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Child Obesity For Physicians and Medical Personnel
The following is an excerpt from "Friendly Mirrors and Contented Closets"
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Medical personnel are in a very powerful position
to help initiate concern about health and weight. The reason is that they are more
likely to detect a weight change. Sometimes, weight increases or decreases so slowly
that it is not noticeable to even the most observant partners or parents. When adults
and children are weighed at the doctor's office, any changes or patterns can be easily
detected. The point? Don't wait for a parent or an adult patient to approach you about
their weight concerns. Regardless of whether their weight is going up or down, it
always easier to lose or re-gain 5 pounds versus 15. Confronting weight changes early
cannot be more heavily stressed. Secondly, when suggesting a person increase or
decrease their weight, try not to startle them... at first, anyway. Let them know that with
this pattern, their health can quickly deteriorate.
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For weight loss, suggest that they get more activity and/or reduce fatty foods in their diet
(i.e., eggs, cheese, peanut butter, butter, and nuts). Notice I said, "reduce," not "eliminate"
fatty foods in their diet. Suggesting an overly restricted diet may contribute to the
development of an eating disorder. For weight gain, suggest small and frequent meals of
high-calorie/low-density foods such as peanut butter, nuts, and eggs, and cheese. Explain
to them that exercise and activity are likely to widen the gap between their energy
requirement and energy intake, which may not help the patient gain weight. Discussing
the function of cortisol can help them grasp the idea that they are losing
Documenting bilirubin, albumin, and other liver function enzymes can help eating
disordered patients and obese fad dieters understand what and why they are not
accomplishing the health goals they want. Abnormal levels of albumin and bilirubin
can be described as a consequence of lean muscle metabolism and a diet lacking in
protein, which can further stress the liver and kidneys. If a patient is suspected to be
vomiting and/or is underweight, electrolyte imbalances can be highlighted, especially
if blood is drawn at regular and brief intervals (i.e., weekly). A comprehensive blood
count can assess the overall health of red blood cells, white blood cells and platelets.
Abnormally large red blood cells and a low platelet count can be concerning. Abnormal
blood levels of reproductive hormones, growth hormone, and white blood cells can
document the negative effects of cortisol on growth, immunity, and fertility. Obtaining
a lipid profile when an eating disorder or anorexia is suspected may further highlight
physiological damage. In general, any level (assessing the health of the liver, kidneys,
heart, and blood) that falls even slightly outside the suggested range may be able
to support the suspected metabolic processes described within this book. When
reviewing blood test profiles with a patient, rather than looking for a pattern of blood
tests that meet a specific diagnostic pattern, comment on levels that are approaching
unhealthy limits. Explain what the abnormal levels mean in terms of overall health
rather than simply indicating that the profile meets (or doesn't meet) the criterion for a
specified illness. Medical personnel can be instrumental in helping a person understand
the consequences of their health habits and bodyweight. Whether the patient leaves a
physician's office with a definitive medical diagnosis or not, evidence of physiological
damage can help break denial about their health status and can thrust a person into
seeking needed professional help.
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