Transcript for the Piece Audio version of Child Obesity - Part One -- The Clinical Approach

CHILDHOOD OBESITY1 - THE CLINICAL APPROACH

Childhood obesity has become a public health crisis in America – and one of first lady Michelle Obama’s main causes. More than thirty percent of all children in America -- about 11 million -- are considered clinically overweight or obese. In Holyoke, Massachusetts, which has many Puerto Rican and low-income residents, the problem is even worse than the national average. In the first of a series, Karen brown reports how one community health center is trying to reverse this trend.

AMB: “hello, ...how are you?”

DOCTOR VINNIE BIGGS WALKS INTO AN EXAM ROOM AT THE HOLYOKE HEALTH CENTER, WHERE KIHUANNA ESPADA – A SHY, CHERUBIC NINE-YEAR-OLD -- IS PERCHED ON THE EXAM TABLE; HER MOTHER AND TEENAGE SISTER SIT NEARBY. KIHUANNA’S NOT SICK – BUT SHE’S NOT EXACTLY WELL. AT FOUR-FOOT-ONE, KIHUANNA WEIGHS 139 POUNDS. THE DOCTOR SPEAKS WITH HER MOM, KEE-UMARI RODRIQUEZ,THROUGH A TRANSLATOR.

doc: so what is mom is worried about? --
mom: que le explique...
trans: she wants her to stop eating a lot. "le digo, le digo" -- she explains to her and she tells and tells her and she doesn't get it --

THE FAMILY IS MAKING ITS FIRST VISIT TO THE PEDIATRIC WEIGHT CLINIC -- AFTER BEING REFERRED THERE BY A PRIMARY CARE DOCTOR. AS KIHUANNA SITS QUIETLY, HER MOTHER TELLS BIGGS THAT SHE’S WORRIED NOT JUST ABOUT KIHAUNNA’S LOOKS, BUT ALSO THE FAMILY’S HISTORY OF DIABETES, HEART DISEASE, AND HIGH CHOLESTEROL. "mi mama e diabetica, my hermano..." ALREADY, KIHUANNA’S SHOWING SIGNS OF SLEEP APNEA, A COMMON COMPLICATON OF OBESITY.

does she snore? a veces. 'does she ever stop breathing?' where she has pauses...and do that "snort" sound? (girl laughs.) si. [fade under: a veces. so most of the days? or fewer? ]

THE PEDIATRICIAN PROBES MORE DEEPLY THAN HE WOULD AT A REGULAR CHECKUP -- PATIENTS ALSO HAVE ACCESS TO A CASEWORKER, NUTRITIONIST, AND EXERCISE CLASSES. THEY COME TO THE CLINIC ONCE A MONTH FOR SIX MONTHS – AND SET GOALS AROUND FOOD AND PHYSICAL ACTIVITY.. IT'S AN INTENSIVE MODEL THAT WAS RECENTLY RECOMMENDED BY A FEDERAL TASK FORCE STUDYING CHILDHOOD OBESITY. BIGGS LAUNCHED THE PROGRAM -- WITH GRANT FUNDING -- AFTER HE'D BEEN WORKING IN HOLYOKE FOR A COUPLE YEARS, AND SAW THE WEIGHT AMONG HIS PATIENTS CREEP STEADILY UP.

at least fifty percent of the kids who walk in the door are either overweight or obese.0:02:31.8 and when we , we know that 30 to 40 percent of those kids who are obese in their lifetime will develop type 2 diabetes, the numbers become immense.0:02:49.9

ALREADY THIS MORNING, BIGGS HAS SEEN A TEN YEAR OLD BOY WITH CHRONIC ANKLE PROBLEMS FROM THE 50 OR SO EXCESS POUNDS HE CARRIES. NOW, HE LOOKS AT THE QUESTIONNAIRE KIHUANNA’S FAMILY FILLED OUT.

*so -- it looks like, she's spending about six hours a day on the tv? 0:23:35.0 watching TV? [translate] no computer, no video games. and for physical activity that she's doing now? what does she do? [trans] *nada. 0:23:58.5 ... hay bicyclete... translate: she bought a bicyle for her to see if she could do anything for her, during the summer. 0:24:16.5 'you like bikes?' 'yeah (softly). 'is that something you want to do more of? ... great, great....

THEY COME UP WITH A PLAN – SHE’LL TRY TO GET OUT ON HER BIKE FIVE TIMES A WEEK, FOR HALF AN HOUR, AND BRING TV WATCHING DOWN TO TWO HOURS A DAY. SHE’LL TRY TO EAT MORE GREENS, LESS JUNK FOOD, SMALLER PORTIONS..... GOALS THAT BIGGS ALSO URGES FOR THE REST OF THE FAMILY -- INCLUDING SISTER GWENDOLYN RODRIQUEZ, WHO'S NOT OVERWEIGHT.

-- i need to stop eating less junk food, and more fruits and vegetables. i don't eat no vegetables either, but i'm gonna do it so she could do it.0:34:08.8

doc: it's much easier when everyone's doing it together. ... you're gonna do this!

AFTER THE FAMILY LEAVES, BIGGS ACKNOWLEDGES .... THAT MANY FAMILIES DON’T STICK TO THE PROGRAM. A POPULATION LIKE HOLYOKE’S – AMONG THE STATE’S POOREST – HAS A LOT STACKED AGAINST IT.

our families are bombarded with messages about things to consume and knowing that fast food or dense calorie food is less expensive, sometimes, 0:17:21.0 there can be difficulty with accessing fresh fruits and vegetables.

AND MANY OF HIS PATIENTS LIVE IN NEIGHBORHOODS KNOWN FOR DRUG OR GANG ACTIVITY. THEIR PARENTS MAY NOT LET THEM PLAY OUTSIDE.

a family that has more financial means will put them in some activity -- they'll pay to have them taking karate, or taking ballet lessons or joining the soccer team. and that's not always available to our families.

WHICH IS WHY THE HEALTH CENTER WORKS WITH LOCAL ORGANIZATIONS -- SUCH AS NEUSTRAS RAICES AND THE HOLYOKE FOOD AND FITNESS POLICY COUNCIL -- THAT ARE TRYING TO MAKE COMMUNITY-WIDE CHANGES -- FROM MORE VEGETABLE GARDENS AND BIKE ROUTES TO HEALTHIER SCHOOL LUNCHES. BUT SOME CHILDREN NEED A DIRECT, CLINICAL APPROACH. DIERDRE OCONNOR RUNS THE CAVU FOUNDATION, WHICH FUNDS THIS - AND SEVEN OTHER -- PEDIATRIC WEIGHT CLINICS IN MASSACHUSETTS.

when a child comes to the doctor, and they ARE overweight and obese, what can you do with that child that will reverse the trends that are already in place. and help prevent chronic longterm conditions that can come down the road.

OCONNOR SAYS THE DATA SHOWS THAT -- WITH SMALL, GRADUAL STEPS -- HALF THE CHILDREN IN THESE PROGRAMS HAVE REDUCED THEIR BODY-MASS-INDEX TO SOME DEGREE – A STATISTIC SHE CONSIDERS PROMISING. EVEN IF THEY ONLY LOSE A FEW POUNDS, FOR A CHILD WHO’S STILL GETTING TALLER, THAT COULD BE ENOUGH TO SET HER ON A BETTER PATH. I’M KAREN BROWN.

OUTCUE: JOIN US TOMORROW TO FIND OUT HOW KIHUANNA AND HER FAMILY ARE DOING WITH THEIR WEIGHT-LOSS PROGRAM.