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The silence of the doctors

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If our kids' weight is risking their future health, why haven't our doctors told us about it? Because, Dr. Anthony Johnson of Little Rock says, pediatricians have perhaps not "been as proactive as we should have been." There are a couple of reasons for that. Obesity is "a difficult problem to fix," and frustrating, Johnson said. There is also a reluctance to look a little patient or his parent in the eye and "point out the child is fat." But Johnson, who's been in practice 20 years, said he expects his colleagues and primary care physicians to sharpen their focus on weight problems, thanks to aggressive public health campaigns and Act 1220's mandated BMI screens at public schools. Johnson's office has started calculating the BMI for all patients 3 years old and older and putting it on a growth chart. He's also calculating BMI from measurements taken on previous visits to look for trends; a patient whose school BMI screen indicates he's at risk of becoming overweight may have received good news if his medical history indicates he was in the overweight category at a younger age. Pediatricians and primary care physicians are receiving help to address obesity in their young patients from two fronts: They've been mailed a two-page Clinician's Guide to Management of Pediatric Overweight, developed by doctors at Arkansas Children's Hospital and the University of Arkansas for Medical Sciences. They're also being offered continuing education credits online by the non-profit Arkansas Foundation for Medical Care, which is offering a course designed by Dr. Arlo Kahn of UAMS. AFMC has also prepared information for Health Department clinics across Arkansas. "Wonderful things are happening around the state," said Dr. Karen Young, director of Children's Hospital's Fitness Clinic. Young treats the children whose weight problems demand notice — children weighing between 200 and 400 pounds, as well as "quite a few over 400." Unfortunately, she says, "we're swamped" with patients at the clinic, now operating two-and-a-half days a week; the clinic had 700 patients in its database in February and she expects the number is closer to 1,000 now. Young is contributing to the "wonderful things" in health care outside the clinic, with an invention of her own — the Champions Club of Arkansas. The club, now at the Agape Church at 701 Napa Valley Drive, gives her patients and their parents a place to exercise, play, learn how to eat better, and learn how to think better of themselves. Children earn medals by meeting certain challenges — like jumping rope 30 times or learning the food pyramid. Other towns are picking up on the Champions Club idea, and Harrison and Jonesboro are starting up pediatric weight loss clinics of their own. Young doesn't expect her Fitness Clinic patients to reach a normal BMI. She's glad that 40 percent of her patients have maintained or lost weight. "I look at it a little differently," Young said. "The main goal I give is not to gain weight. You can't start losing until you stop gaining." She wants her patients to become happy children "who make healthy choices," and for their families to "create a healthy environment."

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