September 21 2006

More information about Maine Coast
Pediatrics Adolescent Obesity Clinic

ELLSWORTH — Confronting an epidemic of childhood obesity is becoming a priority for local educators and health care professionals.

Childhood obesity is a growing problem statewide, as shown by these figures from 2002-03.

—GRAPHIC BY CATHERINE McKINNEY

“It’s a big issue in every community,” said Helena Peterson, director of the Ellsworth-based Union River Healthy Communities organization. “Just look around you. Kids used to be outside, playing. Now they’re inside, playing video games.”

“Children born today will die earlier than the generation born before them because of conditions related to weight.”

— Dr. Jonathan Fanburg, Ellsworth pediatrician

Since 1980, the percentage of overweight young people has doubled in the United States. One study found that 58 percent of overweight school-age children had at least one risk factor for heart disease. Type 2 diabetes, a disease linked to obesity and once limited to adults, is increasing among teenagers.

“Children born today will die earlier than the generation born before them because of conditions related to weight,” said Dr. Jonathan Fanburg, an Ellsworth pediatrician who is actively addressing the problem locally.

According to the Maine Department of Human Services’ Bureau of Health, Maine’s prevalence of overweight youth does not differ appreciably from the national average for either boys or girls. Within Maine, boys in middle school and high school are more likely to be overweight than are girls.

“Overweight” is defined as being at or above the 95th percentile for body mass index (BMI), a calculation based on weight, height, age and sex. “At risk for overweight” is defined as being between the 85th and 94th percentiles of BMI for age and gender.

BMI studies of Maine kindergartners in 2002 showed that 15 percent were overweight and 21 percent were at risk for being overweight. Data collected in 2003 showed 13 percent of Maine’s middle and high school students were overweight, with 18 percent of middle school students and 15 percent of high school students at risk for being overweight.

Working under the Healthy Maine Partnerships umbrella, Union River Healthy Communities has been making small grants to local initiatives designed to increase physical activity and improve eating habits among children.

Using tobacco settlement money provided by the state, the agency recently distributed $3,700 in funding for five projects, including a $1,000 grant to the Ellsworth School Department.

That money is being used this fall to provide pedometers to some 230 third- through fifth- graders who attend the Gen. Bryant E. Moore School in Ellsworth.

“We’re providing them with pedometers as a physical activity incentive,” said Dave Norwood, a physical education teacher at the school. “Within PE classes, we have a structured learning environment that involves physical activities, but we hope the pedometers will encourage more physical activity on their own at recess.”

Norwood said all four of the Ellsworth school system’s physical education teachers have been trained to do fitness assessments of students and to enter the results into a database that will help track local fitness trends over time.

One trend that has Norwood concerned involves new federal and state standardized testing requirements.

“This trend toward state and federal requirements to assess language arts, math and science is demanding more time during the school day, which cuts into the time available for health classes and PE,” he said. “We haven’t seen any cuts in Ellsworth, but it’s been a trend nationally.”

Peterson said the Ellsworth School Department has been “very proactive” in addressing the obesity issue. Vending machines selling sugar-laced soft drinks have been phased out, and changes have been made in school cafeterias to address nutritional concerns. New physical fitness incentives range from climbing walls to students being provided with snowshoes to encourage more outdoor winter activity.

Dr. Fanburg, who serves as the medical adviser to the Ellsworth schools, is now in his second year of developing 10-session group therapy interventions for overweight students ranging in age from 9 to 16.

This week he’s in Washington, D.C., sharing the early results of his intensive weight loss program model at the National Initiative for Children’s Health Care Quality’s conference on “Accelerating Improvement in Childhood Obesity.”

“Ten years ago we recognized there was a problem with overweight children, but we didn’t know what to do with them,” he said last week. “We knew it wasn’t good for their long-term health, but nothing was successful.”

Maine Coast Pediatrics in Ellsworth, where Fanburg is one of three pediatricians, is now among 12 pediatric practices throughout Maine developing new approaches to motivating young overweight patients to lose weight by embracing healthier lifestyles.

Working collectively as the Maine Youth Overweight Collaborative, the program is a joint initiative of the Maine Center for Public Health, the Maine-Harvard Prevention Research Center and the Maine Chapter of the American Academy of Pediatrics.

“Different practices are doing different things,” he said. “But one approach we’re all using is promoting healthy eating and physical activity through ‘5-2-0-1’ messages.”

That translates to a structured program that encourages overweight children to eat at least five servings of fruits and vegetables on most days, to limit “screen time” in front of a computer or television to two hours or less daily, to participate in at least one hour or more of physical activity every day, and to avoid soda and sugar-sweetened drinks.

Fanburg’s evolving group therapy model now involves a physician, a nutritionist, a dietitian, a counselor and an athletic trainer. It also requires parental involvement. Costs vary from patient to patient, depending on income and insurance status.

Nine of the 10 students who participated in group sessions that were held between January and June of 2006 lost weight, as did many of the participating parents. The average weight loss was 8 pounds. One student lost 17 pounds. The students’ average starting weight was 170 pounds.

“We felt very positive about the results,” Fanburg said. “We did extensive work with self-esteem and generating a positive self image. Self-esteem jumped for all patients. The program seemed to have had an effect on the total family dietary health awareness within the households involved.

“We recognize that we are very successfully making behavior changes in the households, but that’s only so many hours a day. We need to work toward better classroom education and long-term community changes that encourage healthy lifestyles community-wide.”

Enrollment for the program’s next session is now under way and continues through Sept. 28.

Information: 664-5680.