Doctor On Childhood Obesity
MICHELE NORRIS, host:
For more, we turn now to a doctor who has seen firsthand the causes and effects of childhood obesity in her own practice. Dr. Gail Nunlee-Bland is a pediatric endocrinologist and director of the diabetes center at Howard University Hospital. She joins us from her home in Maryland. Welcome to the program, doctor.
Dr. GAIL NUNLEE-BLAND (Diabetes Center Director, Howard University Hospital): Thank you.
NORRIS: Tell me about your practice. How much of an increase in childhood obesity have you seen?
Dr. NUNLEE-BLAND: Well, over the last 25 years, I have seen childhood obesity triple.
NORRIS: And when you say obese, are you talking 5, 10, 15 pounds overweight?
Dr. NUNLEE-BLAND: Many of them can be 50 to 100 pounds. And I've seen children have weights as much as 600 pounds.
NORRIS: Six hundred pounds?
Dr. NUNLEE-BLAND: Yes.
NORRIS: Someone younger than 18 years old?
Dr. NUNLEE-BLAND: Yes.
NORRIS: You know, in reading a story about the work that you do there at Howard University some time ago, there was an anecdote that always stuck with me, that some of the children were so large that you weren't able to weigh them on a traditional scale, that you'd have to bring them down to the basement. Tell me why.
Dr. NUNLEE-BLAND: Yes, and those are children who weigh over 400 pounds, and we had to weigh them on the laundry scale because we didn't know their exact weight.
NORRIS: Now, in that case we're talking about extreme examples. Is that something - a problem that starts in early childhood? Or is it the kind of thing that you see growing out of a poor diet or a lack of exercise later in life?
Dr. NUNLEE-BLAND: Well, there are basically three key periods of childhood obesity. An infant can become obese, but the chances of that child remaining obese if intervention occurs is only about 20, 25 percent. If the child is obese at age 5 or 6, about 50 percent may remain obese. By the time they're an adolescent, the chances of them remaining obese is upward to 90, 95 percent. So, the later the age, the higher the incidence that they will remain obese as an adult.
NORRIS: There are all kinds of studies that show that parents who have problems with weight often wind up raising children who, in turn, have problems with their weight. And there are studies that also suggest that more than 50 percent of poor black women or poor Latino women are now obese. How do you break that cycle then?
Dr. NUNLEE-BLAND: It is a challenge. When I see patients in my office, I encourage the families to make lifestyle changes. I mean, it's just not the child's problem - and really encouraging families to have more physical activity in their lives, to choose healthier food. So we really need to work on this in our society so that we can break this vicious cycle.
NORRIS: As we talk about this, is there a particular patient that is most present in your mind that you think about when you talk about this issue?
Dr. NUNLEE-BLAND: Well, I had one patient who weighed nearly 600 pounds. And when he came into the office, he could not sit on the examining table because he would tip it over. He could not go to school because he would not fit into a school desk. He could not lace up his shoes because they wouldn't fit on his feet. And his goal in life was to be able to lose enough weight so that he could ride a bicycle.
NORRIS: What happened to that young man?
Dr. NUNLEE-BLAND: Well, he was able to lose weight and he was able to ride a bicycle, but it took a lot of intervention. He had to be taken out of his environment. And it actually illustrated that, you know, if you reduce the calories, increase the physical activity, that he could lose weight.
NORRIS: What was your "aha" moment on this issue? At what moment did you realize that the nation was really heading in the wrong direction in terms of childhood obesity? At what point did you look up and realize this was a real problem?
Dr. NUNLEE-BLAND: I realized in the early '90s. And when I started seeing type 2 diabetes in children, that's when it was a wakeup call for me. When I first started training, it was unheard of for a child to have type 2 diabetes. It was always type 1 diabetes. And now these children who had type 2 diabetes in the early '90s are now adults and they have significant complications as a result of it. So, really, this is what we're going to see in another 10 to 15 years and it has to be addressed.
NORRIS: Dr. Nunlee-Bland, thank you very much for your time. All the best to you.
Dr. NUNLEE-BLAND: Thank you.
NORRIS: Dr. Gail Nunlee-Bland is a pediatric endocrinologist, and she's also the director of the diabetes center at Howard University Hospital.
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