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The Pediatric Program
The MGH Weight Center's pediatric programs are specially designed to meet the special needs of overweight children and adolescents. Every patient is evaluated by a physician, a registered dietitian, and a psychologist, all of whom specialize in working with children.The team then recommends a program designed to meet the unique needs of each child, to help the child develop healthy eating patterns and set realistic long-term goals. The team is particularly sensitive to issues of teasing, self-esteem, or even depression that may affect overweight children and adolescents, and we work to ensure that coming to the Weight Center is a positive experience.
Group programs
Many children and adolescents do well in a group-based program at the MGH Weight Center. Adolescents are matched with small groups of the same sex, through which they gain peer support and are encouraged to take an active role in working to achieve and maintain a healthy body weight. The groups for younger children focus on active games to improve self-esteem, encourage physical activity, and learn about making healthy lifestyle choices. During the first few months, groups meet weekly; later on they may meet less often to support maintenance of healthy weight.
Family-centered care
Family involvement is critical to a child's success in reaching and maintaining a healthy body weight. The Weight Center team works closely with parents and other family members to help them maintain a healthy home environment and find the best ways of being supportive of their children. With younger children, many of the needed lifestyle changes come through the family; with adolescents, the family's role is more often to support and reinforce goals set by the adolescents themselves.
Isn't there anything better than diet and exercise?
Many overweight children and families have already struggled to change their eating and exercise habits, and it is often discouraging to try once again with these same approaches. However, for children and adolescents, these are clearly the best approaches to reaching and maintaining a healthy body weight.When combined with appropriate support for behavior change - developing healthy eating patterns, and having strong family involvement in the process - long-term success with these methods are good, and indeed considerably better than for overweight adults. The Weight Center team provides a supportive framework that helps you and your child maintain long-term focus on appropriate goals, and allows children and their families to work through discouraging times without giving up.
Currently, diet drugs have a very limited role for children and adolescents, as the available medications are not very effective and are not appropriate for long-term use. However, there are times when the use of a prescription drug might be appropriate as a “boost” while an adolescent is working to make critical life style changes in order to lose weight.
The MGH Weight Center is part of a national research effort to develop improved therapies for weight disorders, and over time this work will likely lead to easier and more effective therapies. When that happens, our pediatric program will be in a position to assess the safety and value of new therapies and recommend the most effective ones for our patients. In selected cases, our patients may want to take advantage of opportunities to participate in a research study of some of the more promising new treatments through the Weight Center; participation in such protocols is entirely optional.
There is little evidence to support the use of highly specialized diets for most children. While many types of structured diets produce short-term results, to date none have shown good long-term success rates. For some severely overweight children who are already facing important medical consequences of their obesity, highly structured diets may be appropriate, as short-term weight loss is medically necessary. The Weight Center team adapts its nutritional advice to the medical condition of each individual, and provides specific diets whenever appropriate.Weight loss surgery has been established as an important treatment option for adults with severe obesity. While there is considerable less information about the use of surgery to achieve weight loss in adolescents, it may be appropriate for a few older adolescents with severe obesity who have exhausted other options for weight management. During a consultation at the MGH Weight Center, the team will consider each option, as appropriate to the individual patient.
Pediatric Programs at the MGH Weight Center
- A multidisciplinary team
- Group programs including nutrition, exercise, emotional support and behavior change
- Long term follow up
- Close links to progress in obesity research
- Consideration of drug treatment or weight loss surgery, where appropriate
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