Taming ‘Horrifyingly Scary’ Pediatric Obesity

"Horrifyingly scary" is how pediatrician Mark Roberts, M.D., describes childhood obesity. Roberts, the chief academic officer at Long Beach (Calif.) Memorial Hospital and its affiliate, Miller Children's Hospital, paints a grim picture of the problem. He says that strides in overcoming pediatric cancer, which now has an 80 percent cure rate, will be completely overshadowed by a forthcoming death rate explosion among obese children.

"We're looking at the first generation of children not expected to outlive their parents," he says. "We have never had anything like this in the modern industrial world. The level of obesity within children is increasing dramatically. In some states, 40 percent of young people are obese."

In the hospital, Roberts sees many teenagers with diseases once associated with middle age, such as adult onset diabetes. "Teens weigh 200 to 300 pounds and are 40 to 50 years old by the biologic clock," he says. "They're not going to live into their 50s. They are in deep trouble."

Roberts pins the problem on adults. Children, he says, behave like their parents. "Children by age three have learned eating and activity behaviors," he says.

So in tackling the problem, Roberts decided to tackle the adult population first. And he started with the staff at the two hospitals. Long Beach joined with Incentahealth, a private company that offers cash incentives as part of its weight loss programs. About 900 employees signed up, Roberts says, but the number of actively participating staff has fallen off to just under 200. Nevertheless, Roberts is encouraged by the results to date, with participants dropping an average of eight pounds each through the first half of the year. "It is an uphill battle keeping folks in a program like this, but 185 people appear to have changed their lives. They are losing weight gradually."

To participate, staff first weigh themselves on one of three digital scales at the hospitals. The information is sent to Incentahealth, which maintains all data-and does not share any of it with the hospital (to reduce the fear factor, Roberts says). Then patients go the Web site and fill out a screening questionnaire. Their answers trigger a series of follow-up e-mails that are customized to their situation. "Success is not dependent on the technology, but on personal decisions," Roberts says. "Most people who look at themselves may not realize they are heavy."

Roberts acknowledges that health care jobs are extremely stressful, one factor in driving caregivers to neglect their own health. "This is different than working at a loading dock. Staff often worry more about others then they worry about themselves." He's optimistic that the program can help improve the health of employees, and in turn, set a good example for the community. "Making an impact on employee health may take three to five years. And our health insurance rate has not dropped yet. But gains in absenteeism and productivity will move faster than the cost of insurance."

For more on chronic care I.T., click here to read HDM's August print cover story. HDM is also hosting a Web seminar featuring providers who are on the front lines of disease management. To register for the event, click here.