What's the ideal way to approach a kid like this?

[medstudentx]

I saw this pretty funny picture (it was on the frontpage of digg.com; http://digg.com/comedy/Must_Eat_Ice_cream_pic). Well, the picture funny and sad at the same time.

Its sad this kid is so freakin' fat at such a young age.

I was just wondering. If this kid came to a pediatrician for the first time for vaccinations or an ear infection (ie, something other than excess weight), what's the ideal way to approach this kid's weight?

I'm assuming the doctor would first have a talk with the parent about it.

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[PalmOlive]

I saw this pretty funny picture (it was on the frontpage of digg.com; http://digg.com/comedy/Must_Eat_Ice_cream_pic). Well, the picture funny and sad at the same time.

Its sad this kid is so freakin' fat at such a young age.

I was just wondering. If this kid came to a pediatrician for the first time for vaccinations or an ear infection (ie, something other than excess weight), what's the ideal way to approach this kid's weight?

I'm assuming the doctor would first have a talk with the parent about it.

I think that the only way to deal with this would be to council the parents about proper nutrition and limiting things like juice, ice cream etc . . . This might be difficult as the parents might likely be obese as well. There is an obesity epidemic and it is not unusual these days to see kids with type 2 diabetes.

 

[kristing]

ahh the best way to do this is to talk to the folks. But the folks probably look like the kid, so it's tricky. I tried to stay away from the discussion during sick visits, because really, there's a time crunch (and that is not ideal, I know). But during a well child visit, it's really easy to show the growth curve and show how the kid is way way above the 97%ile for weight, especially compared to height. (BMI means nothing to these folks. it's nebulous and doesn't help them, but a visual on a weight chart, that's great.)

It's also so important to gauge the parents to see if they consider his weight to be a problem. because if they don't, good luck instituting any sort of behavioral change. So you have to get them to understand why being a kid this big isn't healthy. i usually did it with "I am really worried about your son's weight. I've seen kids with the kind of diabetes that adults get because they are so heavy. I've also hd to put kids on blood pressure medicine because they are so heavy and it can hurt their heart."

This kid isn't fat just because he eats too much. he's fat because he doesn't get out and play. And you have to find out why. It's so easy for those of us who are middle class to rant about how kids have to get out and play outside, but so many of my obese kids lived in horrendous neighborhoods where I wouldn't recommend letting your kid go run around in.

So you have to get the kid active, and that takes some skill, because you gotta figure out where he can play, where he can run around, etc. For my older kids that are big, I recommend sports, and say "wow - he'd be so great at baseball. He could be a real bruiser hitting that ball." or something like that.

And my god, get the kid on skim milk, skip any soda, ask the folks to give you an idea of what he eats.

Man, I really went off.

I think the funniest thing about this picture is not the weight but the mullett and the underwear. My guess is you will have a hard time getting these parents to do anything because their kid is OUTSIDE IN HIS UNDERWEAR. They have no shame.