Childhood Obesity Epidemic: Dr. Decotiis on Solutions & Treatments

Childhood Obesity Epidemic: Dr. Decotiis Discusses Solutions & Treatments
Say there's a need for early and intensive treatment to battle childhood obesity, which has tripled since the 1980s. And here now to tell us more about this is doctor Sue Decotiis. She's a board certified medical weight loss doctor with a practice in Westport. So thank you so much for joining us. We just mentioned child obesity rates have tripled in the last 40 years. What are some of the driving forces behind that and why is obesity so dangerous for a kid.
Well, this is going to be the first generation of children who are not going to outlive their parents. That's pretty shocking, don't you think? I mean, in the past 100 years, children have always outlived the preceding generation. We're certainly concerned about, you know, kids spending more screen time, video games. Also, I think in general our food supply is not good. There are a lot of chemicals in our foods, even if we think they're organic. But we have to realize that all of these different factors cause insulin resistance. And once insulin resistance sets in for a child or an adult, it may be very difficult to lose the weight with lifestyle in.
Your practice, what kind of screening do you do with kids and teens to see if they are a good fit for a weight loss drug.
You have to take a very good history. How long has this person been overweight? What are their eating habits? What exactly are they eating? And then also, I put every patient on a body composition scale. So it's that body fat percentage that really guides me. And the higher it is, probably the more insulin resistant someone is. And then as that person is losing weight, no matter how they're doing it, I still have to follow that body composition to make sure they're not losing muscle and to make sure that they're attaining adequate hydration. When we lose fat, we lose water so the patient can become dehydrated, and then the body shuts the whole fat burning process down, you know? So a lot of the hysteria around people losing muscle is that they're not doing it the right way.
Now, are there any risks a child or their parents should be aware of before a kid starts using a weight loss drug?
Yeah. So you want to make sure that there isn't anything in diet and lifestyle that can be corrected. Number one. Number two, you want to make sure does this child, is this child depressed? Um, is this child perhaps being bullied at school? Are there psychosocial factors involved? Is does this child have a history of anorexia or bulimia? That's very, very important. And if the answer is to that is not always easy. So it could be that a child should need to see a therapist and get a complete workup before starting these medications.
What is the time frame for seeing results in a child on a weight loss drug, and how do you kind of track that progress?
We track it with the body composition scale, and what I like to do with the medications is titrate the dose up slowly, almost like you're climbing stairs, get that body fat way down, and then titrate the patient off the drug. And then as we're bringing it down, we're seeing how the child is doing. There's something called metabolic reset. So after anyone loses weight the metabolism tends to reset itself unfortunately at a lower metabolic rate for a while. So during that period of time there has to be a lot of handholding. We have to follow the body composition, watch nutrition carefully. As I said before, hydration is very important and then make sure that the patient is adapting the proper lifestyle.
How does addressing obesity in childhood make a difference for their life going forward?
Well, I think their self-esteem is greatly improved. So if a child goes through early childhood and teen and a teen as being overweight, that can really affect the self esteem throughout the entire life. And there are many other new drugs in the pipeline that I'm excited about. This way we have another drug, and we have a bigger supply that we can use on the increasing growing number of patients that need these drugs.
All right, doctor Sue Decotiis, thank you so much for your insight tonight. Thank you.
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