Case Study: Mexican Obese Child

Abstract

ObjectivesIntroduction: The risk of overweight and obesity development, is determined by the exposure to many factors. Around 40% of Mexican kids are living with this disease. MethodsCase Description: A 14-year-old patient is referred to a nutritional support appointment. The patient had no interest on her health, but her brother wanted to help her. Assessment: The first 3 months of life exclusive breastfeeding, after that formula and juices. She began gaining weight at age seven. Height (1.62 m), weight (80.4 kg), fat mass (40%), waist (96 cm) and neck circumference (37 cm). Glucose 98 mg/dL, cholesterol 189 mg/dL, triacylglicerides 250 mg/dL, HDL 45 mg/dL and LDL 140 mg/dL. Energy intake 1800 calories with high sugar consumption (1 liter of soda/day). Sedentary behavior with 6 hours/day on a screen. She was on the pre-contemplation stage of the Transtheoretical Model. Diagnosis: Obesity, related to a high consumption of sugar and a sedentary lifestyle, evidenced by food analysis and family report. Intervention: We developed a strategy of food exchange based on colored-coins in order to get the patient involved in the process. The patient’s brother took responsibility to help his sister with food selection. SMART goals were stablished, involving less soda consumption and daily physical activity. Monitoring and Evaluation: During her follow-up (1st month), the patient reduced 1.7 kg, 3 cm waist, glucose, cholesterol, triacylglicerides and LDL levels. ResultsDiscussion: When treating overweight children, the family and environment play a crucial roll. Getting her brother involved in the process was a good strategy, because he spent most part of the day with her; and was aware of her eating patterns. In this specific case, a colored-coin and food lists strategy was implemented, taking into account her initial lack of interest. This strategy helped her cognitive development, thus she moved in to the action stage of the Transtheoretical Model. ConclusionsConclusions: Child obesity treatment requires a multidisciplinary approach, but most of all, family commitment. In this case, the brother roll was an essential part of the treatment success. Our responsibility as health workers is to guide lifestyle changes and help to implement them. With this kid, the colored-coin game was the key to getting her attention in her eating habits. Funding SourcesN/A.