Maimonides’ new Healthy Lifestyle Program for Kids, a collaboration between Maimonides Pediatrics and Maimonides Pediatric Endocrinology, provides a setting where specialists can help guide families in establishing healthy lifestyle habits and addressing the many medical, psychosocial, and cultural factors that influence weight gain. With the recent launch of Maimonides’ Weight Management Center, an integrated, comprehensive program for adults seeking help with weight loss, our efforts to address the prevalence and risks of obesity in Brooklyn are an increasing priority.
The Risks of High BMI in Children
Maintaining a healthy weight is an important aspect of successful primary care. Excessive weight gain can lead to diabetes, heart disease, high blood pressure cancer, and many other health conditions for adults as well as children1. Current research shows that obesity in children is likely to persist into adult life, underscoring the need to address it early in childhood.
The prevalence of pediatric obesity in the United States is 19.7%2, a figure that has tripled over the past 50 years. In New York City, roughly 40% of public school children are overweight or obese3, a figure that is mirrored in Maimonides’ pediatric primary care settings.
Obesity in childhood can sometimes be difficult to identify; some parents may be reluctant to label their children as obese or overweight for a myriad of reasons. This is why primary care provider well visits, where physicians can measure height and weight to determine BMI, are important to the diagnostic process.
“Having a high BMI affects all parts of the body and all aspects of a patient’s life,” says Swati Narain, MD, primary care pediatrician and obesity medicine specialist at Maimonides. “Medically, it can cause prediabetes, obstructive sleep apnea, fatty liver disease, emotionally it can lead to depression, low self-esteem and bullying. It is also very hard to address obesity as it is often associated with food insecurity, especially in populations who live in food deserts with limited access to healthy food options.”
Intensive, Individualized Health Behavior and Lifestyle Treatment
For some patients, guidance on diet, nutritional changes, and physical activity with management by a primary care provider can be enough to get them on track toward a healthier weight. For those who do not respond to those measures, the American Academy of Pediatrics suggests intensive health behavior and lifestyle treatment. This is when comprehensive obesity treatment, like that offered by Maimonides’ Healthy Lifestyle Program, can be most effective.
“Our clinic helps provide multidisciplinary high-intensity lifestyle intervention to patients, with an emphasis on compassionate, culturally sensitive care delivery,” says Dr. Narain. “Patients receive nutritional counseling based on the family’s specific needs. Along with a team of specialists, we offer a longitudinal care to address the other medical, socialand emotional aspects of obesity.”
The program follows a chronic care model for treating obesity by implementing medical interventions in patients’ home lives, in which physicians and care teams address the varied social, emotional, developmental needs of the child and family in addition to medical needs. Providers work with Maimonides care management teams and other community-based organizations for care coordination.
These services include:
- Family-based and individual nutritional counseling
- Mental health screening
- Lab testing for metabolic conditions
- Addressing social determinants of health
- Screening for sleep apnea
- Referrals to other pediatric specialists, like gastroenterologists and endocrinologists
- Close follow-up with providers for continued support
Maimonides providers know that the efficacy of any intervention can vary greatly from patient to patient. For all specialties and primary care, our pediatricians are adept at providing care to a culturally and socioeconomically diverse community. This translates to our weight management services, where it is especially important to be aware of the socioeconomic factors that drive pediatric health4. Cultural, social, and economic sensitivity is of the utmost importance as we work alongside families to find solutions that fit into their lives and work for them.
“One size does not fit all,” says Dr. Narain. “We want to provide culturally sensitive nutritional counseling, encouraging patients to eat a healthy diet with within their cultural context, because the best diet is the one that you can stick to. So, if dietary recommendations incorporate elements of the patient’s cultural diet, and are manageable based on parents’ time and resources, they are more likely to find success with it.”
Early Intervention Means Lifetime Impacts
Weight loss can be transformative to health at any time throughout the lifespan, but it is especially critical in childhood.
“Childhood obesity is a strong predictor of adult obesity, so children who are obese or overweight are likely to continue to be obese and overweight adults,” says Dr. Narain. “However, if intervention is performed early, the likelihood of developing obesity-linked conditions diabetes or high blood pressure as adults is decreased significantly.”
For primary care providers, it’s important to recognize when greater intervention is needed and help connect families to resources that can make a difference. In general, children are healthier and have greater physical resilience than adults, but face potential lifelong impacts from their developmental environment. These factors make childhood a key time to make changes.
“Developing healthy habits early on means saving children from having to face problems in adulthood, when habits are more engrained and they may need greater strength and motivation, having to do it on their own,” says Dr. Narain. “At Maimonides Pediatrics, our goal is to help children grow into healthy adults.”
Maimonides Healthy Lifestyle Program, led by American Board of Obesity Medicine certified physicians, is key to this mission, educating families on their health and nutritional choices and promoting medical and emotional support and self-care. For patients over two years of age with a BMI over 95%; a BMI over 85% and interest in nutritional counseling; or showing signs of prediabetes, Maimonides Healthy Lifestyle Program for Kids provides the supportive setting needed for better long-term health.
Learn more about pediatric obesity and endocrinology care and pediatric primary care at Maimonides. To refer a patient or make an appointment, call 718-283-7500.
- https://pmc.ncbi.nlm.nih.gov/articles/PMC9805112/
- https://www.cdc.gov/obesity/childhood-obesity-facts/childhood-obesity-facts.html
- 3. NYC Department of Education, FITNESSGRAM, 2018-2019
- https://www.pnas.org/doi/10.1073/pnas.1321355110
