BMI in determining obesity in children
Results and conclusions are not the end of a study many studies have a life outside the academic research. These types of studies usually deal with some great dilemma of the age such as the early work done on Gay Related Immune Deficiency (GRID) that led to the understanding of HIV/AIDS today. This could be true of the studies on end childhood obesity. In a pilot program in Muskegon Michigan the researchers wanted to develop a protocol for using Body Mass Index (BMI) in determining both overweight and obesity in children ages two to 18. This pilot program also set up a four part plan for dealing with the problem with a lifestyle change for both the child (patient) and the parent. This pilot program was designed to empower the patient to take control of his or her life choices. The results of the program were both encouraging and eye opening. The researchers ended the program with the belief that it could be simple-to-implement and cost effective despite the significant barriers including the increase of asthma. The study was as much to indicate that a current health care provider on a one-to-one bases deal with this crisis.
In the initial part of the study the researchers wanted to define the parameters of the data to be used and what defines obesity in children. This included the use of Body Mass Index (BMI) as an indicator. Because this study was done on a local clinic level with medical professional and their patients the patient’s identity and private information could be contained within doctor patient confidentiality and Health Insurance Portability and Accountability Act (HIPAA) regulation while releasing no identifying indicators of either progress or failure.
The main tool used for entry into the pilot program was a screening tool using the BMI of patients ranging in ages of two to 18. The initial visit the researchers used the Patient Empowerment Readiness Model (PERM) to determine if the patient and parent are willing and able to use the program. The idea of empowering a patient to make him or her in-charge of his or her care rather than his or her health care provider is an idea growing in the medical industry. “Health belongs to the individual. And, the individual has the prime responsibility for their own health” (Natural Health Perspective 2011, para. 2). The patient and in this case the patient’s parents have a direct effect on his or her own health. “PERM identifies 4 attitudes related to change: (a) precontemplative, (b) contemplative/preparation, (c) assessment of readiness for change, and (d) action/ maintenance” (Kwapiszewski & Lee Wallace, 2011, p. 633).
Another result of the pilot program was a link between the rise in asthma and obesity in children. The connection has its own vicious circle with asthma causing children to be less active. This inactivity helps attribute to depression and overeating, the overeating, and lack of activity causing obesity. The obesity adversely affects the patents asthma as well as other obesity-related diseases.
Data Analysis Procedures
The screening process along with the secondary screening by age allowed the researchers to develop a profile of what could be considered an average pediatric practice. Out of more than 4,700 patents reviewed for the study ranging from age two to 18 using BMI 792 patients were considered overweight and 924 are identified as obese. This is a dramatic difference between BMI and other diagnostic tools that recognized only 33 patients as overweight and 387 as obese. This process would seem to suggest that by using BMI more people would be considered either overweight or obese.
The pilot program consists of four visits with the first visit covering the process, second visit a parent consultation on diet and nutrition, the third visit lab tests and therapy, and the fourth visit covering exercise. The first visit should express the importance of informing the parents and patients of every aspects of the program to comply with informed consent. Because this is a volunteer process only those who choose to join the pilot program are used. During the 10-month program only 68 patients joined with only 19 completing the second visit, nine completing the third visit, and only six patients completing all four visits. The quantitative data such as the initial and week three BMI, participation rate, and obesity-related diseases can be used to develop a model on how this program can be used in other practices. One level of data inferred by the success rate versus completion rate is that for the patients BMI to show improvement the patient’s parents need to be involved. This is seen that most patients BMI did not decrease until the second visit when the patient’s parents meet with physicians, peers, and the parent is instructed with a better understanding of nutrition.
The pilot program ended with the preliminary results saying that this program could be a cost effective easy to use approach to dealing with obesity in children. The study infers that with the decrease in obesity in children the obesity will decrease in adults. The parents of the child will most likely adopt the lifestyle change and will also see an improvement in his or her weight and health.
The pilot program ran into some obstacles including the lack of most physicians willing to use BMI to gauge a child’s BMI. Also diseases such as asthma that can be a cause on a child’s inactivity and weight gain. Another problem that became apparent was the lack of willingness to participate with the program by the parents with many of the patients dropping out before week two. Even with the amount of patients who did not finish the program shows a high the effectiveness. The program shows promise that if both the patient and parent are willing to put the time in than the obesity can be managed and reduced. An important aspect of the pilot program was the use of PERM to judge if both the patent and the parent are willing to participate to make the necessary changes in lifestyle. The study ended with the recognition that for this program to be successful any change will have to include an understanding that obesity also can company other disease. The study also says that a support system such as health care provider, parent, and peer is also vital. The goal of showing a local solution to a national problem makes this pilot program useful everywhere.
Kwapiszewski, R. M., & Lee Wallace, A. (2011 July). A Pilot Program ot Identify and Reverse Childhood Obesity in a Primary Care Clinic. Clinical Pediatrics, 50(7), 630-5.
Natural Health Perspective. (2011). Patient Empowerment. Retrieved from http://naturalhealthperspective.com/attitude/empowerment.html
DO you think BMI could be useful for children?
- Weight Goals and Life Goals
Is weight loss a matter of diet and exercise or does it require a fundamental lifestyle change on how we view our approach to food and how we live?