education (Content)
•Describe the relationship of overweight/obesity & dietary fat intake with diabetes and
cardiovascular disease to child as well as parent education
•Reduce energy & fat intake as noted in the prescription, replace soda with water and whole
milk with low fat milk, reduce total fat and saturated fat, teach portion sizes, teach meal
prepping , teach food labels to parents and provide a grocery store tour
Nutrition Education (Application)
•Short term goals: Read and understand 4 food labels each week for 2 weeks with child and
parent. Add 5 servings of fruits and vegetables for meals and snacks per day. Long-term goal:
Read over all food labels and understand and select food options based on knowledge of food
labels. Incorporate a fruit and/or vegetable for each meal and snack. Have parents buy
correct groceries for the child as the gatekeeper.
• Physical Activity to encourage self-esteem and improve mood
• Ensure patient and parents are getting proper nutrition support and education
to prevent DM and weight gain
• Ensure patient continues to attend nutrition follow-up meetings
• Serum TG, HDL-C, LDL-C, FBG, total energy intake, physical activity
• BMI, weight changes, overall Mood
A