Don’t start here! Go to the spreads Food is a battlefield on the next pages! By Kristen Zeis
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Food is a battlefield Denmark currently has an estimated 240,000 overweight children. Dr. Jens-Christian Holm and his staff at the Unit for Overweight Children and Adolescents in HolbĂŚk are working hard to lower these numbers
By Kristen Zeis
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Front: Ida Larsen,6, lays under a Dualenergy X-ray absorptiometry (DXA) machine as part of her treatment within the Unit for Overweight Children and Adolescents at HolbĂŚk Hospital in HolbĂŚk, Denmark. The children undergo the scan so that the doctors can see the distribution of bone composition in comparison to body fat.
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t’s a round table with five seats. All but one is taken and a discussion is taking place. The topic at heart isn’t a light one. It’s not a dinner table but a table found in a room in the children’s ward inside of the Unit for Overweight Children and Adolescents at Holbæk Hospital in Holbæk, Denmark. Ida Larsen is 6 years old and she is the topic of conversation today. She sits and colors with a marker and a few pens while everything about her past and present is discussed at the table. What is her family’s health history? Was she born prematurely or via cesarean section? What does she typically eat and drink in a week? What is her activity level? All of these questions, along with the list of others on a six-page questionnaire are answered, no stone left unturned. Among the 240,000 overweight children, Ida is one of 60,000 of those children classified in the obese weight range, meaning that her calculated BMI is more than 30. Ida’s mother seems surprised when she realizes how high her daughter’s weight is and how concerned the doctors are about getting it under control. Ida’s father looks down for a few moments, avoiding eye contact from Cæcilie Truer Sørensen the Ph.D student leading the consultation. Ida sits, still coloring, seemingly unaware of how the meeting applies to her and what it means for her future. Looking for answers
The Larsen family has traveled more than 200 km for their appointment today at the obesity unit with Dr. JensChristian Holm, one of Denmark’s leading childhood obesity specialists and also head of the Unit for Overweight Children and Adolescents in Holbæk. Traveling this far isn’t uncommon for the patients of the clinic, some of whom have to wait six months for an appointment. The clinic on average is treating about 500 patients a year and has helped over 1,500 children to date since they opened their doors four and a half years ago. Ida’s parents have reached out to the “We don’t give the patients what doctors at the one-of- they want, we give them what they a-kind clinic looking need.” for answers to their Jens-Christian Holm, Unit for Overweight daughter’s weight Children and Adolescents problem and ready for a solution to help her live a healthier lifestyle. For Ida, her family has a long history of obesity. Both her mother and her father have undergone weight loss surgery and their own days of struggling with weight are not a distant memory. Born at 4.8 kilos, approximately 10.5 pounds, Ida has been a larger child from the beginning. “To me, when I’m treating her, it is obvious that she has inherited her obesity. Of course there are a lot of things that I can do for her, but she has the genes to combat also. So that will explain to me why she started to be
Dr. Jens-Christian Holm meets with Ida Larsen,6, and her family. Currently the program at Holbæk Hospital which opened four and a half years ago has treated other 1,500 patients with a 70 percent success rate. Food is a battlefield
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Ida’s mother, Lottte Larsen shows listens to the Cæcilie Truer Sørensen , the Ph.D student at Holbæk Hospital who will be following them t also has a two-year-old son at home was given a list of about 10-14 points about their lifestyle and eating habits which they need to change
overweight already from her birth,” said Cæcilie Truer Sørensen. Recognizing that your child’s weight needs attention isn’t easy for some parents, and it is becoming more difficult. “The scary thing is that our overall idea of what is overweight is changing,” said Charlotte Lemming, a nurse within the clinic. As Europe grows in weight, so does the general idea of what a normal weight is. A new outlook After the questionnaire is completed, Ida will begin a series of medical procedures and tests. The information gathered will be used to rule out any medical causes for her obesity and will also be added to a database in which Dr. Jens
-Christian Holm and his staff are currently working alongside other top researchers in Denmark to try to find new information that can help in the obesity struggle. Ida will stay for 24 hours in the hospital. Her measurements are taken, her food intake at meals are controlled, she will have a DXA scan to determine body fat composition, and some blood work will be taken. In between each appointment, Ida continues to color and play like an ordinary 6-year-old. The clinic is unique in that it is designed to follow the children for several years with occasional check-ins. The clinic also does this because they acknowledge that weight loss isn’t an easy task and that sometimes you can fall off track. Each child in the program is given an individual treat-
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Ida gets her blood taken as her mom calms her. By taking blood samples the doctors are able to rule out any conditions that may be causing the weight gain and they also use the blood for current research projects about childhood obesity.
through Ida’s weight loss. The family, who e not just for Ida, but also as a family.
Rikke Haslund Melskens meets with Ida and her mom and explains how to take a proper stool sample, the sample will be examined for a study that the unit is currently working on.
ment plan after all of the questions on the questionnaire are filled out. In all, around 14-19 habits are usually changed. For Ida, some of her changes will include watching her portions, cutting white breads out of her diet, limiting her juice and soda intake, and only having sweets once a week. From now on, she will be having several smaller meals throughout the day, instead of only three larger meals. “With so many issues to address, you need to make it very clear how to stop them. So in that way I think the strictness is actually compassion and empathy because we explain clearly to the patients what they need,” said Dr. Holm. “We don’t give the patients what they want, we give them what they need.” he emphasized. Dr. Jens-Christian Holm estimates that around 80 per
cent of the children in care of the clinic have a sugar addiction. Ida’s parents try to help her eat healthier and allow her to have six to eight pieces of fruit a day. That much fruit, however, is actually too much, according to the doctors. Her body craves the sweetness, like an addiction. For Ida and so many other children that enter the clinic, food is their danger zone. Even the foods like fruit that they think are good for them are only good in moderation. So appointments with Dr. Jens-Christian Holm act as a learning experience for both child and parent. At just 6 years old, the new routine likely won’t come easily for Ida. Her parents will have to help her set the limits if she is to lose the weight and have a healthier future.
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