Dr. Cooper and Dr.
Uddin
Pediatric Clinic of La
porte
Mrs. Holk
Some of the research
comes from outside
sources.
Mentors: Marcina Cooper, M.D.
Rahman Uddin, M.D.
Veronica Zavala, P.A.
 Went
to Stony Brook University in New York
for undergrad and medical school.
 In college she was on the Deans List and
Graduated Magna Cum Laude.
Mentorship
Pediatric Obesity
 Pediatric
Obesity has been viewed as a growing
epidemic of the past few decades.
 34% of Americans are affected.
 Approximately 17%of children and adolescents are
obese.
 It can be viewed as the top public health threat.
 Pediatric Obesity affects all organ systems.

Schneider, Marcie B., MD, and Susan R. Brill, MD. "Obesity in Children and Adolescents- Growth and Development." Pediatrics in Review. N.p., May 2006.
Web. 24 Sept. 2012. <http://pedsinreview.aappublications.org/content/26/5/155>.
Causes of obesity
 Many
factors, including genetics, environment,
metabolism, lifestyle, and eating habits, are
believed to play a role in the development of
obesity.
 More than 90% of cases are idiopathic or
unknown but less than 10% are associated with
hormonal or genetic causes.

Obesity occurs when energy intake exceeds
energy expenditure.
Why is prevention of
obesity important?
 Its
extremely wide ranged in all age groups, sexes,
ethnic, and racial groups.
 They are more likely to have risk factors for
cardiovascular disease, type 2 diabetes, joint problems,
etc..
 One study showed that children who became obese as
early as age 2 were more likely to be obese as adults.
The Pediatricians Role
 The
first step is during well care visits beginning with
an assessment and calculation of body mass index
(BMI).
 Basic well care visits should be followed by treatment
and prevention visits.
 Going beyond the practice is important for prevention
and treatment. Physicians and health professionals
can play a key role in advocating for policy and
built environmental changes.
Diagnosis
BMI is Body Mass Index. It is most
commonly used by pediatricians to look at how
an individuals height, weight, and age compare.
Height and weight should be calculated
accurately measured because it is sensitive to
measurement errors.
Hypertension can be diagnosed by using an
NHLBI table (blood pressure table).
How to calculate BMI:

 Weight in Pound
Height in Inches
Height in Inches
x
703
Food Pyramids
Choose MyPlate, “10 Tips to a Great Plate”. http://www.choosemyplate.gov/downlaods/TenTips/DGTipsheet1ChooseMyPlate.pdf
Obesity video
http://www.youtube.com/watch?v=6wSIvplOStA
Respiratory: Asthma
 Children
with higher levels of body fat and lower levels of
physical activity had greater amounts of airway narrowing
after exercise.
 In obese people, lungs are under expanded and the size of
breaths are smaller.
 Systemic inflammation can also appear to originate in fat
tissue which can affect the smooth muscle in the airways
causing is to narrow excessively/ respiratory tract.

Myron, Kevin. "Is Obesity a Risk Factor for Asthma?" “Medical News Today”.
MediLexicon International, 05 May 2005. Web. 13 Oct 2012.
<http://www.medicalnewstoday.com/releases/24118.php>.
Obstructive sleep apnea
syndrome (OSAS)
OSAS
is recurrent episodes of partial or complete
obstruction of the upper airway during sleep, which disrupt
the normal ventilation and sleep patterns.
Obese
children are more apt to have persistent OSA after
tonsillectomy and adenoidectomy than are nonobese children.
It
is not clear whether the mechanism of OSA is related to
increased visceral fat having an effect on decreasing airway
tone and predisposing the airways to collapse, or whether
increased fat in the neck decreases the caliber of the airway.
Obstructive sleep apnea
syndrome (OSAS)
13-year-old girl referred for evaluation of
sleep apnea and airway obstruction. Lateral
scout image from CT shows narrowing of
nasopharynx and excessive soft tissue.
Strife, Janett L. American Journal of Roetgenology. American Roentgen Ray Society, 6 Dec. 2006. Web. 18 Nov. 2012. <http://www.ajronline.org/content/188/4/1118.full>.
Musculoskeletal
Disorders- Slipped Capital
Femoral Epiphysis (SCFE)
SCFE is a hip disorder in adolescents that causes
symptoms of hip or knee pain. It occurs when the femoral
head slips off the femoral neck along a weakened growth
plate.

