Physicians offer weight-related counsel more often than in past

A survey shows many doctors are still reluctant to discuss the topic.
PITTSBURGH (AP) -- Denise Sherry knew there was a problem when her daughter started asking what was for lunch as she was eating breakfast. As Mackenzie grew, so did her appetite.
So the 7-year-old's mom brought up the subject with her pediatrician during a yearly visit in 2004. At a follow-up visit the next year, Mackenzie was about 14 pounds lighter, thanks to a weight management program she had been referred to at Children's Hospital of Pittsburgh.
According to a new study, physicians are talking with the parents of their young patients more about weight problems than they did a decade ago. It's interaction that many experts say is vital in spreading awareness of the obesity epidemic among children, as well as helping children develop tools to control it.
Difficult conversation
"It's a unique problem in the sense that it's kind of in the closet, even though it's an obvious thing," said Dr. Goutham Rao, the study's lead researcher and clinical director of Children's Weight Management and Wellness Center.
According to the National Institutes of Health, one of every five children is obese. Being overweight puts children at a greater risk of developing diabetes, heart disease, high blood pressure, stroke and other problems.
The study, published in the November-December issue of Ambulatory Pediatrics, looked at nationwide data from two national surveys from 1993 to 2002. It found that physicians offered obesity-related counseling while treating children only 4 percent of the time in 1995, a number that rose to 15 percent in 2002.
Morgan Downey, executive director of the Washington-based American Obesity Association, said doctors tend to avoid talking about their patient's weight because it's a difficult conversation to have.
"Sometimes physicians want to discuss their patients' weight, but they're reluctant because they are worried about how the patient is going to react," Downey said. "It's compounded in children. Sometimes you get a degree of guilt on the part of the parents."
Developing protocol
Dr. Rao said many doctors also don't feel they have the tools or knowledge to help their patients with their weight. Dr. Rao said he's trying to develop a protocol that physicians could follow to identify overweight children, bring the subject up and offer practical advice.
He said it's unrealistic to put children on strict diets; instead, they should be offered ways to change their behavior. That means they could do anything from changing how many times they eat fast food each week to exercising more.
For Mackenzie, that meant getting counseling from nutritionists and exercise psychologists. She started eating healthier foods, something that supplements her already active schedule of dancing and cheerleading.
Her mom has also had to make changes.
"I was making mistakes, making her plates that look like her teenage brothers'. ... And the crying about the food, I was giving in," said Denise Sherry, who lives in suburban Pittsburgh with her husband, daughter and two sons.
Downey said physicians are key to getting kids help early and making changes that will last a lifetime.
"The message that your weight is going to have a serious impact on your health is one that patients usually respond to," Downey said. Physicians are "in a position to kind of mobilize parents and children around addressing an issue which few other institutions we have are able to do."
Copyright 2005 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.