An interdisciplinary approach is often required and, increasingly, pediatric sleep specialists and otolaryngologists are working closely with pediatric obesity experts to design treatment plans that tackle both OSA and obesity.
Start with Compassion
Obese children and their families are often the targets of criticism, and anti-fat attitudes can even exist within medical practices. Research has shown that it’s not uncommon for health professionals to perceive obese patients as “lazy,” “stupid” or “worthless” (Obes Res. 2003;11(9):1033-1039). Replacing such attitudes with compassionate concern is the first step toward effectively caring for overweight and obese children, said Stephen Pont, MD, MPH, medical director of the Texas Center for the Prevention and Treatment of Childhood Obesity in Austin. “Every touch point that the child and parent have with medical care is the opportunity to plant small seeds of change and encouragement for them,” said Dr. Pont. “If we step back and say, ‘What’s the most effective way to help someone get healthier?’ it’s not to guilt and blame them into it. Instead, you want to empower the parents and patient.”
All otolaryngologists and sleep specialists should obtain a BMI, or body mass index, on their pediatric patients. “It takes very little time but is very important,” said Dr. Pont. A child who falls in the 85th to 95th percentile for their age and gender is considered overweight, while a child who is beyond the 95th percentile is clinically obese. Those terms are not the best to use when talking with children or families, however. “Instead, we might say, ‘Your child has excess weight that could be impacting his health,’” Dr. Pont said. “Those kinds of tweaks in language help establish rapport and really open the door to a productive conversation, rather than putting people on the defensive.”