Yes, we need guidelines and parameters for childhood obesity, but  it's far more than a disease with a treatment. Parents, patients, siblings, extended family and friends ALL may have a distorted view of a child's weight ... as can the child. On inquiry, sometimes a chubby girl will be built like a family member ... and if that is the overachieving father's fat sister, the doc has a one kind of problem on her hands. (Dad sees the girl as a disappointment.)If the chubby 9 year old boy is built exactly like his dad and grandfather (both of whom died in their thirties of heart disease), the doctor has a very different problem on her hands. (The boy's cholesterol was 530.)I've even seen a 70-pound three year old in a household where grandma, aunts, uncles and parents not only all weighed over 350 pounds, but lived together. They family literally thought I was WRONG; a 70 pound three year old was NORMAL  to them. Children can be very angry when their diets are artificially changed in a way the child sees as negative (e.g. take away sugars). They HATE having to eat not only differently ... even more so if the family eats normally  As one wise mum once said, "I have a fat kid and a skinny kid. I give one carrot sticks and one ice cream. Then they trade." Treating childhood obesity is a minefield; I welcome the addition of more tools, but the situation must be seen holistically.  And it absolutely cannot be addressed in a ten or fifteen minute appointment.

Yes, we need guidelines and parameters for childhood obesity, but  it's far more than a disease with a treatment. Parents, patients, siblings, extended family and friends ALL may have a distorted view of a child's weight ... as can the child. On inquiry, sometimes a chubby girl will be built like a family member ... and if that is the overachieving father's fat sister, the doc has a one kind of problem on her hands. (Dad sees the girl as a disappointment.)If the chubby 9 year old boy is built exactly like his dad and grandfather (both of whom died in their thirties of heart disease), the doctor has a very different problem on her hands. (The boy's cholesterol was 530.)I've even seen a 70-pound three year old in a household where grandma, aunts, uncles and parents not only all weighed over 350 pounds, but lived together. They family literally thought I was WRONG; a 70 pound three year old was NORMAL  to them. Children can be very angry when their diets are artificially changed in a way the child sees as negative (e.g. take away sugars). They HATE having to eat not only differently ... even more so if the family eats normally  As one wise mum once said, "I have a fat kid and a skinny kid. I give one carrot sticks and one ice cream. Then they trade." Treating childhood obesity is a minefield; I welcome the addition of more tools, but the situation must be seen holistically.  And it absolutely cannot be addressed in a ten or fifteen minute appointment.

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