WIN Wyoming

Thought Bullets
for
October 2000

This summer I attended the Lillian Fountain Smith Conference for Nutrition Educators at Colorado State University. William Troy Donahoo, MD, of the University of Colorado Heath Sciences Center, spoke on the long term metabolic and medical complications of obesity in adolescents. This month’s thought bullets include some of the highlights I captured from Dr. Donahoo’s presentation.

• Accurate obesity standards for children are very difficult to establish due to the growth patterns in this age group. A reference population of children is critical. Most of the charts now in use are over 30 years old. The Centers for Disease Control and Prevention developed BMI charts for screening children and adolescents. The charts can be accessed at: http://www.cdc.gov/growthcharts/.
  
  
• Body Mass Index (BMI) charts capture approximately 65% of body fatness. However, for some groups, this rate falls as low as 50%. One such group is adolescent males.
  
  
• Although BMI charts are easy to use and are currently widely used, they must be interpreted carefully. When Arnold Schwarzenegger first started making action movies, his BMI was 31. Clearly he was not "obese" as defined by standard BMI charts.
  
  
• The percentage of body fat is only one consideration when assessing health status. Placement of body fat is crucial. A good predictor of health complications tied to obesity is when a high BMI is accompanied with a high waist measurement.
  
  
• Approximately 95% of individuals who lose weight gain it back. We can no longer consider the failure to maintain weight loss as a "self-failure" of an individual.
  
  
• During an interview, Monica Lewinsky stated she was often referred to as the "fat chick." She stated society would not have tolerated such reference to her race, ethnicity, or religion, but the reference as the "fat chick" usually went forward without being changed by editors.
  
  
• Treatment of obesity in children and adolescents remains controversial. Many individuals recommend weight maintenance while allowing growth to occur. Others recommend monitored weight loss, including pharmaceutical therapy, especially for severely obese adolescents. There is agreement on increased physical activity being a major tool for preventing and treating adolescent obesity.

Sources:
Anderson J, Kendall P, Pineda C, ed. 2000 Program Synopsis, Lillian Fountain Smith Conference for Nutrition Educators.  Fort Collins, CO: Colorado State University, June 2000.

Personal notes of Betty Holmes, conference attendee.

Compiled by Betty Holmes, MS, RD, 4-H Youth Specialist, Cooperative Extension Service, University of Wyoming; bholmes@uwyo.edu.

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