Sudbury targets childhood obesity

BY KATYA HERMAN, PhD

A new program targeting childhood obesity in northeastern Ontario has recently been launched by Sudbury Regional Hospital. 

The Pediatric Healthy Weights Program is timely, considering 26 per cent of Canadian children aged 2 to 17 are overweight or obese, including 8 per cent who are obese.  In Northern Ontario, 23 per cent of children are overweight or obese, including 10 per cent who are obese.

Currently a one-year pilot project, the Healthy Weights Program kicked off in October with enrolment capped at 20 children.  Referrals are accepted from pediatricians only, and a wait list now exists.  Eligible children are aged 3 to 18, and are either clinically obese with a BMI above the 97th percentile, or have a BMI above the 85th percentile and at least one additional comorbidity. 

The children come from as far away as Elliot Lake, Massey, Espanola, Timmins, Sault Ste. Marie and Manitoulin Island. 

“We do have some unique health determinants that make a higher incidence [of obesity] more likely in Sudbury relative to some of the larger urban centres,” said Dr. Sean Murray, pediatrician and medical director of the Family and Child Program.

Murray has observed several negative health outcomes affecting obese children in his practice, including worsening of asthma, restrictive lung disease, mild hyperlipidemias, musculoskeletal problems, and some borderline hypertension.  

The Healthy Weights Program is run by a multidisciplinary team including a pediatrician, nurse practitioner, dietician, exercise specialist and social worker.  Following a comprehensive intake assessment, an individualized plan is developed for each child.  Subsequent monthly appointments involve a clinical check-up and round-table discussion, and individual meetings or further follow-up as needed.

The program’s exercise component takes place twice weekly at a local school, with age-appropriate exercise sessions based on the established stages of Long Term Athletic Development. 

Additional activities include monthly education sessions, a family grocery store tour, a Christmas dance, and an outdoor family hike.

The program has some unique delivery aspects.  “The social worker is responsible for not only looking at the generalized construct of the family, but also for cognitive behavioural therapy interventions that are important in significant morbid obesity,” said Murray.

 “The exercise specialist uses an integrated rather than prescriptive approach, and works with the children after hours at times that are more convenient for them.”

Early results are promising.  According to nurse practitioner Angie Wiwczor, several children have shown steady BMI decreases, an outcome highly correlated with consistent participation in the twice-weekly exercise sessions. 

Wiwczor identified family support as another key factor in success.  “The parents of these particular children have really bought into the program, so they are making lifestyle changes for the whole family, based on the recommendations they’re being given.”

Research has shown that a large majority of obese children develop into obese adults.  “To this point, as a trajectory most of the kids who are obese as youngsters continue to be obese as they get into adolescence, and in fact it often becomes an escalating problem,” said Murray.

Lifestyle choices

The Healthy Weights program aims to derail this trajectory.  “Our plan is to provide them with the tools so that they can always make those healthy lifestyle choices,” said Wiwczor.  “If we can provide them with the education and give them the tools to work with, then we are looking for and hoping that they have success [in the long term].”

Murray said the program had been several years in the making.  A pediatric needs assessment conducted across the northeast six years ago identified an obesity clinic to be of primary interest and importance.  The Healthy Weights Program is the first clinic developed through the Pediatric Centre of Excellence, which has seen Sudbury pediatricians co-located since 2009.

In developing the program, the multidisciplinary team aligned itself with a service delivery framework released in 2007 by the Ministry of Health and Long Term Care and the Provincial Council for Maternal and Child Health.

The pilot project has been using existing resources and personnel under the hospital’s general operating budget.  Pending the pilot’s success, the hope is for dedicated funding from the Ministry, allowing continuation and expansion of the program.

Murray is confident the clinic will be a success.  “I think over time this clinic will be a springboard for a lot more advocacy, and more of a profile in the community in relation to this issue in children.”

“To this point, there’s been no effective strategy that’s worked outside of the home environment, so it really is important to reflect on where this begins and ends.  It’s not the responsibility of educators and the school boards and the public health unit to take control of these children’s eating habits.  It really needs to be focused in the home.  So we’re starting off one child and family at a time, but I think if you build on that, hopefully you’ll get some changes in the community in the future.” 

Katya Herman was born and raised in Sudbury and earned her PhD in Kinesiology at Queen’s University, specializing in Physical Activity & Obesity Epidemiology.