Dr. Milagros Huerta and Dr. John Barcia are co-directors of U.Va.’s new Children’s Fitness Clinic, which offers assessment and individualized treatment plans for obese children.

Childhood obesity presents serious health risks for U.S. children. In 1999, 13 percent to 14 percent of children ages 6 to 19 were overweight. And about 60 percent of America’s overweight children are at great risk for serious health problems. For instance, an increasing number of overweight children are developing type 2 diabetes, previously known as adult-onset diabetes.

Adult data show that even a relatively small weight loss can have great health
benefits in reducing risk for chronic illnesses. But losing weight and keeping it off is difficult. Many people, especially children, need help. That’s why UVa Health System established its new Children’s Fitness Clinic—a comprehensive, team-based approach to provide assessment and individualized, intensive treatment plans for overweight children. “Being overweight,” says Milagros Huerta, M.D., clinic co-director, “is not a cosmetic problem, it’s a health problem.”

Team-Based Intervention

Overweight children need to make lifestyle changes to ensure they don’t grow up to be overweight adults. The key lies in identifying problems early and then engaging both child and family in changing behaviors, contend Huerta and clinic co-director, John Barcia, M.D.“ Treatment is not complicated. Children need to be motivated to increase their level of physical activity, spend less time watching TV or video games and eat better,” says Huerta. “What makes our clinic unique is that we offer a multidisciplinary team able to work closely with children and their families
to establish behavioral changes. In addition, through referrals to our pediatric
specialty clinics, our clinic provides state-ofthe-art evaluation and treatment for obesityrelated health problems.”

Huerta, a pediatric endocrinologist, and Barcia, a pediatric nephrologist, lead a team that includes a nurse practitioner, an exercise physiologist, a nutritionist, child psychologists and a pediatric surgeon.

Lifestyle Changes

All children entered into the program will be invited to take part in its six-month
Intensive Lifestyle Modification Program. This consists of weekly individual and
group sessions, including both counseling and exercise, held evenings at UVa’s Kluge Children’s Rehabilitation Center’s gym

“We teach parents the principles of behavior modification, including identifying specific goals for change, monitoring progress and setting up a rewards system. We want the child to tell us which goals they want to set,” says Huerta.“ Children need encouragement from their parents. Family involvement is an important component to ensure success.”

Initial Visit and Follow Up

The first visit lasts about 21/2 hours. Children will have an opportunity to meet individually with each team member. If children have obesity-related health
problems, they may be referred to other pediatric specialists. If families are unable to attend the weeklysessions, children will be seen at the clinic for monthly follow-up visits. The team sends progress reports to the family’s primary care physician.