To the editors:
I was very excited to receive the February edition of the Pediatrie Annals (2007;36;2) about pediatrie obesity. However, I think that your issue totally missed the mark. What pediatricians need is solid advice about addressing pediatrie overweight/obesity and not more articles about what a terrible problem it is. Most physicians don't have the slightest idea how to start to deal with obesity other than to recommend that the patients "need to lose weight."
The article by De Santis-Moniaci and Altshuler came close to this (2007;36(2):102-108) but still fell short of giving more specific approaches that are helpful. I really liked the article by Lustig in the December issue (2006;35(12):898907) about the leptin/insulin relationship. That was most helpful to me. It gave me practical information to pass along to my patients.
I have started actively following my overweight patients and currently have about 30 patients whom I follow intensively. I see them monthly, and together we set the goal for the next month. So far, all but one of my patients has lost weight, lost inches from the waist, or improved their BMI percentages.
It would be great to get the successful weight-loss programs to give detailed information about what works for their patients. I would love to start a group that meets regularly, but I don't know what information or program to use for it. I can do the medical part. It's the other aspects that I desperately need help with.
By the way, endocrinologiste in the Washington, DC, area are not accepting patients for obesity currently unless they have a specific endocrine diagnosis, such as diabetes mellitus or hypothyroid. There are very few programs even dealing with obesity in our area. So unfortunately, referral is out of the question. There just isn't anyone to send them to.
I applaud your efforts to address the issue but want to encourage you to re-think your approach. Scholarly articles on the statistics and future implications of pediatrie obesity are great but not helpful to those of us in the trenches. We all know that this is a growing health crisis. What we need to know is specifically how to address it.