The
possibility exists that SCFE occurs in younger
children in the presence of obesity, and that early age of
onset and obesity increase the risk for bilateral disease
Strife, Janett L. American Journal of Roetgenology. American Roentgen Ray Society, 6 Dec. 2006. Web. 18 Nov. 2012. <http://www.ajronline.org/content/188/4/1118.full>.
Musculoskeletal DisordersAdolescent Tibia Vara
(Blount disease)
Blount Disease is due to the effects of weight on the
growth plate.

The inner part of the shin bone, just below the knee, fails
to develop normally.

This
leads to decreased growth and a varus deformity.
Early degenerative arthritis of the knee may result.
Strife, Janett L. American Journal of Roetgenology. American Roentgen Ray Society, 6 Dec. 2006. Web. 18 Nov. 2012. <http://www.ajronline.org/content/188/4/1118.full>.
Musculoskeletal
Disorders- Osteoarthritis
Form
of arthritis that features the breakdown and
eventual loss of the cartilage of one or more joints.
Osteoarthritis
commonly affects the hands, feet, spine,
and large weight-bearing joints, such as the hips and knees.
Weight
loss reduces physical pressure on all weightbearing joints and bones.
Marc C., M.D. "Osteoarthritis (Degenerative Arthritis) Causes." WebMD. WebMD, 15 Oct. 2011. Web. 01 Dec. 2012. <http://www.webmd.com/osteoarthritis/guide/osteoarthritis-causes>.

Osteoarthritis of knee joint in 16-year-old
girl with chronic knee pain.
Anteroposterior radiograph of knee joint
shows obesity, loss of height of medial
component, and small osteophyte (arrow)
Blount disease (tibia vara) in a girl. In 4-year-old
obese girl, coronal T1-weighted MR image shows
irregular, widening depression of medial growth
plate; unossified medial epiphysis (arrow); and
hypertrophy of medial meniscus.
Strife, Janett L. American Journal of Roetgenology. American Roentgen Ray Society, 6 Dec. 2006. Web. 18 Nov. 2012. <http://www.ajronline.org/content/188/4/1118.full>.
Gout
 Gout
is a condition in which the joints become painful,
red and inflamed.
 Gout
is caused when the urate crystals accumulate in the
joints, due to the high amount of uric acid in the blood.
 People
with higher BMI have increased uric acid levels,
which increases the risk of gout.
 Being
overweight and eating foods such as red meat and
sea food, greatly increases the risk of gout.
"Obesity: A Major Risk for Gout." Obesity Site Wide Activity RSS. YGOY Health Care Community, 15 June 2010. Web. 01 Dec.
2012. <http://obesity.ygoy.com/2009/03/16/obesity-a-major-risk-factor-for-gout/>.
Gastrointestinal:
Gallbladder/Gallstones
 People
 Gall
that are obese have more cholesterol in their bile
stones are basically deposits of cholesterol.
 People
with excess fat around their stomach (abdominal
obesity) may have a higher risk of developing gall stones.
 Rapid
weight loss or cycling further increases cholesterol
production in the liver, which results in supersaturation
and an increased risk for gallstones.

Scott, Jennifer A., MD. "Gallstones." ‘EverydayHealth.com’. Everyday Health Media, LLC, 25 Jan. 2010. Web. 13 Oct. 2012.
<http://www.everydayhealth.com/gallbladder/gallstones-the-obesity connection.aspx>.
Cardiovascular:
Hypertension
 Hypertension,
also referred to as high blood pressure, is
a condition in which the arteries have persistently
elevated blood pressure.
 High blood pressure is one of the most common
complications of obesity.
 Normal blood pressure is less than 120/80 but being
obese can cause your blood pressure to raise to 140/90
because overweight individuals may have a higher blood
volume and an increased production of insulin.
 Blood pressure is also increased by raised sodium levels
and thickening of the arteries.

