Stop Typecasting Overweight Kids

An innovative program treats patients and fledgling doctors too.

Posted Jan 25, 2013

Let’s be honest, this is what you picture when you hear about childhood obesity: a chubby, lazy kid gorging on junk food in front of a computer. As opposed to say, the other kind of kids who are not only thin and outdoorsy but popular and multi-talented.

Maybe that’s stretching it a bit—none of us are quite that judgmental—but the way experts see it, all too many overweight children feel typecast which is not only emotionally scarring but a huge barrier to letting them reach their fitness goals. This is one of the key points in a welcome new program launched at Duke and aimed at children and their families.

“If you watch the kids on Biggest Loser, what you see portrayed is always unflattering shots and these kids doing unhealthy things. But in reality many overweight kids do great things. They sing. They dance. They do all sorts of things that are not the typical portrayals of these children,” said Dr. Sarah Armstrong, a pediatrician and director of the Duke Healthy Lifestyle Program.

Her program includes talking to the children—mostly adolescents—and their families about healthy eating and providing them with a fitness routine at a local gym. A program for the entire family to do together.

And while the program is too new to know whether it will work--meaning whether it will truly inspire longterm behavior changes--recent findings suggest they are doing the right thing. When a group of toddlers from poor families in New York City were enrolled in a nutrition program, obesity rates shrank from about 18 percent to 15 percent within the first six years, according to a recent report by the U.S. Centers for Disease Control. The researchers tracked weight changes from 2003 to 2009. At the same time, obesity rates did not budge among toddlers in Los Angeles, though they did start to decline after programs were initiated. In an accompanying editorial, the investigators said the link does not prove cause and effect, but does suggest strongly that these programs work.

As part of the Duke program, some of the families took part in Duke-produced documentaries that allowed the children to shine. They talked about their new fitness program as well as other things that identify them. Amy Huang, an undergraduate videographer, said that she was surprised that the greatest motivating factor for the kids was not that the program was free or that it was conveniently located but that the kids were in the gym with other kids in the same program. They all said, she added, that they hated being the lone fat kid in a gym with skinny girls and buff guys.

And while the point of the video was to empower the children to show their multifaceted personalities, there was another positive side effect: For Amy, it made her see the “humane side of medicine. It takes you out of the bubble you are in at school when you are just thinking about the goal of becoming a doctor and puts you in a situation when you think of the people who are involved in your goal.”

So maybe Duke’s Healthy Lifestyle program along with their innovative documentary course (the brainchild of Liisa Sinikka Ogburn) is not only treating the patients but the future health providers as well. Let’s hope we see programs like this flourish.