Clinic Devoted to Child Obesity Offers New Treatment Options 1-28-2005
Greg Plemmons, M.D., director of the new obesity clinic at the Monroe Carell Jr. Children’s Hospital at Vanderbilt, examines 15-year-old Sarah Howard during her first visit to the clinic.
photo by Anne Rayner
A pediatrician at the Monroe Carell Jr. Children's Hospital at Vanderbilt has opened a clinic to help families tackle the problem of childhood obesity. Greg Plemmons, M.D., assistant professor of Pediatrics, opened the Weight Management Clinic in December 2004 and immediately had eight referrals.
A recent report by the American Heart Association states that 10 percent of children ages 2 to 5 are overweight, up from 7 percent in 1994. It’s a problem that is concerning to families and is even driving legislation regarding physical education and nutrition in schools.
Body Mass Index, or BMI, is the common measure doctors use to track obesity. A BMI of 25 to 30 in adults is considered overweight; over 30 is obese.
“But children are not adults,” Plemmons said. “Specific charts have been developed by the CDC to determine appropriate BMIs for each age. Generally, if a child's BMI is above 85 percent of other children their age, they are considered overweight. If they have a greater BMI than 90 percent of children their age, they are considered obese.”
Plemmons says he didn't start this clinic because of any particular interest in obesity, even though he overcame the problem himself as a child. He says it was a simple matter of seeing a need. Plemmons said parents were frustrated and didn't know where to begin to help their children.
Calley Stroud was one of the first parents to come to Plemmons' clinic. Her 9-year-old daughter Catie weighed 163 pounds just before the holidays.
“She was a nine-pound baby,” Stroud said. “I was overweight at pregnancy. She's been overweight her whole life. I came to the clinic because I was looking for emotional and medical support. Catie is seeing a counselor to help her self-esteem. Kids are really hard on her.”
Another patient, Sarah Howard, is experiencing physical symptoms that could be helped by weight loss. She has polycystic ovary syndrome and is already taking a drug, metformin, that has some benefit for the disease as well as obesity, but it is not a “magic pill.” Working with Sarah on diet and long-term lifestyle changes will be harder, Plemmons said, but just as important.
Sarah’s mother, Debra Howard, said she needs practical, simple advice she can use daily to make gradual changes.
When they come to the Weight Management Clinic at Vanderbilt Children’s Hospital, families meet with dietitian Andrea Klint, who recommends diet changes, then Plemmons talks with the family in a style he calls “motivational interviewing.” Older teens will continue to be seen in the Adolescent Medicine Eating Disorders Program.
“I try to help the families come up with their own plan,” Plemmons explains. “If they make the choices, they are more likely to follow through. Most parents and children are already aware of the health risks, and don't want to be lectured. We encourage the family to come up with simple goals.
Plemmons says he realizes he has an uphill battle. About 30 percent of families who come to childhood obesity clinics never return, while the rate of success in the best programs that address childhood obesity is about 30 percent.
Contact: Carole Bartoo, 322-4747