Provost lecture series: Childhood obesity

Kathleen Rourke, associate professor of nursing drove home the realities of childhood obesity recently in her Provost Lecture Series installment, “Treatment of Obesity in Children: Could a successful model lead to other long-term Health Issues?”

According to the Centers for Disease Control and Prevention, childhood obesity has more than doubled in children and quadrupled in adolescents in the past 30 years with more than one third of children and adolescents reported to be overweight or obese in 2012.

“This is the first generation of children who are not expected to outlive their parents,” she told those in attendance.

Rourke has spent 20 years doing research into obesity, a health issue with significant consequences. The topic of obesity occupies a great deal of political debate time among policy makers, retailers, manufacturers and the health care world, she says.

And the effects of obesity are a costly matter.

“Healthcare costs have increased due to obesity,” Rourke said, noting that ORs are now equipped with special tables and equipment because so many of the patients passing through their doors are obese. The CDC says that in 2008, overall medical care costs related to obesity for U.S. adults were estimated to be as high as $147 billion. Individuals who were obese had medical costs that were $1,429 higher than persons of normal body weight.

“There is so much connection between refined foods and poverty ratio to obesity,” she said, citing an example of a Native American reservation that was given lots of refined sugars and foods from the government. This, in turn, led to numerous cases of diabetes among those on the reservation.

“There is a direct correlation between ethnicity and obesity,” she says. “Some cultures look at large children as a sign that the family is well taken care of. You have to break through that, understand that to make a difference.”

It’s not just the culture we’re from or the money we make, Dr. Rourke says, noting that the rise in technology has meant a time when we would walk to the butcher or baker has passed, and we’re out walking much less. That means fewer sidewalks.

“There really aren’t a lot of sidewalks anymore,” Dr. Rourke says. “There’s no place to walk. If you live in Chicago or New York City, you don’t see a lot of obesity, because you walk everywhere.”

She says this is a keen example of why all members of society (even those in charge of things like infrastructure), not just those in the healthcare field, need to understand the importance of nutrition.

While working at the Emergency Room at Albany Medical Center, Dr. Rourke says, she saw countless patients who were obese from drinking too much, eating too much and not exercising enough. She decided she wanted to do something to prevent this revolving door into the ER and says she made her focus children, when they are developing and accruing most of their bone mass.

Obese youth are more likely to have risk factors for cardiovascular disease, such as high cholesterol or high blood pressure, according to the CDC. In a population-based sample of 5- to 17-year-olds, 70% of obese youth had at least one risk factor for cardiovascular disease. Obese youth are also at much greater risk for bone and joint problems, sleep apnea, and social and psychological problems such as poor self-esteem.

And those are only considered the short-term effects. The CDC says children and adolescents who are obese are much likelier to be obese as adults, putting them at even more risk for heart disease, type 2 diabetes, stroke, cancer, and osteoarthritis.

“In the past, we’ve often blamed the victim, saying they’re lazy or don’t have the willpower, but it’s beyond that,” she says.

Her research projects explore both physiological and behavioral variables associated with the disease of obesity, including data that suggests that successful treatment of obesity in children may have negative long-term consequences on bone mass outcomes. That research has included putting patients on a restrictive diet for six months to a year, along with tackling the issue of stress management and weight loss programming.

“What do we do when we’re stressed?” she asks. “We pick up things and we eat.”

In fact, she says that after September 11, 2001, the sales of comfort food saw a dramatic increase.

In her research with kids, she was looking at what happened to bone density when kids, who were accruing fifty percent of their adult bone, they lost weight. Through a stress management program that included things like muscle relaxation, massage….she found these techniques really helped them.

“Their anxiety levels decreased.”

The stress management program also included breathing and progressive relaxation, exercise and positive affirmation, and they also provided educational programs for the parents. Rourke says she had a child psychologist on their team who was able to pick out that some of the kids in the program came from abusive homes and several of the kids in the program had parents with eating disorders.

“If those kids have those issues, I can’t help them change their weight, so those are things that are really important.”

Ultimately, Rourke said, she would like to create a type of summer camp where children can get the knowledge, experience and guidance they need in order to lead healthier lifestyles.

“If you can teach kids good nutrition programming, even if their parents are not a good influence, you can give them something.”

Note: Rourke’s lecture is available online at: https://www.youtube.com/watch?v=n2PrplcFtrM