Schneider, Marcie B., MD, and Susan R. Brill, MD. "Obesity in Children and
Adolescents- Growth and Development." Pediatrics in Review. N.p., May 2006.
Web. 24 Sept. 2012. <http://pedsinreview.aappublications.org/content/26/5/155>.
Heart Disease
 Overweight
and obese people have an increased
incidence of heart disease, and fall victim to heart
attack, heart failure, sudden cardiac death, and
abnormal heart rhythm more often than those that
maintain a healthy BMI.
 Obesity
often increases the risk of heart disease
because of its negative effect on blood lipid levels,
which increase in obese patients and then, in turn,
increase triglyceride levels and decrease high-density
lipoprotein (good cholesterol)
Endocrinologic: Type Two Diabetes
 Type
2 diabetes is associated with insulin resistance. Insulin
is an important hormone that delivers glucose (sugar) to our
cells.
 When
a person is overweight, the cells in the body become
less sensitive to the insulin that is released from the pancreas.
 There
is some evidence that fat cells are more resistant to
insulin than muscle cells. If a person has more fat cells than
muscle cells, then the insulin becomes less effective.
Rose, Ellen S., MD. "Nutrition." Obesity Prevention and Treatment 32.9 (2011): 36373. Rpt. in Pediatrics in Review. 2011 ed. Vol. 32. Illinois: American Academy of
Pediatrics, 2011. 363-73. Peds in Review. Web. 25 Sept 2012.
<http://pedsinreview.aappublications.org>.
Psychological
 Poor
self image and social isolation are the root
of many other psychological problems
especially in severely overweight people.
 In younger children it may isolate them from
opportunities to participate in sports and other
physical activities which causes inactivity and
over
eating.
 Low self esteem may cause depression, eating
disorders, and low performance in school/
work.

Schneider, Marcie B., MD, and Susan R. Brill, MD. "Obesity in Children and Adolescents- Growth and Development." Pediatrics in Review. N.p.,
May
2006. Web. 24 Sept. 2012. <http://pedsinreview.aappublications.org/content/26/5/155>.
Conclusion
There are many conditions obesity can cause
which will affect the growth and development of a
child, but if not prevented at an early age, these
conditions can develop into adulthood. If
diagnosed at an early age, a Pediatrician can help
guide and prevent obesity in children.
Works Cited
 Choose MyPlate, “10 Tips to a Great Plate.<http://www.choosemyplate.gov/downlaods/TenT
ips/DGTipsheet1ChooseMyPlate.pdf>
Marc C.,
M.D. "Osteoarthritis (Degenerative Arthritis) Causes." WebMD. WebMD, 15 Oct, 2011. Web. 01 Dec. 2012. <http://www.webmd.com/osteoarthritis/guide/
osteoarthritis-causes>.
Myron,
Kevin. "Is Obesity a Risk Factor for Asthma?" “Medical News Today”.
MediLexicon International, 05 May 2005. Web. 13 Oct 2012.
<http://www.medicalnewstoday.com/releases/24118.php>.

"Obesity: A Major Risk for Gout." Obesity Site Wide Activity RSS. YGOY Health Care Community, 15 June

2010. Web. 01 Dec. 2012. <http://obesity.ygoy.com/2009/03/16/obesity-a-major-risk-factor-for-gout/>.
Rose,
Ellen S., MD. "Nutrition." Obesity Prevention and Treatment 32.9 (2011): 36373. Rpt. in Pediatrics in Review. 2011 ed. Vol. 32. Illinois: American Academy of
Pediatrics, 2011. 363-73. Peds in Review. Web. 25 Sept 2012.
<http://pedsinreview.aappublications.org>.
Schneider, Marcie B.,
MD, and Susan R. Brill, MD. "Obesity in Children and
Adolescents- Growth and Development." Pediatrics in Review. N.p., May 2006. Web.
24 Sept. 2012. <http://pedsinreview.aappublications.org/content/26/5/155>.
Scott,
Jennifer A., MD. "Gallstones." ‘EverydayHealth.com’. Everyday
Health Media, LLC, 25 Jan. 2010. Web. 13 Oct. 2012.
<http://www.everydayhealth.com/gallbladder/gallstones-the-obesityconnection.aspx>.
•Strife, Janett L.
American Journal of Roetgenology. American Roentgen Ray Society, 6 Dec. 2006.
Web. 18 Nov. 2012. <http://www.ajronline.org/content/188/4/1118.full>.
Thank You!
I would like to thank my mentors Dr. Cooper and
Dr. Uddin along with the rest of the staff. You
have given me such a great opportunity and an
idea about my future. I would also like to thank
my teacher, Mrs. Holk, for guiding me through
this class and my parents for driving me
everywhere and supporting me.
I really enjoyed this mentorship and know
everything I have learned will benefit me in
college and my career.